Science.gov

Sample records for active voluntary euthanasia

  1. The dead donor rule, voluntary active euthanasia, and capital punishment.

    PubMed

    Coons, Christian; Levin, Noah

    2011-06-01

    We argue that the dead donor rule, which states that multiple vital organs should only be taken from dead patients, is justified neither in principle nor in practice. We use a thought experiment and a guiding assumption in the literature about the justification of moral principles to undermine the theoretical justification for the rule. We then offer two real world analogues to this thought experiment, voluntary active euthanasia and capital punishment, and argue that the moral permissibility of terminating any patient through the removal of vital organs cannot turn on whether or not the practice violates the dead donor rule. Next, we consider practical justifications for the dead donor rule. Specifically, we consider whether there are compelling reasons to promulgate the rule even though its corresponding moral principle is not theoretically justified. We argue that there are no such reasons. In fact, we argue that promulgating the rule may actually decrease public trust in organ procurement procedures and medical institutions generally - even in states that do not permit capital punishment or voluntary active euthanasia. Finally, we examine our case against the dead donor rule in the light of common arguments for it. We find that these arguments are often misplaced - they do not support the dead donor rule. Instead, they support the quite different rule that patients should not be killed for their vital organs.

  2. Rethinking voluntary euthanasia.

    PubMed

    Stoyles, Byron J; Costreie, Sorin

    2013-12-01

    Our goal in this article is to explicate the way, and the extent to which, euthanasia can be voluntary from both the perspective of the patient and the perspective of the health care providers involved in the patient's care. More significantly, we aim to challenge the way in which those engaged in ongoing philosophical debates regarding the morality of euthanasia draw distinctions between voluntary, involuntary, and nonvoluntary euthanasia on the grounds that drawing the distinctions in the traditional manner (1) fails to reflect what is important from the patient's perspective and (2) fails to reflect the significance of health care providers' interests, including their autonomy and integrity.

  3. U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide.

    PubMed

    Dickinson, George E; Lancaster, Carol J; Clark, David; Ahmedzai, Sam H; Noble, William

    2002-01-01

    A comparison of the views of geriatric medicine physicians and intensive care physicians in the United Kingdom on the topics of active voluntary euthanasia and physician-assisted suicide revealed rather different attitudes. Eighty percent of geriatricians, but only 52% of intensive care physicians, considered active voluntary euthanasia as never justified ethically. Gender and age did not play a major part in attitudinal differences of the respondents. If the variability of attitudes of these two medical specialties are anywhere near illustrative of other physicians in the United Kingdom, it would be difficult to formulate and implement laws and policies concerning euthanasia and assisted suicide. In addition, ample safeguards would be required to receive support from physicians regarding legalization.

  4. 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.

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

    PubMed

    Kerridge, I H; Mitchell, K R

    1996-10-01

    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

  6. 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.

  7. 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

  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.

  9. 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

  10. 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)

  11. [Euthanasia].

    PubMed

    Julesz, Máté

    2013-04-28

    The problem of euthanasia emerges again and again in today's Europe. The Dutch type of regulation of euthanasia could be introduced into the Hungarian legal system. Today, in Hungary, the ethical guidelines of the chamber of medicine, the criminal law and the administrative health law also forbid active euthanasia. In Hungary, the criminal code reform of 2012 missed to liberalise the regulation of euthanasia. Such liberalisation awaits bottom-up support from the part of the society. In Europe, active euthanasia is legal only in the Netherlands, Belgium, Luxemburg and Switzerland. In Hungary, a passive form of euthanasia is legal, i.e. a dying patient may, under strict procedural circumstances, refuse medical treatment. The patient is not allowed to refuse medical treatment, if she is pregnant and foreseeably capable to give birth to her child.

  12. 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.

  13. 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

  14. Active euthanasia--time for a decision.

    PubMed Central

    Jeffrey, D

    1994-01-01

    There has been renewed interest in the moral arguments surrounding euthanasia. Some patients are now apprehensive of advanced medical technology which they fear may result in a prolonged and undignified death. In the current situation of scarce resources for health care, both patients and doctors could be coerced into considering active euthanasia if it was legally available. In this paper it is argued that doctors now need to make a clear statement rejecting active euthanasia but affirming that in certain cases passive euthanasia, or letting die, may be morally justifiable. PMID:8204323

  15. 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

  16. Euthanasia: a summary of the law in England and Wales.

    PubMed

    Simillis, Constantinos

    2008-07-01

    When medical treatment becomes futile, or the patient's suffering is intractable, doctors face the agonising dilemma of whether to proceed with euthanasia. It is important for a doctor to be familiar with the law surrounding euthanasia, in order to avoid prosecution. This paper explores the law in England and Wales regarding the different categories of euthanasia: voluntary euthanasia, nonvoluntary euthanasia, passive euthanasia, and active euthanasia. PMID:18754203

  17. 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.

  18. Support for voluntary and nonvoluntary euthanasia: what roles do conditions of suffering and the identity of the terminally ill play?

    PubMed

    Ho, Robert; Chantagul, Natalie

    2015-01-01

    This study investigated the level of support for voluntary and nonvoluntary euthanasia under three conditions of suffering (pain; debilitated nature of the body; burden on the family) experienced by oneself, a significant other, and a person in general. The sample consisted of 1,897 Thai adults (719 males, 1,178 females) who voluntarily filled in the study's questionnaire. Initial multivariate analysis of variance indicated significant group (oneself, significant other, person in general) differences in level of support for voluntary and nonvoluntary euthanasia and under the three conditions of suffering. Multigroup path analysis conducted on the posited euthanasia model showed that the three conditions of suffering exerted differential direct and indirect influences on the support of voluntary and nonvoluntary euthanasia as a function of the identity of the person for whom euthanasia was being considered. The implications of these findings are discussed.

  19. Euthanasia.

    PubMed

    Sanchez-Sweatman, L

    1994-01-01

    Nurses are often involved in situations associated with euthanasia. Examples may include removal of life-supporting devices, "do-not-resuscitate" orders and the prescribing of large potentially lethal doses of narcotics or sedatives. The result of such situations is that physicians order "euthanasia-like" procedures that nurses comply with. Thus nurses must confront euthanasia issues and related implications for nursing practice from a legal and ethical perspective.

  20. Voluntary euthanasia, physician-assisted suicide, and the goals of medicine.

    PubMed

    Varelius, Jukka

    2006-04-01

    It is plausible that what possible courses of action patients may legitimately expect their physicians to take is ultimately determined by what medicine as a profession is supposed to do and, consequently, that we can determine the moral acceptability of voluntary euthanasia and physician-assisted suicide on the basis of identifying the proper goals of medicine. This article examines the main ways of defining the proper goals of medicine found in the recent bioethics literature and argues that they cannot provide a clear answer to the question of whether or not voluntary euthanasia and physician-assisted suicide are morally acceptable. It is suggested that to find a plausible answer to this question and to complete the task of defining the proper goals of medicine, we must determine what is the best philosophical theory about the nature of prudential value.

  1. 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)

  2. 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.

  3. 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.

  4. 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…

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

    PubMed

    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

  6. Voluntary euthanasia, physician-assisted suicide, and the right to do wrong.

    PubMed

    Varelius, Jukka

    2013-09-01

    It has been argued that voluntary euthanasia (VE) and physician-assisted suicide (PAS) are morally wrong. Yet, a gravely suffering patient might insist that he has a moral right to the procedures even if they were morally wrong. There are also philosophers who maintain that an agent can have a moral right to do something that is morally wrong. In this article, I assess the view that a suffering patient can have a moral right to VE and PAS despite the moral wrongness of the procedures in light of the main argument for a moral right to do wrong found in recent philosophical literature. I maintain that the argument does not provide adequate support for such a right to VE and PAS.

  7. 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.

  8. 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

  9. [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

  10. [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.

  11. [Requests for active euthanasia: which reality in an oncology center.].

    PubMed

    Chvetzoff, G; Perret, M; Thevenet, G; Arbiol, E; Gobet, S; Saltel, P

    2009-09-01

    Euthanasia is a controversial issue in today's society. In countries where euthanasia is legal, it is mainly associated with people with cancer. We retrospectively studied the frequency and basis of patients' requests for active euthanasia in the oncology setting.MethodsRecurrent requests for euthanasia made by the patients of Leon-Berard cancer center (Lyon, France) between 2001 and 2003 were recorded by questioning the physicians and nurse supervisors in charge or by collecting information from the minutes of multidisciplinary palliative care meetings. We also collected information on the general health status of the patients, their motives and their evolution over time, as well as responses from caregivers.ResultsWe identified 16 requests for euthanasia. These involved 8 men, 7 women and 1 child (median age, 56 years), corresponding to 1% of the total deaths recorded during the period. In 2 cases, the request had come from the family only. The most frequent motives were psychological distress (38%), desire for self-autonomy (31%) and pain (31%). Half of the patients, particularly those striving for autonomy, persisted with their request until death, whereas 2 of 3 requests motivated by physical or psychological distress were not maintained. Sedation was administered to 3 patients in response to recurrent requests.ConclusionRequests for euthanasia in cancer patients are rare but may occur. Sometimes suffering is not relieved by palliative care and the request is maintained. Dealing with these patients puts caregivers in a difficult situation.

  12. The terminal quality of life and passive or active euthanasia.

    PubMed

    Daikos, G K

    1990-01-01

    The problems presented by the different categories of dying people are briefly discussed from the point of view of terminal quality of life. Euthanasia is used in its broader meaning, including both passive and active aspects. Passive euthanasia (PE) is exercised by withholding advanced or basic life support measures, the commonest form being do not resuscitate orders (DNR). Some data on its application are presented. Active euthanasia (AE), which has been proposed and being applied to a limited extent lately, is criticized as leading the physician and the Society onto risky ground. A position is being taken against it. Decision making, examples of guidelines, legal, philosophical and spiritual considerations are discussed. Wisdom and loving care should be exercised by the physician to assist people in their terminal phases and to alleviate their suffering. That there is not a single answer to the problem is discussed.

  13. Euthanasia and related practices worldwide.

    PubMed

    Kelleher, M J; Chambers, D; Corcoran, P; Keeley, H S; Williamson, E

    1998-01-01

    The present paper examines the occurrence of matters relating to the ending of life, including active euthanasia, which is, technically speaking, illegal worldwide. Interest in this most controversial area is drawn from many varied sources, from legal and medical practitioners to religious and moral ethicists. In some countries, public interest has been mobilized into organizations that attempt to influence legislation relating to euthanasia. Despite the obvious international importance of euthanasia, very little is known about the extent of its practice, whether passive or active, voluntary or involuntary. This examination is based on questionnaires completed by 49 national representatives of the International Association for Suicide Prevention (IASP), dealing with legal and religious aspects of euthanasia and physician-assisted suicide, as well as suicide. A dichotomy between the law and medical practices relating to the end of life was uncovered by the results of the survey. In 12 of the 49 countries active euthanasia is said to occur while a general acceptance of passive euthanasia was reported to be widespread. Clearly, definition is crucial in making the distinction between active and passive euthanasia; otherwise, the entire concept may become distorted, and legal acceptance may become more widespread with the effect of broadening the category of individuals to whom euthanasia becomes an available option. The "slippery slope" argument is briefly considered. PMID:9884456

  14. 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…

  15. Attitudes toward euthanasia: implications for social work practice.

    PubMed

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

    2009-01-01

    This article reports the findings of a randomized general household survey that examined the attitudes of 618 Chinese respondents toward different types of euthanasia. The general public is found to agree with active euthanasia and non-voluntary euthanasia, but is neutral about passive euthanasia. Support for euthanasia is predicted by decreasing importance of religious belief, higher family income, experiences in taking care of terminally ill family members, being non-Protestants, and increasing age. Patients were perceived as the chief decision makers in euthanasian decisions. Finally, suggestions on social work practice and professional training are made.

  16. 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

  17. 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.…

  18. [Legal issues of physician-assisted euthanasia. Part II--Help in the dying process, direct and indirect active euthanasia].

    PubMed

    Laux, Johannes; Röbel, Andreas; Parzeller, Markus

    2013-01-01

    In Germany, physician-assisted euthanasia involves numerous risks for the attending physician under criminal and professional law. In the absence of clear legal provisions, four different categories of euthanasia have been developed in legal practice and the relevant literature: help in the dying process, direct active euthanasia, indirect active euthanasia and passive euthanasia. The so-called "help during the dying process" by administering medically indicated analgesic drugs without a life-shortening effect is exempt from punishment if it corresponds to the will of the patient. If the physician omits to give such analgesic drugs although the patient demands them, this is deemed a punishable act of bodily injury. The same applies if the physician administers analgesics against the will of the patient. Medically indicated pain treatment which has a potential or certain life-shortening effect (indirect active euthanasia) is permitted under certain conditions: if there are no alternative and equally suitable treatment options without the risk of shortening the patient's life, if the patient has given his consent to the treatment and if the physician does not act with the intention to kill. The deliberate killing of a dying or terminally ill patient for the purpose of ending his suffering (direct active euthanasia) is prohibited. This includes both deliberately killing a patient against or without his will (by so-called "angels of death") and the killing of a patient who expressly and earnestly demands such an act from his physician (killing on request/on demand). Physician-assisted suicide is generally not liable to punishment in Germany. Nevertheless, the action may be subject to punishment if the physician omits to rescue the life of an unconscious suicide victim. "Palliative sedation" is regarded as a special case. It may become necessary if certain symptoms in the terminal stage of a fatal disease unbearable for the patient cannot be controlled by any other

  19. [Euthanasia in history and the present - in the spectrum between euthanasia and terminal care].

    PubMed

    von Engelhardt, Dietrich

    2010-01-01

    Euthanasia signifies in antiquity an easy and happy death and not at all an active termination of life, which was forbidden in the Hippocratic oath, but justified by philosophers. In the Christian middle ages active euthanasia and abortion are explicitly refused. At the beginnings of modern times MORE (1516) and BACON (1623) plead for euthanasia and differentiate for the first time between "euthanasia interior" as a mental preparation and "euthanasia exterior" as a physical and direct termination of life. Around 1900 a change takes place--in medicine as well as in the humanities and arts. The lawyer Karl BINDING and the psychiatrist Alfred HOCHE (1920) support active euthanasia in the case of mental deficiency; similar views are taken by the population. Under the "Third Reich" euthanasia unlawfully is carried out as termination of life without or even against consent. Today oaths, declarations and laws are intended to prevent such a "medicine without humanity" (MITSCHERLICH and MIELKE 1947). Active voluntary euthanasia is under certain conditions allowed by the legislation in some countries (Netherlands, Belgium, Luxembourg). Essential seem the consideration of different types of euthanasia and above all a psychical-mental assistance in the process of dying. The height of culture is measured by dealing with death and dying.

  20. 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

  1. [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.

  2. 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.

  3. 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

  4. 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.

  5. Allied health students' attitudes toward euthanasia.

    PubMed

    Laken, D E; Dowd, S B

    1998-01-01

    Euthanasia, whether active or passive, remains a controversial issue in health care, and allied health professionals are likely to encounter situations of potential active or passive euthanasia during their careers. This survey of allied health students sought to determine their attitudes toward euthanasia and whether their self-reported euthanasia ideology corresponded with their behavioral endorsement of euthanasia actions. Disciplines and educational levels were also compared to determine differences between the program groups and their pro- or anti-euthanasia beliefs. Differing attitudes about euthanasia were found from group to group, and a significant correlation was found between the euthanasia ideology scores and the euthanasia behavioral scores.

  6. 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...

  7. 77 FR 36566 - Agency Information Collection Activities: Voluntary Customer Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-19

    ... 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...: Voluntary Customer Survey. OMB Number: 1651-0135. Abstract: Customs and Border Protection (CBP) plans...

  8. Euthanasia. Definitions and debate.

    PubMed

    Martin, J

    This paper looks at the origins and history of euthanasia and describes active and passive intervention. The author also describes the development of the various organisations advocating euthanasia or supporting those who wish to use it. Public opinion on the subject is explored, as well as the rights of patients and practitioners.

  9. 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.

  10. 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

  11. 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

  12. 75 FR 47607 - Agency Information Collection Activities: Voluntary Customer Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... agencies. This proposed information collection was previously published in the Federal Register (75 FR... SECURITY U.S. Customs and Border Protection Agency Information Collection Activities: Voluntary Customer... accordance with the Paperwork Reduction Act: Voluntary Customer Survey. This is a new collection...

  13. Euthanasia revisited.

    PubMed

    Chao, D V K; Chan, N Y; Chan, W Y

    2002-04-01

    Euthanasia is a debatable issue. It is illegal all over the world. The Netherlands is the only country where euthanasia and physician-assisted suicide are openly practised since the physician performing these acts will not be prosecuted under certain circumstances. There were several court cases and court decisions that affected the development of euthanasia and physician-assisted suicide in individual countries. When a patient asked for euthanasia, it was very important to find out the underlying reasons and make all legal means available to relieve the pain and other distressing symptoms. PMID:11906976

  14. 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.

  15. 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

  16. [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.

  17. [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

  18. [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.

  19. [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

  20. 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 Survey AGENCY: U.S. Customs and Border Protection, Department of Homeland Security. ACTION: 30-Day notice.... Customs and Border Protection (CBP) of the Department of Homeland Security will be submitting...

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

    PubMed Central

    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

  2. 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.

  3. 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

  4. Assisted suicide and euthanasia.

    PubMed

    van der Heide, Agnes

    2013-01-01

    Several countries have adopted laws that regulate physician assistance in dying. Such assistance may consist of providing a patient with a prescription of lethal medication that is self-administered by the patient, which is usually referred to as (physician) assistance in suicide, or of administering lethal medication to a patient, which is referred to as euthanasia. The main aim of regulating physician assistance in dying is to bring these practices into the open and to provide physicians with legal certainty. A key condition in all jurisdictions that have regulated either assistance in suicide or euthanasia is that physicians are only allowed to engage in these acts upon the explicit and voluntary request of the patient. All systems that allow physician assistance in dying have also in some way included the notion that physician assistance in dying is only accepted when it is the only means to address severe suffering from an incurable medical condition. Arguments against the legal regulation of physician assistance in dying include principled arguments, such as the wrongness of hastening death, and arguments that emphasize the negative consequences of allowing physician assistance in dying, such as a devaluation of the lives of older people, or people with chronic disease or disabilities. Opinion polls show that some form of accepting and regulating euthanasia and physician assistance in suicide is increasingly supported by the general population in most western countries. Studies in countries where physician assistance in dying is regulated suggest that practices have remained rather stable in most jurisdictions and that physicians adhere to the legal criteria in the vast majority of cases.

  5. Euthanasia: An Indian perspective.

    PubMed

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

    2012-04-01

    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

  6. 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

  7. Intensive care unit nurses' opinions about euthanasia.

    PubMed

    Kumaş, Gülşah; Oztunç, Gürsel; Nazan Alparslan, Z

    2007-09-01

    This study was conducted to gain opinions about euthanasia from nurses who work in intensive care units. The research was planned as a descriptive study and conducted with 186 nurses who worked in intensive care units in a university hospital, a public hospital, and a private not-for-profit hospital in Adana, Turkey, and who agreed to complete a questionnaire. Euthanasia is not legal in Turkey. One third (33.9%) of the nurses supported the legalization of euthanasia, whereas 39.8% did not. In some specific circumstances, 44.1% of the nurses thought that euthanasia was being practiced in our country. The most significant finding was that these Turkish intensive care unit nurses did not overwhelmingly support the legalization of euthanasia. Those who did support it were inclined to agree with passive rather than active euthanasia (P = 0.011).

  8. Physician-assisted suicide, euthanasia, and Christian bioethics: moral controversy in Germany.

    PubMed

    May, Arnd T

    2003-01-01

    Discussions in Germany regarding appropriate end-of-life decision-making have been heavily influenced by the liberalization of access to physician-assisted suicide and voluntary active euthanasia in the Netherlands and Belgium. These discussions disclose conflicting moral views regarding the propriety of physician-assisted suicide and euthanasia, threatening conflicts within not only the medical profession, but also the mainline churches in Germany, whose membership now entertains views regarding end-of-life decision-making at odds with traditional Christian doctrine. On the surface, there appears to be a broad consensus supporting the hospice movement and condemning physician-assisted suicide and euthanasia. The German Supreme Court has held that treatment decisions should, in absence of known patients' wishes, be made in light of commonly shared values, unless these violate the principle of "in dubio pro vita". The Roman Catholic church and the Evangelical Lutheran church in Germany have developed an advance directive for treatment choices at the end of life, while condemning physician-assisted suicide and euthanasia. This stance is in tension with the strong emerging support for physician-assisted suicide and euthanasia, a development that promises to open up foundational disagreements within mainline German Christianity regarding the appropriate approach to intentionally terminating human life.

  9. Attitudes of Catholic and Protestant clergy on euthanasia and abortion.

    PubMed

    Nagi, M H; Pugh, M D; Lazerine, N G

    1981-01-01

    The attitudes of a random sample of 614 Catholic and Protestant clergymen from the Cleveland area were analyzed in relation to the following: 1) acceptance of euthanasia; 2) the establishment of legal guidelines; and 3) the similarity between euthanasia and abortion. In general the clergy were not opposed to all forms of euthanasia. They tended to make strong distinctions between passive and active euthanasia. Active euthanasia was highly unacceptable to the clergy, but they viewed passive euthanasia more favorably. There was a definite ranking in priority of the different circumstances under which the termination of life-supporting techniques would be acceptable to the clergy. Also significant was the fact that they did not tend to evaluate the issues surrounding euthanasia completely from a spiritual, or sacred perspective. Both Protestants and Catholics tended to approve of passive euthanasia, but they highly disapproved of active euthanasia. Catholics were significantly more opposed to both forms of euthanasia. In general conservative Protestants were more opposed to passive euthanasia on most dimensions than were Catholics. Both Catholic and Protestant clergy showed fear that official approval of types of euthanasia would spread into abuses. Although spiritually oriented clergy tended to show somewhat less unfavorable views on euthanasia when compared with abortion, generally, appreciable differences or role types on this particular sub-dimension was lacking.

  10. 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

  11. Voluntary activation of human knee extensors measured using transcranial magnetic stimulation.

    PubMed

    Goodall, S; Romer, L M; Ross, E Z

    2009-09-01

    The aim of this study was to determine the applicability and reliability of a transcranial magnetic stimulation twitch interpolation technique for measuring voluntary activation of a lower limb muscle group. Cortical voluntary activation of the knee extensors was determined in nine healthy men on two separate visits by measuring superimposed twitch torques evoked by transcranial magnetic stimulation during isometric knee extensions of varying intensity. Superimposed twitch amplitude decreased linearly with increasing voluntary torque between 50 and 100% of mean maximal torque, allowing estimation of resting twitch amplitude and subsequent calculation of voluntary activation. There were no systematic differences for maximal voluntary activation within day (mean +/- s.d. 90.9 +/- 6.2 versus 90.7 +/- 5.9%; P = 0.98) or between days (90.8 +/- 6.0 versus 91.2 +/- 5.7%; P = 0.92). Systematic bias and random error components of the 95% limits of agreement were 0.23 and 9.3% within day versus 0.38 and 7.5% between days. Voluntary activation was also determined immediately after a 2 min maximal voluntary isometric contraction; in four of these subjects, voluntary activation was determined 30 min after the sustained contraction. Immediately after the sustained isometric contraction, maximal voluntary activation was reduced from 91.2 +/- 5.7 to 74.2 +/- 12.0% (P < 0.001), indicating supraspinal fatigue. After 30 min, voluntary activation had recovered to 85.4 +/- 8.8% (P = 0.39 versus baseline). These results demonstrate that transcranial magnetic stimulation enables reliable measurement of maximal voluntary activation and assessment of supraspinal fatigue of the knee extensors.

  12. 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

  13. A model euthanasia workshop: one class's experience at Tufts University.

    PubMed

    Cohen-Salter, Cynthia; Folmer-Brown, Susan; Hogrefe, Kimberly M; Brosnahan, Margaret

    2004-01-01

    Performing euthanasia is likely one of the most challenging tasks a veterinarian faces. Four students at Tufts University School of Veterinary Medicine felt that they and their classmates needed additional training on this subject. They informally surveyed their classmates to determine what topics and formats the students desired. The findings were used to develop the Euthanasia Workshop at the university, a voluntary series of lectures and discussions on technical and emotional issues relating to euthanasia. The four students then informally surveyed 30 North American veterinary colleges to determine the scope of euthanasia training in other veterinary programs. They found that euthanasia, while often covered within other courses, is rarely taught as a stand-alone course. PMID:15962253

  14. Comparison of body-powered voluntary opening and voluntary closing prehensor for activities of daily life.

    PubMed

    Berning, Kelsey; Cohick, Sarah; Johnson, Reva; Miller, Laura Ann; Sensinger, Jonathon W

    2014-01-01

    Persons with an upper-limb amputation who use a body-powered prosthesis typically control the prehensor through contralateral shoulder movement, which is transmitted through a Bowden cable. Increased cable tension either opens or closes the prehensor; when tension is released, some passive element, such as a spring, returns the prehensor to the default state (closed or open). In this study, we used the Southampton Hand Assessment Procedure to examine functional differences between these two types of prehensors in 29 nondisabled subjects (who used a body-powered bypass prosthesis) and 2 persons with unilateral transradial amputations (who used a conventional body-powered device). We also administered a survey to determine whether subjects preferred one prehensor or the other for specific tasks, with a long-term goal of assessing whether a prehensor that could switch between both modes would be advantageous. We found that using the voluntary closing prehensor was 1.3 s faster (p = 0.02) than using the voluntary opening prehensor, across tasks, and that there was consensus among subjects on which types of tasks they preferred to do with each prehensor type. Twenty-five subjects wanted a device that could switch between the two modes in order to perform particular tasks.

  15. 78 FR 57818 - Commission Participation and Commission Employee Involvement in Voluntary Standards Activities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-20

    ... the development of voluntary standards (43 FR 19216 (May 4, 1978)). Acknowledging the contribution... 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...

  16. Startle activation is additive with voluntary cortical activation irrespective of stimulus modality.

    PubMed

    Maslovat, Dana; Drummond, Neil M; Carter, Michael J; Carlsen, Anthony N

    2015-10-01

    When a startling acoustic stimulus (SAS) is presented during a simple reaction time (RT) task, it can trigger the prepared response through an involuntary initiation pathway. Previous research modelling the effects of presenting a SAS at various intervals following a non-startling auditory imperative signal (IS) suggested that involuntary initiation-related neural activation is additive with the voluntary initiation processes. The current study tested the predictions of this additive model when the SAS and IS are of different modalities by using a visual rather than auditory go-signal. Because voluntary RT latencies are delayed for visual stimuli compared to acoustic stimuli, it was hypothesised that the time course of additive activation would be similarly delayed. Participants performed 150 RT trials requiring a targeted 20° wrist extension task with a SAS presented 0-125 ms following a visual go-signal. Results were not different to those predicted by an additive model (p=0.979), yet were significantly different to those predicted by a horse-race model (p=0.037), indicating a joint contribution of voluntary and involuntary activation, even when the IS and SAS are of different modalities. Furthermore, the results indicated that voluntary RT differences due to stimulus modality are attributable to processes that occur prior to the increase in initiation-related activation.

  17. Voluntary muscle activation is impaired by core temperature rather than local muscle temperature.

    PubMed

    Thomas, Melissa M; Cheung, Stephen S; Elder, Geoff C; Sleivert, Gordon G

    2006-04-01

    Fatigue during hyperthermia may be due in part to a failure of the central nervous system to fully activate the working muscles. We investigated the effects of passive hyperthermia on maximal plantar flexor isometric torque (maximal isometric voluntary contraction) and voluntary activation to determine the roles of local skin temperature, core temperature, and peripheral muscle temperature in fatigue. Nine healthy subjects were passively heated from 37.2 to 39.5 degrees C (core temperature) and then cooled back down to 37.9 degrees C using a liquid-conditioning garment, with the right leg kept at a thermoneutral temperature throughout the protocol, whereas the left leg was allowed to heat and cool. Passive heating resulted in significant decreases in torque from [mean (SD)] 172 N x m (SD 39) to 160 N x m (SD 44) and in voluntary activation from 96% (SD 2) to 91% (SD 5) in the heated leg, and maximal isometric voluntary contraction decreased similarly from 178 N xm (SD 37) to 165 N x m (SD 38) and voluntary activation from 97% (SD 2) to 94% (SD 5) in the thermoneutral leg. The initiation of cooling, which produced a rapid decrease in skin temperature and cardiovascular strain [heart rate reserve decreased from 58% (SD 12) to 31% (SD 12)], did not immediately restore either torque or voluntary activation. However, when core temperature was lowered back to normal, torque and voluntary activation were restored to baseline values. It was concluded that an increase in core temperature is a factor responsible for reducing voluntary activation during brief voluntary isometric contractions and that temperature-induced changes in the contractile properties of muscle and local thermal afferent input from the skin do not contribute significantly to the decrement in torque.

  18. [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.

  19. 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

  20. 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.

  1. 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

  2. Physiological alterations of maximal voluntary quadriceps activation by changes of knee joint angle.

    PubMed

    Becker, R; Awiszus, F

    2001-05-01

    The purpose of this study was to investigate the influence of different angles of the knee joint on voluntary activation of the quadriceps muscle, estimating the ability of a subject to activate a muscle maximally by means of voluntary contraction. Isometric torque measurement was performed on 6 healthy subjects in 5 degrees intervals between 30 degrees and 90 degrees of knee joint flexion. Superimposed twitches at maximal voluntary contraction (MVC) and at a level of 60% and 40% of the MVC were applied and the voluntary activation estimated. At between 30 degrees and 75 degrees of knee flexion, the maximal extension torque increased at an average rate of 2.67 +/- 0.6 Nm/degree, followed by a decline with further flexion. However, throughout the joint-angle range tested, voluntary activation increased on average by 0.37%/degree with a maximum at 90 degrees of flexion. Due to the influence of joint position it is not possible to generalize results obtained at the knee joint angle of 90 degrees of flexion, which is usually used for the quadriceps twitch-interpolation technique. Consequently, it is useful to investigate voluntary activation deficits in knee joint disorders at a range of knee joint angles that includes, in particular, the more extended joint angles used frequently during daily activity.

  3. 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

  4. Voluntary activation and cortical activity during a sustained maximal contraction: an fMRI study.

    PubMed

    Post, Marijn; Steens, Anneke; Renken, Remco; Maurits, Natasha M; Zijdewind, Inge

    2009-03-01

    Motor fatigue is an exercise-induced reduction in the force-generating capacity. The underlying mechanisms can be separated into factors residing in the periphery or in the central nervous system. We designed an experiment in which we investigated central processes underlying motor fatigue by means of magnetic resonance imaging in combination with the twitch interpolation technique. Subjects performed a sustained maximal abduction (2 min) with the right index finger. Brain activation was recorded with an MR scanner, together with index finger abduction force, EMG of several hand muscles and interpolated twitches. Mean activity per volume was calculated for the primary motor cortex and the secondary motor areas (supplementary motor, premotor, and cingulate areas) as well as mean force and mean rectified EMG amplitude. Results showed a progressive decline in maximal index finger abduction force and EMG of the target muscles combined with an increase in brain activity in the contralateral primary motor cortex and secondary motor areas. Analysis of the twitches superimposed on the sustained contraction revealed that during the contraction the voluntary drive decreased significantly. In conclusion, our data showed that despite an increase in brain activity the voluntary activation decreased. This suggests that, although the CNS increased its input to the relevant motor areas, this increase was insufficient to overcome fatigue-related changes in the voluntary drive.

  5. 16 CFR 1031.4 - Effect of voluntary standards activities on Commission activities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... standard that adequately addresses the problem and the extent to which that voluntary standard is complied..., epidemiological, health sciences, human factors, other appropriate interests, and the Voluntary...

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

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... standard that adequately addresses the problem and the extent to which that voluntary standard is complied..., epidemiological, health sciences, human factors, other appropriate interests, and the Voluntary...

  7. 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

  8. 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)

  9. Activation deficit correlates with weakness in chronic stroke: evidence from evoked and voluntary EMG recordings

    PubMed Central

    Li, Sheng; Liu, Jie; Bhadane, Minal; Zhou, Ping; Rymer, W. Zev

    2014-01-01

    Objective To use evoked (M-wave) and voluntary (during maximal voluntary contraction (MVC)) EMG recordings to estimate the voluntary activation level in chronic stroke. Methods Nine chronic hemiparetic stroke subjects participated in the experiment. M-wave (EMGM-wave) and MVC (EMGMVC) EMG values of the biceps brachii muscles were recorded. Results Peak torque was significantly smaller on the impaired than non-impaired side. EMGM-wave was also significantly smaller on the impaired than non-impaired side. However, the normalized EMGM-wave/TorqueMVC ratio was not significantly different between two sides. In contrast, both absolute EMGMVC and normalized EMGMVC/TorqueMVC were smaller on the impaired than non-impaired side. The voluntary activation level, EMGMVC/M-wave, was also smaller on the impaired than non-impaired side. The voluntary activation level on the impaired side was highly correlated with weakness (R=0.72), but very low (R=0.32) on the non-impaired side. Conclusion Collectively, our findings suggest that both peripheral and central factors contribute to post-stroke weakness, but activation deficit correlates most closely with weakness as estimated from maximum voluntary torque generation. PMID:24747057

  10. 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.

  11. 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

  12. Battlefield euthanasia - courageous compassion or war crime?

    PubMed

    Neuhaus, Susan J

    2011-03-21

    Issues relating to voluntary euthanasia that are currently being debated by Australian society are distinctly different from those encountered by battlefield doctors. Doctors in war undertake to treat those affected by conflict; their participation in euthanasia challenges the profession's definition of "duty of care". Euthanasia must be distinguished from "triage" and medical withdrawal of care (which are decided within a medical facility where, although resources may be limited, comfort care can be provided in the face of treatment futility). Battlefield euthanasia is a decision made, often immediately after hostile action, in the face of apparently overwhelming injuries; there is often limited availability of pain relief, support systems or palliation that would be available in a civilian environment. The battlefield situation is further complicated by issues of personal danger, the immediacy of decision making and difficulties with distinguishing civilians from combatants. Regardless of the circumstances on a battlefield, doctors, whether they are civilians or members of a defence force, are subject to the laws of armed conflict, the special provisions of the Geneva Conventions and the ethical codes of the medical profession.

  13. Comparison of voluntary and foraging running wheel activity on food demand in mice.

    PubMed

    Atalayer, Deniz; Rowland, Neil E

    2011-01-10

    The effects of running wheel activity on food intake and meal patterns were measured under several cost conditions for food in CD1 mice. In a first experiment, voluntary wheel running activity increased daily food intake relative to a sedentary group, and runners consumed bigger but fewer meals. Although they ate more, runners had significantly lower body fat than sedentary mice. In a second experiment, running was used as an approach cost and food access was contingent on running wheel activity. Mice were able to emit more wheel revolution responses compared to a condition in which nose poking was the approach response. In both voluntary and foraging running protocols mice had inelastic demand functions compared to the non-running groups. When running was voluntary (experiment 1), the day-night cycle for activity was more pronounced compared to when running was a foraging or approach activity (experiment 2).

  14. Comparison of voluntary and foraging running wheel activity on food demand in mice.

    PubMed

    Atalayer, Deniz; Rowland, Neil E

    2011-01-10

    The effects of running wheel activity on food intake and meal patterns were measured under several cost conditions for food in CD1 mice. In a first experiment, voluntary wheel running activity increased daily food intake relative to a sedentary group, and runners consumed bigger but fewer meals. Although they ate more, runners had significantly lower body fat than sedentary mice. In a second experiment, running was used as an approach cost and food access was contingent on running wheel activity. Mice were able to emit more wheel revolution responses compared to a condition in which nose poking was the approach response. In both voluntary and foraging running protocols mice had inelastic demand functions compared to the non-running groups. When running was voluntary (experiment 1), the day-night cycle for activity was more pronounced compared to when running was a foraging or approach activity (experiment 2). PMID:20951151

  15. EMG activity and voluntary activation during knee-extensor concentric torque generation.

    PubMed

    Babault, Nicolas; Pousson, Michel; Michaut, Anne; Ballay, Yves; Hoecke, Jacques Van

    2002-04-01

    This study was designed to re-examine and compare the neural drive of the knee extensors during isokinetic concentric muscular actions by means of the twitch interpolation technique (activation level, AL) and surface electromyographic (EMG) recordings (root mean square, RMS). Torque, AL and RMS amplitudes of three knee extensors and one knee flexor were measured in nine subjects during maximal and sub-maximal voluntary contractions, performed under concentric (60 degrees.s(-1) and 120 degrees.s(-1); Con60 and Con120, respectively) and isometric (Iso) conditions. Mean (SD) maximal voluntary torque was significantly lower ( P<0.01) during concentric contractions [Con60: 208.6 (26.8) Nm and Con120: 184.7 (26.4) Nm] compared with isometric contractions [327.4 (52.0) Nm]. A significantly lower AL ( P<0.05) was recorded during Con60 [80.9 (8.8)%] compared with Iso [87.9 (5.1)%] and Con120 [88.2 (6.6)%] maximal contractions. Simultaneously, a lower knee extensor average RMS amplitudes (av.RMS) was measured during Con60 maximal contractions compared with Iso and Con120 maximal contractions. The antagonist biceps femoris RMS values were not different between maximal Iso, Con60 and Con120 contractions. During sub-maximal voluntary contractions, the RMS/torque relationships were similar whatever the muscle considered (vastus lateralis, vastus medialis or rectus femoris) and the AL/av.RMS relationships did not reveal any noticeable differences between each contractile condition. The results of the present study indicate that av.RMS and AL describe similarly the neural drive during maximal and sub-maximal efforts and indicate that during maximal voluntary efforts, neural drive is dependent upon concentric angular velocity (up to 120 degrees.s(-1)). Thus, our results suggest that when applying different contractile conditions, the torque output is regulated via complex interactions between intrinsic muscular properties and the neural drive.

  16. [Dementia, end of life and euthanasia].

    PubMed

    Bier, J C; Salmon, E; Ivanoiu, A

    2014-09-01

    Among legislative criteria granting the right to practice euthanasia or assisted suicide, there are systematically four major elements. Precisely, any request must be voluntary, persistent, to be well thought and well informed. Such euthanasia raises numerous difficult questions in case of dementia. It also justifies thinking about possibilities that can offer specific arrangements of anticipated demands in such peculiar cases. Empirical experiences show us that it applies with difficulties in practice. Finally, to avoid that a big majority of these demands would find themselves not applied in practice, it would certainly be necessary to add to it structural valuation of advance care planning, and assure its recognition and development. These should not be limited to a single pathological target but would address all of us to increase advance care planning initiation, which remains the most limiting factor of such any early but continuous procedure. PMID:25675648

  17. [Dementia, end of life and euthanasia].

    PubMed

    Bier, J C; Salmon, E; Ivanoiu, A

    2014-09-01

    Among legislative criteria granting the right to practice euthanasia or assisted suicide, there are systematically four major elements. Precisely, any request must be voluntary, persistent, to be well thought and well informed. Such euthanasia raises numerous difficult questions in case of dementia. It also justifies thinking about possibilities that can offer specific arrangements of anticipated demands in such peculiar cases. Empirical experiences show us that it applies with difficulties in practice. Finally, to avoid that a big majority of these demands would find themselves not applied in practice, it would certainly be necessary to add to it structural valuation of advance care planning, and assure its recognition and development. These should not be limited to a single pathological target but would address all of us to increase advance care planning initiation, which remains the most limiting factor of such any early but continuous procedure.

  18. 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

  19. 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

  20. 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

  1. [Dynamics of Brain Activity during Voluntary Movement: fMRI Study].

    PubMed

    Sedov, A S; Devetiarov, D A; Semenova, U N; Zavyalova, V V; Ushakov, V L; Medvednik, R S; Ublinsky, M V; Akhadov, T A; Semenova, N A

    2015-01-01

    The use of event-related fMRI makes it possible to investigate spatio-temporal dynamics of cortical and subcortical human brain structures activity during voluntary movement performance in response to presentation of relevant verbal stimuli. The results of the study showed that voluntary movement was associated with higher contralateral brain activation in a number of areas: primary motor and somatosensory cortex, premotor cortex, supplementary motor area and insula with adjacent regions. Ipsilateral activation of the cerebellum also was observed. It should be emphasized that contralateral strio-pallidal complex and ventral thalamus showed significant response to motor tasks. Similarly, the dynamics of cortex and deep brain structures activation involving in the phasic and tonic components of voluntary movement was uncovered. We showed, in particular, the noticeable difference in brain activation between the right and left hand movement performance. The obtained results enable to enhance understanding of the role of deep brain structures in voluntary movement organization in human and motor control system as a whole. PMID:26601503

  2. Activity patterns of the diaphragm during voluntary movements in awake cats.

    PubMed

    Uga, Minako; Niwa, Masatoshi; Ochiai, Naoyuki; Sasaki, Sei-Ichi

    2010-05-01

    The diaphragm is an important inspiratory muscle, and is also known to participate in the postural function. However, the activity of the diaphragm during voluntary movements has not been fully investigated in awake animals. In order to investigate the diaphragmatic activity during voluntary movements such as extending or rotating their body, we analyzed the electromyogram (EMG) of the diaphragm and trunk muscles in the cat using a technique for simultaneous recordings of EMG signals and video images. Periodic respiratory discharges occurred in the left and right costal diaphragm when the cat kept still. However, once the cat moved, their periodicity and/or synchrony were sometimes buried by non-respiratory activity. Such non-periodic diaphragmatic activities during voluntary movements are considered as the combination of respiratory activity and non-respiratory activity. Most of the diaphragmatic activities started shortly after the initiation of standing-up movements and occurred after the onset of trunk muscle activities. Those activities were more active compared to the normal respiratory activity. During rotation movements, left and right diaphragmatic activities showed asymmetrical discharge patterns and higher discharges than those during the resting situation. This asymmetrical activity may be caused by taking different lengths of each side of the diaphragm and trunk muscles. During reaching movements, the diaphragmatic activity occurred prior to or with the onset of trunk muscle activities. It is likely that diaphragmatic activities during reaching movements and standing-up movements may have been controlled by some different control mechanisms of the central nervous system. This study will suggest that the diaphragmatic activity is regulated not only by the respiratory center but also by inputs from the center for voluntary movements and/or sensory reflex pathways under the awake condition.

  3. 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

  4. 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.

  5. On euthanasia: exploring psychological meaning and attitudes in a sample of Mexican physicians and medical students.

    PubMed

    del Río, Asunción Álvarez; Marván, Ma Luisa

    2011-12-01

    Euthanasia has become the subject of ethical and political debate in many countries including Mexico. Since many physicians are deeply concerned about euthanasia, due to their crucial participation in its decision and implementation, it is important to know the psychological meaning that the term 'euthanasia' has for them, as well as their attitudes toward this practice. This study explores psychological meaning and attitudes toward euthanasia in 546 Mexican subjects, either medical students or physicians, who were divided into three groups: a) beginning students, b) advanced students, and c) physicians. We used the semantic networks technique, which analyzed the words the participants associated with the term 'euthanasia'. Positive psychological meaning, as well as positive attitudes, prevailed among advanced students and physicians when defining euthanasia, whereas both positive and negative psychological meaning together with more ambivalent attitudes toward euthanasia predominated in beginning students. The findings are discussed in the context of a current debate on a bill proposing active euthanasia in Mexico City.

  6. Measurement of voluntary activation based on transcranial magnetic stimulation over the motor cortex.

    PubMed

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

    2016-09-01

    This article reviews the use of transcranial magnetic stimulation (TMS) over the motor cortex to make estimates of the level of voluntary drive to muscles. The method, described in 2003 (Todd et al. J Physiol 551: 661-671, 2003), uses a TMS pulse to produce descending corticospinal volleys that synaptically activate motoneurons, resulting in a muscle twitch. Linear regression of the superimposed twitch amplitude and voluntary force (or torque) can generate an "estimated" resting twitch for muscles involved in a task. This procedure has most commonly been applied to elbow flexors but also to knee extensors and other muscle groups. Data from 44 papers using the method were tabulated. We identify and discuss five major technical challenges, and the frequency with which they are addressed. The technical challenges include inadvertent activation of the cortical representation of antagonist muscles, the role of antagonist torques at the studied joint, uncertainty about the effectiveness of the TMS pulse in activating the motoneuron pool, the linearity of the voluntary force (or torque) and superimposed twitch relationship, and variability in the TMS-evoked EMG and force/torque responses. The ideal situation in which the descending corticospinal volleys recruit all of the agonist motoneurons and none of the antagonist motoneurons is unlikely to ever occur, and hence results must be carefully examined to assess the authenticity of the voluntary activation estimates in the context of the experimental design. A partial compromise lies in the choice of stimulus intensity. We also identify aspects of the procedure that require further investigation.

  7. 16 CFR 1031.7 - Commission support of voluntary standards activities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) Providing epidemiological and health science information and explanations of hazards for consumer products. (2) Encouraging the initiation of the development of voluntary standards for specific consumer... activities. 1031.7 Section 1031.7 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL...

  8. 76 FR 2124 - Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-12

    ... HUMAN SERVICES Food and Drug Administration Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary National Retail Food Regulatory Program Standards AGENCY: Food and... 3520 500 1 500 0.1 50 Conference for Food Protection 500 3 1,500 0.1 150 Training Plan and Log...

  9. [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.

  10. 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

  11. Euthanasia: the role of good care.

    PubMed

    Seale, C; Addington-Hall, J

    1995-03-01

    The results from two surveys in England of relatives and others who knew people in samples drawn from death certificates are reported. The main focus is on a sample of 3696 people dying in 1990 in 20 health authorities, with supporting analysis from an earlier national sample of 639 people dying in 1987. The argument that good care and, in particular, hospice care is effective in reducing the desire for euthanasia has been proposed as an argument against the legalization of voluntary euthanasia. The findings suggest that the picture is in fact more complex. People who received hospice care were, if anything, more likely to have respondents who felt that it would have been better if they had died earlier. The latter held when controlling for other variables found to influence respondents' views, such as the level of distress and dependency experienced by the dying person. It appears possible that the same may apply to the dying peoples' own wishes, although here the time order of events could not be controlled for in the data. It is suggested that this may be due to hospice care being geared to helping patients express their fears and exercise choice. The wish for euthanasia may then be an assertion of personal control, rather than an act of surrender. Alternatively, people (and their relatives) who accept hospice care may be predisposed to consider the benefits of an earlier death.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. [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.

  13. Suffering and euthanasia.

    PubMed

    Cohen, S P; Sawyer, D C

    1991-03-01

    Suffering is a powerful but elusive concept in veterinary medicine. Because the companion animal cannot talk, assessment of suffering requires the best judgment of veterinarian, family, and other interested participants. Determining whether euthanasia is appropriate rests on a similar consensus but is based on the entire medical and social situation. Clinicians need skill, sensitivity, and a well-developed sense of timing to uncover what clients really feel and want. Offering the family options, such as to be present during the euthanasia, makes the veterinarian's task easier and helps clients cope. PMID:1804480

  14. 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.

  15. 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

  16. [Euthanasia: compulsory reflection].

    PubMed

    Kraus, A

    1995-01-01

    Euthanasia should be considered one of the main philosophical topics of today's medical practice. In view of the technological advances in medicine, the economic pressure in the majority of our medical systems, and a deep alteration and modification in the patient-physician relationship, the status of some patients in their final days should be reconsidered. The increased awareness of the public about euthanasia and related topics (pain, assisted suicide, dying with dignity, etc.) suggests that a urgent dialogue between lay persons and physicians is needed.

  17. 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

  18. Intention, procedure, outcome and personhood in palliative sedation and euthanasia.

    PubMed

    Materstvedt, Lars Johan

    2012-03-01

    Palliative sedation at the end of life has become an important last-resort treatment strategy for managing refractory symptoms as well as a topic of controversy within palliative care. Furthermore, palliative sedation is prominent in the public debate about the possible legalisation of voluntary assisted dying (physician-assisted suicide and euthanasia). This article attempts to demonstrate that palliative sedation is fundamentally different from euthanasia when it comes to intention, procedure, outcome and the status of the person. Nonetheless, palliative sedation in its most radical form of terminal deep sedation parallels euthanasia in one respect: both end the experience of suffering. However, only the latter intentionally ends life and also has this as its goal. There is the danger that deep sedation could bring death forward in time due to particular side effects of the treatment. Still that would, if it happens, not be intended, and accordingly is defensible in view of the doctrine of double effect.

  19. 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

  20. 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.

  1. Voluntary activation of the different compartments of the flexor digitorum profundus.

    PubMed

    van Duinen, Hiske; Gandevia, Simon C; Taylor, Janet L

    2010-12-01

    Flexor digitorum profundus (FDP), the sole flexor of the fingertips, is critical for tasks such as grasping. It is a compartmentalized multitendoned muscle with both neural and mechanical links between the fingers. We determined whether voluntary activation (VA), the level of neural drive to muscle, could be measured separately in its four compartments, whether VA differed between the fingers, and whether maximal voluntary contraction (MVC) force and VA changed when the non-test fingers were extended from full flexion to 90° flexion to partially "disengage" the test finger. Transcranial magnetic stimulation (TMS) of the motor cortex was used to measure VA, in a position in which only FDP generated force at the fingertip. Despite differences among the fingers in MVCs, VA for each finger was ∼92% (n = 8), with no differences between fingers. When the test finger was partially disengaged by extending the other fingers to 90° flexion, performance was more variable both within and between subjects. MVCs decreased significantly by about 25-40% for the four fingers. However, VA was not significantly changed (n = 6) and was similar for the four fingers. In both positions, there were strong linear relationships between the voluntary forces and the superimposed twitch sizes, indicating that the method to measure VA was very reliable. Our results indicate that maximal VA is similar for all four compartments of FDP when force production by the other fingers is unconstrained. When altered mechanical connections between the compartments decrease voluntary force output there is little difference in neural drive.

  2. 75 FR 78257 - Agency Information Collection Activities; Proposed Collection; Comment Request; Voluntary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-15

    ... Collection; Comment Request; Voluntary Cosmetic Registration Program AGENCY: Food and Drug Administration... solicits comments on the collection of information associated with the Agency's Voluntary Cosmetic... appropriate, and other forms of information technology. Voluntary Cosmetic Registration Program--21 CFR...

  3. 77 FR 43366 - Agency Information Collection Activities: Proposed Collection; Comments Requested: Voluntary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... Collection; Comments Requested: Voluntary Magazine Questionnaire for Agencies/ Entities Who Store Explosives... collection. (2) Title of the Form/Collection: Voluntary Magazine Questionnaire for Agencies/Entities...

  4. Effect of hypohydration on peripheral and corticospinal excitability and voluntary activation.

    PubMed

    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 drive rather

  5. 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

  6. Measurement of voluntary activation based on transcranial magnetic stimulation over the motor cortex.

    PubMed

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

    2016-09-01

    This article reviews the use of transcranial magnetic stimulation (TMS) over the motor cortex to make estimates of the level of voluntary drive to muscles. The method, described in 2003 (Todd et al. J Physiol 551: 661-671, 2003), uses a TMS pulse to produce descending corticospinal volleys that synaptically activate motoneurons, resulting in a muscle twitch. Linear regression of the superimposed twitch amplitude and voluntary force (or torque) can generate an "estimated" resting twitch for muscles involved in a task. This procedure has most commonly been applied to elbow flexors but also to knee extensors and other muscle groups. Data from 44 papers using the method were tabulated. We identify and discuss five major technical challenges, and the frequency with which they are addressed. The technical challenges include inadvertent activation of the cortical representation of antagonist muscles, the role of antagonist torques at the studied joint, uncertainty about the effectiveness of the TMS pulse in activating the motoneuron pool, the linearity of the voluntary force (or torque) and superimposed twitch relationship, and variability in the TMS-evoked EMG and force/torque responses. The ideal situation in which the descending corticospinal volleys recruit all of the agonist motoneurons and none of the antagonist motoneurons is unlikely to ever occur, and hence results must be carefully examined to assess the authenticity of the voluntary activation estimates in the context of the experimental design. A partial compromise lies in the choice of stimulus intensity. We also identify aspects of the procedure that require further investigation. PMID:27418687

  7. Changes in voluntary activation assessed by transcranial magnetic stimulation during prolonged cycling exercise.

    PubMed

    Jubeau, Marc; Rupp, Thomas; 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

  8. Pathological tremor and voluntary motion modeling and online estimation for active compensation.

    PubMed

    Bo, Antônio Padilha Lanari; Poignet, Philippe; Geny, Christian

    2011-04-01

    This paper presents an algorithm to perform online tremor characterization from motion sensors measurements, while filtering the voluntary motion performed by the patient. In order to estimate simultaneously both nonstationary signals in a stochastic filtering framework, pathological tremor was represented by a time-varying harmonic model and voluntary motion was modeled as an auto-regressive moving-average (ARMA) model. Since it is a nonlinear problem, an extended Kalman filter (EKF) was used. The developed solution was evaluated with simulated signals and experimental data from patients with different pathologies. Also, the results were comprehensively compared with alternative techniques proposed in the literature, evidencing the better performance of the proposed method. The algorithm presented in this paper may be an important tool in the design of active tremor compensation systems.

  9. Persistence of diet-induced obesity despite access to voluntary activity in mice lacking sarcolipin

    PubMed Central

    Gamu, Daniel; Trinh, Anton; Bombardier, Eric; Tupling, A Russell

    2015-01-01

    Several rodent models of obesity have been shown to develop excessive adiposity only when voluntary cage ambulation is restricted. We have previously shown that mice lacking the sarco(endo)plasmic reticulum Ca2+-ATPase pump regulatory protein sarcolipin (Sln–/–), an uncoupler of Ca2+ uptake, develop excessive diet-induced obesity under standard housing conditions. However, it is unclear whether this phenotype is due, in part, to the sedentary housing environment in which these animals are kept. To address this, we allowed wild-type and Sln–/– animals ad libitum access to voluntary wheel running while consuming a standard chow or high-fat diet for 8 weeks. During this period, wheel revolutions were monitored along with weekly mass gain. Postdiet glucose tolerance and visceral adiposity were also taken. The volume of wheel running completed was similar between genotype, regardless of diet. Although voluntary activity reduced mass gain relative to sedentary controls within each diet (P < 0.05), visceral adiposity was surprisingly unaltered with activity. However, Sln–/– mice developed excessive obesity (P < 0.05) and glucose intolerance (P < 0.05) with high-fat feeding relative to wild-type controls. These findings indicate that the excessive diet-induced obese phenotype previously observed in Sln–/– mice is not the result of severely restricted daily ambulation, but in fact the inability to recruit uncoupling of the Ca2+-ATPase pump. PMID:26400985

  10. [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

  11. [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.

  12. 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

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. Cortical voluntary activation of the human knee extensors can be reliably estimated using transcranial magnetic stimulation.

    PubMed

    Sidhu, Simranjit K; Bentley, David J; Carroll, Timothy J

    2009-02-01

    The objective of this study was to determine if a transcranial magnetic stimulation (TMS) method of quantifying the degree to which the motor cortex drives the muscles during voluntary efforts can be reliably applied to the human knee extensors. Although the technique for estimating "cortical" voluntary activation (VA) is valid and reliable for elbow flexors and wrist extensors, evidence that it can be applied to muscles of the lower limb is necessary if twitch interpolation with TMS is to be widely used in research or clinical practice. Eight subjects completed two identical test sessions involving brief isometric knee extensions at forces ranging from rest to maximal voluntary contraction (MVC). Electromyographic (EMG) responses to TMS of the motor cortex and electrical stimulation of the femoral nerve were recorded from the rectus femoris (RF) and biceps femoris (BF) muscles, and knee extension twitch forces evoked by stimulation were measured. The amplitude of TMS-evoked twitch forces decreased linearly between 25% and 100% MVC (r(2) > 0.9), and produced reliable estimations of resting twitch and VA (ICC(2,1) > 0.85). The reliability and size of cortical measures of VA were comparable to those derived from motor nerve stimulation when the resting twitches were estimated on the basis of as few as three TMS trials. Thus, TMS measures of VA may provide a reliable and valid tool in studies investigating central fatigue due to exercise and neurological deficits in neural drive in the lower limbs. PMID:19034956

  18. Euthanasia--definition, dangers and alternatives.

    PubMed

    Saunders, C

    1994-03-01

    There is as yet (1992) no law specifically allowing euthanasia, the active intervention to end a patient's life. The discussion has so far been restricted to such action as taking place at a patient's request, but evidence from the Netherlands appears to show that the move to involuntary euthanasia is a real danger. Palliative medicine offers appropriate treatment for relief and support where limits are set on interventions that would no longer be in a patient's best interests. It is possible to relieve distress by using the increasing knowledge in this field. It is important to distinguish this from euthanasia and the term "passive euthanasia" is confusing and unfortunate. Those with extensive experience in the treatment of advanced cancer have much to share with practitioners in other specialties, not least in the possible achievements of both patient and family at the end of life. Society has the responsibility for including them in its concern to the end of life and for supporting those who find it difficult to believe in any meaning in their existence.

  19. Tracking the will to attend: Cortical activity indexes self-generated, voluntary shifts of attention.

    PubMed

    Gmeindl, Leon; Chiu, Yu-Chin; Esterman, Michael S; Greenberg, Adam S; Courtney, Susan M; Yantis, Steven

    2016-10-01

    The neural substrates of volition have long tantalized philosophers and scientists. Over the past few decades, researchers have employed increasingly sophisticated technology to investigate this issue, but many studies have been limited considerably by their reliance on intrusive experimental procedures (e.g., abrupt instructional cues), measures of brain activity contaminated by overt behavior, or introspective self-report techniques of questionable validity. Here, we used multivoxel pattern time-course analysis of functional magnetic resonance imaging data to index voluntary, covert perceptual acts-shifts of visuospatial attention-in the absence of instructional cues, overt behavioral indices, and self-report. We found that these self-generated, voluntary attention shifts were time-locked to activity in the medial superior parietal lobule, supporting the hypothesis that this brain region is engaged in voluntary attentional reconfiguration. Self-generated attention shifts were also time-locked to activity in the basal ganglia, a novel finding that motivates further research into the role of the basal ganglia in acts of volition. Remarkably, prior to self-generated shifts of attention, we observed early and selective increases in the activation of medial frontal (dorsal anterior cingulate) and lateral prefrontal (right middle frontal gyrus) cortex-activity that likely reflects processing related to the intention or preparation to reorient attention. These findings, which extend recent evidence on freely chosen motor movements, suggest that dorsal anterior cingulate and lateral prefrontal cortices play key roles in both overt and covert acts of volition, and may constitute core components of a brain network underlying the will to attend. PMID:27301353

  20. Effect of voluntary vs. artificial activation on the relationship of muscle torque to speed

    NASA Technical Reports Server (NTRS)

    Dudley, Gary A.; Harris, Robert T.; Duvoisin, Marc R.; Hather, Bruce M.; Buchanan, Paul

    1990-01-01

    The suggestion by Phillips and Petrofsky (1980) and Wickiewicz et al. (1984) that artificial activation of the knee extensor muscles should result in greater relative changes in torque than those evident with maximal voluntary activation is examined by investigating the speed-torque relationship of the right knee extensor muscle group in eight human subjects in whom activation was achieved by 'maximal' voluntary effort or by electrical stimulation. Torque was measured at a specific knee angle during isokinetic concentric or eccentric actions at velocities between 0.17 and 3.66 rad/s and during isometric actions. It is shown that, with artificial activation, the relative changes in both eccentric and concentric torque were greater as the speed increased; the speed-torque relationship was independed of the extent of activation and was similar to that of an isolated muscle. On the other hand, activation by the central nervous system during maximal effort depended on the speed and the type of muscle action performed.

  1. 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)

  2. 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

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

    PubMed

    Zhao, Zaorui; Sabirzhanov, Boris; Wu, Junfang; Faden, Alan I; Stoica, Bogdan A

    2015-09-01

    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

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

    PubMed

    Zhao, Zaorui; Sabirzhanov, Boris; Wu, Junfang; Faden, Alan I; Stoica, Bogdan A

    2015-09-01

    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.

  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. 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.

  7. Debate: euthanasia--a physician's viewpoint.

    PubMed Central

    Twycross, R G

    1982-01-01

    Discussion about euthanasia is often confused because of a failure to distinguish between deliberate death acceleration and letting nature take its course. There is a need to reiterate the traditional principles upon which the care of the dying should be based, including the need for the doctor to practise medicine in the knowledge that eventually all his patients will die. It follows that a doctor does not have a duty to preserve life at all costs. The care of the patient with far-advanced cancer has improved considerably in many areas as a result of the establishment of hospices and domiciliary support teams. Treating the patient as a person is the key to a successful doctor-patient relationship. An analytical approach is necessary to control pain and other symptoms. Care of the relatives is also fundamental. Voluntary euthanasia and 'assisted suicide' represent an extreme solution to a situation which demands a far more comprehensive and compassionate approach. The need is not for a change in the law but for a change of emphasis in medical education. PMID:7108913

  8. Temporal muscle activation assessment by ultrasound imaging during flexor withdrawal reflex and voluntary contraction.

    PubMed

    Jose, Gomez-Tames; Shuto, Nakamura; Jose, Gonzalez; Wenwei, Yu

    2013-01-01

    Activating flexor reflexes by electrical stimulation has been used as a mechanism to initiate the swing phase or to enhance it for spinal cord injured patients. However, it is necessary to know their contraction dynamics in order to artificially induce them at the right moment of a walking cycle. This requires understanding the temporal activation pattern of both surface and deep muscles simultaneously. This study aimed at developing a system to measure and analyze the temporal activation of both surface and deep muscles during voluntary contraction and flexor reflexes (also called withdrawal reflexes) using ultrasound imaging. A set of experiments were done to verify the validity of the system, while exploring the temporal pattern of muscle activation during flexor reflexes. As a result, we were able to quantify the surface and deep muscle activity by measuring the muscle thickness, pennation angle and long-axis displacement, from the ultrasound images.

  9. 77 FR 10572 - Agency Information Collection Activities; Existing Collection, Comments Requested: the Voluntary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-22

    ... Requested: the Voluntary Appeal File (VAF) Brochure ACTION: 30-Day Notice of Information Collection Under... Information Collection: Approval of an Existing Collection (2) Title of the Forms: Voluntary Appeal File (3... abstract: Primary: Any individual requesting entry into the Voluntary Appeal File (VAF) of the FBI...

  10. 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.

  11. 16 CFR 1031.4 - Effect of voluntary standards activities on Commission activities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    .... 2058, section 3(f) of the Federal Hazardous Substances Act, 15 U.S.C. 1262(f), or section 4(a) of the... adequate voluntary standards, in combination with appropriate certification programs, may be appropriate to... risk of injury the Commission may commence a proceeding for the development of a consumer...

  12. EEG activations during intentional inhibition of voluntary action: an electrophysiological correlate of self-control?

    PubMed

    Walsh, E; Kühn, S; Brass, M; Wenke, D; Haggard, P

    2010-01-01

    An important aspect of volition is the internal decision whether to act or to withhold an action. We used EEG frequency analysis of sensorimotor rhythms to investigate brain activity when people prepare and then cancel a voluntary action. Participants used a rotating clock-hand to report when they experienced the intention to press a key with their right hand, even on trials where they freely decided to inhibit movement at the last moment. On action trials, we observed the classical pattern of reduced beta-band spectral power prior to movement, followed by beta rebound after movement. On inhibition trials where participants prepared but then cancelled a movement, we found a left frontal increase in spectral power (event-related synchronisation: ERS) peaking 12 ms before the perceived intention to move. This neural correlate of intentional inhibition was significantly different from the activity at the corresponding moment in action trials. The results are discussed in the context of a recent model of voluntary action (WWW model; Brass & Haggard, 2008). Planned actions can be subjected to a final predictive check which either commits actions for execution or suspends and withholds them. The neural mechanism of intentional inhibition may play an important role in self-control.

  13. Rich, white, and vulnerable: rethinking oppressive socialization in the euthanasia debate.

    PubMed

    Krag, Erik

    2014-08-01

    Anita Silvers (1998) has criticized those who argue that members of marginalized groups are vulnerable to a special threat posed by physician-assisted suicide (PAS) and voluntary active euthanasia (VAE). She argues that paternalistic measures prohibiting PAS/VAE in order to protect these groups only serve to marginalize them further by characterizing them as belonging to a definitively weak class. I offer a new conception of vulnerability, one that demonstrates how rich, educated, white males, who are typically regarded as having their autonomy enhanced by their social status, are just as, if not more, vulnerable to threats posed by PAS/VAE as a result of the harmful social messages at work just below the surface of contemporary Western culture. I use this new conception of vulnerability to reinforce arguments for continued statutory prohibitions on PAS/VAE.

  14. 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.

  15. 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

  16. To end life or not to prolong life: the effect of message framing on attitudes toward euthanasia.

    PubMed

    Gamliel, Eyal

    2013-05-01

    People ascribe "euthanasia" different values and view it differently. This study hypothesized that a different framing of objectively the same euthanasia situations would affect people's attitudes toward it. Indeed, "positive" framing of euthanasia as not prolonging life resulted in more support for both passive and active euthanasia relative to "negative" framing of the objectively same situations as ending life. Two experiments replicated this pattern using either continuous measures of attitude or dichotomous measures of choice. The article offers two theoretical explanations for the effect of message framing on attitudes toward euthanasia, discusses implications of this effect, and suggests future research.

  17. 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

  18. A behavioral analysis of the impact of voluntary physical activity on hippocampus-dependent contextual conditioning.

    PubMed

    Greenwood, Benjamin N; Strong, Paul V; Foley, Teresa E; Fleshner, Monika

    2009-10-01

    Voluntary physical activity induces molecular changes in the hippocampus consistent with improved hippocampal function, but few studies have explored the effects of wheel running on specific hippocampal-dependent learning and memory processes. The current studies investigated the impact of voluntary wheel running on learning and memory for context and extinction using contextual fear conditioning which is known to be dependent on the hippocampus. When conditioning occurred prior to the start of 6 weeks of wheel running, wheel running had no effect on memory for context or extinction (assessed with freezing). In contrast, when wheel running occurred for 6 weeks prior to conditioning, physical activity improved contextual memory during a retention test 24 h later, but did not affect extinction learning or memory. Wheel running had no effect on freezing immediately after foot shock presentation during conditioning, suggesting that physical activity does not affect the acquisition of the context-shock association or alter the expression of freezing, per se. Instead, it is argued that physical activity improves the consolidation of contextual memories in the hippocampus. Consistent with improved hippocampus-dependent context learning and memory, 6 weeks of wheel running also improved context discrimination and reduced the context pre-exposure time required to form a strong contextual memory. The effect of wheel running on brain-derived neurotrophic factor (BDNF) messenger ribonucleic acid (mRNA) in hippocampal and amygdala subregions was also investigated. Wheel running increased BDNF mRNA in the dentate gyrus, CA1, and the basolateral amygdala. Results are consistent with improved hippocampal function following physical activity.

  19. 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.

  20. 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.

  1. Fatigue in multiple sclerosis is associated with abnormal cortical activation to voluntary movement--EEG evidence.

    PubMed

    Leocani, L; Colombo, B; Magnani, G; Martinelli-Boneschi, F; Cursi, M; Rossi, P; Martinelli, V; Comi, G

    2001-06-01

    Converging evidence is consistent with the view that fatigue in Multiple Sclerosis is independent from pyramidal tract involvement, suggesting a possible involvement of frontal areas. During voluntary movement, changes of the EEG rhythms can be observed over sensorimotor areas. Event-related desynchronization (ERD) of the 10 and 20 Hz frequency bands occurs during motor planning and execution and is followed after movement termination by event-related synchronization (ERS), expressing cortical idling or inhibition. We evaluated the pattern of cortical activation to voluntary movement in MS patients complaining of fatigue assessed using the Fatigue Severity Scale. Fifteen MS patients complaining of fatigue, 18 MS patients without fatigue, and 14 normal controls were studied. The two patients groups were similar for age, sex, disease duration, and were not disabled (score <1.5 at the Expanded Disability Status Scale). Twenty-nine channel EEG was recorded during about 60 self-paced extensions of the right thumb. The onset latency and amount of the contralateral sensorimotor (C3 electrode) 10 and 18--22 Hz ERD were similar in the three groups. ERD was more widespread anteriorly in the fatigue group compared with normal controls (P < 0.01 over Fz electrode). Postmovement contralateral sensorimotor 18--22 Hz ERS was significantly lower in fatigue MS patients compared with normal subjects (P < 0.005) and with nonfatigue MS patients (P = 0.02). These findings are consistent with a central origin of fatigue in MS and indicate cortical dysfunction even during a simple motor task, resulting in hyperactivity during movement execution and failure of the inhibitory mechanisms intervening after movement termination. PMID:11352624

  2. 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…

  3. 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

  4. Attitude toward euthanasia scale: psychometric properties and relations with religious orientation, personality, and life satisfaction.

    PubMed

    Aghababaei, Naser; Wasserman, Jason Adam

    2013-12-01

    End-of-life decisions (ELDs) represent a controversial subject, with ethical dilemmas and empirical ambiguities that stand at the intersection of ethics and medicine. In a non-Western population, we examined individual differences in perceiving ELDs that end the life of a patient as acceptable and found that an attitude toward euthanasia (ATE) scale consists of 2 factors representing voluntary and nonvoluntary euthanasia. Also, acceptance of ELDs that end the life of a patient negatively correlated with life satisfaction, honesty-humility, conscientiousness, and intrinsic and extrinsic personal motivation toward religion. These findings provided additional construct validity of the ATE scale.

  5. Short-term effects of electrical stimulation and voluntary activity on corticomotor excitability in healthy individuals and people with stroke.

    PubMed

    Taylor, Lynne; Lewis, Gwyn N; Taylor, Denise

    2012-06-01

    Electrical stimulation (ES) of muscle is often used to augment motor recovery in populations with neurologic disorders. The aim of the study was to examine the changes in corticomotor excitability in response to different forms of ES applied to the wrist extensors. Healthy adults and people with stroke completed three separate test sessions. In each session, 60 wrist extensor contractions were elicited by one of the three interventions: (1) voluntary isometric muscle activation, (2) automated ES, or (3) electromyography-triggered ES. Motor evoked potentials were significantly increased after the voluntary contraction and electromyography-triggered ES interventions, but not after automated ES, in healthy participants. There was no significant change in motor evoked potential amplitude after any of the interventions in the participants with chronic stroke. Using the ES parameters of this study, voluntary drive was required to induce change in corticomotor excitability in the healthy participants. The stimulation intensity and duration parameters used did not induce any immediate changes in corticomotor excitability in the participants with stroke. The authors conclude that combining voluntary activation with ES may enhance the efficacy of stimulation in healthy adults. Repeated applications or longer durations of stimulation may be necessary to alter neuronal excitability in a stroke population. PMID:22659717

  6. 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....

  7. 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....

  8. 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....

  9. 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....

  10. 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....

  11. 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... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity be... resources, hardware, software, and technical assistance to the Self-Governance Tribes to facilitate...

  12. 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... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity be... resources, hardware, software, and technical assistance to the Self-Governance Tribes to facilitate...

  13. 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... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity be... resources, hardware, software, and technical assistance to the Self-Governance Tribes to facilitate...

  14. 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... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity be... resources, hardware, software, and technical assistance to the Self-Governance Tribes to facilitate...

  15. 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... Provisions Health Status Reports § 137.205 Will this voluntary uniform data set reporting activity be... resources, hardware, software, and technical assistance to the Self-Governance Tribes to facilitate...

  16. Attitudes towards euthanasia and assisted suicide: a comparison between psychiatrists and other physicians.

    PubMed

    Levy, Tal Bergman; Azar, Shlomi; Huberfeld, Ronen; Siegel, Andrew M; Strous, Rael D

    2013-09-01

    Euthanasia and physician assisted-suicide are terms used to describe the process in which a doctor of a sick or disabled individual engages in an activity which directly or indirectly leads to their death. This behavior is engaged by the healthcare provider based on their humanistic desire to end suffering and pain. The psychiatrist's involvement may be requested in several distinct situations including evaluation of patient capacity when an appeal for euthanasia is requested on grounds of terminal somatic illness or when the patient is requesting euthanasia due to mental suffering. We compare attitudes of 49 psychiatrists towards euthanasia and assisted suicide with a group of 54 other physicians by means of a questionnaire describing different patients, who either requested physician-assisted suicide or in whom euthanasia as a treatment option was considered, followed by a set of questions relating to euthanasia implementation. When controlled for religious practice, psychiatrists expressed more conservative views regarding euthanasia than did physicians from other medical specialties. Similarly female physicians and orthodox physicians indicated more conservative views. Differences may be due to factors inherent in subspecialty education. We suggest that in light of the unique complexity and context of patient euthanasia requests, based on their training and professional expertise psychiatrists are well suited to take a prominent role in evaluating such requests to die and making a decision as to the relative importance of competing variables.

  17. 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.

  18. Ancient euthanasia: 'good death' and the doctor in the graeco-Roman world.

    PubMed

    Van Hooff, Anton J L

    2004-03-01

    This article maps the concept of 'good death' (euthanasia) in the ancient world and explores the marginal role of the doctor at a 'good dying'. His assistance was not needed when the Homeric warrior died as a hero and was expected to accept death with resignation. Later the city-state regarded as heroes the men fallen for the cause of the community, honouring these model citizens as those who died well. In the more individualistic age of Hellenism and the Roman Empire, a death in luxury or without suffering could be styled euthanasia. The doctor had neither a place in those acts of dying nor in cases of natural death. He shunned death as a failure of his art. Sometimes a doctor was called in to assist in voluntary death, a role that was not forbidden by the Hippocratic oath. An appeal to this oath by opponents of euthanasia in the modern sense of the word therefore is mistaken.

  19. GPi Oscillatory Activity Differentiates Tics from the Resting State, Voluntary Movements, and the Unmedicated Parkinsonian State

    PubMed Central

    Jimenez-Shahed, Joohi; Telkes, Ilknur; Viswanathan, Ashwin; Ince, Nuri F.

    2016-01-01

    Background: Deep brain stimulation (DBS) is an emerging treatment strategy for severe, medication-refractory Tourette syndrome (TS). Thalamic (Cm-Pf) and pallidal (including globus pallidus interna, GPi) targets have been the most investigated. While the neurophysiological correlates of Parkinson's disease (PD) in the GPi and subthalamic nucleus (STN) are increasingly recognized, these patterns are not well characterized in other disease states. Recent findings indicate that the cross-frequency coupling (CFC) between beta band and high frequency oscillations (HFOs) within the STN in PD patients is pathologic. Methods: We recorded intraoperative local field potentials (LFPs) from the postero-ventrolateral GPi in three adult patients with TS at rest, during voluntary movements, and during tic activity and compared them to the intraoperative GPi-LFP activity recorded from four unmedicated PD patients at rest. Results: In all PD patients, we noted excessive beta band activity (13–30 Hz) at rest which consistently modulated the amplitude of the co-existent HFOs observed between 200 and 400 Hz, indicating the presence of beta-HFO CFC. In all 3TS patients at rest, we observed theta band activity (4–7 Hz) and HFOs. Two patients had beta band activity, though at lower power than theta oscillations. Tic activity was associated with increased high frequency (200–400 Hz) and gamma band (35–200 Hz) activity. There was no beta-HFO CFC in TS patients at rest. However, CFC between the phase of 5–10 Hz band activity and the amplitude of HFOs was found in two TS patients. During tics, this shifted to CFC between the phase of beta band activity and the amplitude of HFOs in all subjects. Conclusions: To our knowledge this is the first study that shows that beta-HFO CFC exists in the GPi of TS patients during tics and at rest in PD patients, and suggests that this pattern might be specific to pathologic/involuntary movements. Furthermore, our findings suggest that during tics

  20. 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

  1. Voluntary activation failure is detectable in some myositis patients with persisting quadriceps femoris weakness: an observational study

    PubMed Central

    Molloy, Catherine B; Al-Omar, Ahmed O; Edge, Kathryn T; Cooper, Robert G

    2006-01-01

    This cross-sectional, observational study was undertaken to examine whether voluntary activation failure could contribute to the persisting weakness observed in some patients with treated idiopathic inflammatory myositis. In 20 patients with myositis of more than six months' duration (5 males, 15 females; mean [± 1 SD] age 53 [11] years) and 102 normal subjects (44 males, 58 females; mean age 32 [8] years), isometric maximum voluntary contractions (MVCs) of the dominant quadriceps femoris (QF) were quantified. Absolute MVC results of normal subjects and patients were then normalised with respect to lean body mass (force per units of lean body mass), giving a result in Newtons per kilogram. Based on mass-normalised force data of normal subjects, patients were arbitrarily stratified into "weak" and "not weak" subgroups. During further MVC attempts, the "twitch interpolation" technique was used to assess whether the QF voluntary activation of patients was complete. This technique relies on the fact that, because muscle activation is incomplete during submaximal voluntary contractions, electrical stimulation of the muscle can induce force increments superimposed on the submaximal voluntary force being generated. No between-gender differences were seen in the mass-normalised MVC results of healthy subjects, so the gender-combined results of 6.6 (1.5) N/kg were used for patient stratification. No between-gender difference was found for mass-normalised MVCs in patients: males 5.4 (3.2) and females 3.0 (1.7) N/kg (p > 0.05). Mass-normalised MVCs of male patients were as great as those of normal subjects (p > 0.05), but mass-normalised MVCs of female patients were significantly smaller than those of the normal subjects (p < 0.001). Only one of the six "not weak" patients exhibited interpolated twitches during electrical stimulation, but six of the 14 "weak" patients did, the biggest twitches being seen in the weakest patient. That interpolated twitches can be induced in

  2. Selective recruitment of high-threshold human motor units during voluntary isotonic lengthening of active muscles.

    PubMed Central

    Nardone, A; Romanò, C; Schieppati, M

    1989-01-01

    1. We have investigated the possibility that voluntary muscle lengthening contractions can be performed by selective recruitment of fast-twitch motor units, accompanied by derecruitment of slow-twitch motor units. 2. The behaviour of motor units in soleus, gastrocnemius lateralis and gastrocnemius medialis muscles was studied during (a) controlled isotonic plantar flexion against a constant load (shortening contraction, S), maintained plantar flexion, or dorsal flexion resisting the load and gradually yielding to it (lengthening contraction, L), (b) isometric increasing or decreasing plantar torque accomplished by graded contraction or relaxation of the triceps surae muscles, (c) isometric or isotonic ballistic contractions, and (d) periodic, quasi-sinusoidal isotonic contractions at different velocities. The above tasks were performed under visual control of foot position, without activation of antagonist muscles. The motor units discharging during foot rotation were grouped on the basis of the phase(s) during which they were active as S, S + L and L. The units were also characterized according to both the level of isometric ramp plantar torque at which they were first recruited and the amplitude of their action potential. 3. S units were never active during dorsal flexion; some of them were active during the sustained contraction between plantar and dorsal flexion. Most S + L units were active also during the maintenance phase and were slowly derecruited during lengthening; their behaviour during foot rotations was similar to that during isometric contractions or relaxations. L units were never active during either plantar or maintained flexion, but discharged during lengthening contraction in a given range of rotation velocities; the velocity of lengthening consistently influenced the firing frequency of these units. Such dependence on velocity was not observed in S + L units. 4. A correlation was found between the amplitude of the action potential and the

  3. Are firms' voluntary environmental management activities beneficial for the environment and business? An empirical study focusing on Japanese manufacturing firms.

    PubMed

    Nishitani, Kimitaka; Kaneko, Shinji; Fujii, Hidemichi; Komatsu, Satoru

    2012-08-30

    In this paper, to clarify whether a firm's voluntary approach to environmental protection is beneficial for both the environment and business, we analyze whether a firm's voluntary implementation of an environmental management system (EMS) simultaneously reduces its environmental impacts and improves its productivity. Using data on Japanese manufacturing firms for 2002-2008, we find empirical support for the view that the implementation of an EMS simultaneously reduces environmental impacts and improves productivity, and that a reduction in environmental impacts also improves productivity. However, in the context of this relationship, the direct effect of implementing an EMS on productivity is conditional. If various other activities designed to improve productivity implemented in response to market discipline are also taken into account, the effect of implementing an EMS is hidden by the effects of these activities. This implies that voluntary environmental management activities are merely a minor component of these activities. Therefore, the relationship between the implementation of an EMS and productivity improvement is not strong, although implementing an EMS indirectly improves productivity by reducing environmental impacts.

  4. 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.

  5. 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…

  6. 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)

  7. 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

  8. 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

  9. Mental health and other clinical correlates of euthanasia attitudes in an Australian outpatient cancer population.

    PubMed

    Carter, G L; Clover, K A; Parkinson, L; Rainbird, K; Kerridge, I; Ravenscroft, P; Cavenagh, J; McPhee, J

    2007-04-01

    A majority of patients with cancer have been reported to endorse euthanasia and physician assisted suicide (PAS) in general and a substantial proportion endorse these for themselves. However, the potential influence of mental health and other clinical variables on these decisions is not well understood. This study of 228 outpatients attending an oncology clinic in Newcastle, Australia used a cross-sectional design and logistic regression modelling to examine the relationship of demographic, disease status, mental health and quality of life variables to attitudes toward euthanasia and PAS. The majority reported support for euthanasia (79%, n=179), for PAS (69%, n=158) and personal support for euthanasia/PAS (68%, n=156). However, few reported having asked their doctor for euthanasia (2%, n=5) or PAS (2%, n=5). Three outcomes were modelled: support for euthanasia was associated with active religious belief (adjusted odds ratio (AOR) 0.21, 95% CI: 0.10-0.46); support for PAS was associated with active religious belief (AOR 0.35, 95% CI: 18-0.70) and recent pain (AOR 0.87, 95% CI: 0.0.76-0.99); and personal support for euthanasia/PAS was associated with active religious belief (AOR 0.26, 95% CI: 0.14-0.48). Depression, anxiety, recent suicidal ideation, and lifetime suicide attempt were not independently associated with any of the three outcomes modelled.

  10. 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

  11. 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.

  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.

  13. 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

  14. 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

  15. 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

  16. 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.

  17. [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.

  18. [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

  19. Voluntary and involuntary running in the rat show different patterns of theta rhythm, physical activity, and heart rate.

    PubMed

    Li, Jia-Yi; Kuo, Terry B J; Yen, Jiin-Cherng; Tsai, Shih-Chih; Yang, Cheryl C H

    2014-05-01

    Involuntarily exercising rats undergo more physical and mental stress than voluntarily exercising rats; however, these findings still lack electrophysiological evidence. Many studies have reported that theta rhythm appears when there is mental stress and that it is affected by emotional status. Thus we hypothesized that the differences between voluntary and involuntary movement should also exist in the hippocampal theta rhythm. Using the wheel and treadmill exercise models as voluntary and involuntary exercise models, respectively, this study wirelessly recorded the hippocampal electroencephalogram, electrocardiogram, and three-dimensional accelerations of young male rats. Treadmill and wheel exercise produced different theta patterns in the rats before and during running. Even though the waking baselines for the two exercise types were recorded in different environments, there did not exist any significant difference after distinguishing the rats' sleep/wake status. When the same movement-related parameters are considered, the treadmill running group showed more changes in their theta frequency (4-12 Hz), in their theta power between 9.5-12 Hz, and in their heart rate than the wheel running group. A positive correlation between the changes in high-frequency (9.5-12 Hz) theta power and heart rate was identified. Our results reveal various voluntary and involuntary changes in hippocampal theta rhythm as well as divergences in heart rate and high-frequency theta activity that may represent the effects of an additional emotional state or the sensory interaction during involuntary running by rats. PMID:24623507

  20. Brain activation induced by voluntary alcohol and saccharin drinking in rats assessed with manganese-enhanced magnetic resonance imaging.

    PubMed

    Dudek, Mateusz; Abo-Ramadan, Usama; Hermann, Derik; Brown, Matthew; Canals, Santiago; Sommer, Wolfgang H; Hyytiä, Petri

    2015-11-01

    The neuroanatomical and neurochemical basis of alcohol reward has been studied extensively, but global alterations of neural activity in reward circuits during chronic alcohol use remain poorly described. Here, we measured brain activity changes produced by long-term voluntary alcohol drinking in the alcohol-preferring AA (Alko alcohol) rats using manganese-enhanced magnetic resonance imaging (MEMRI). MEMRI is based on the ability of paramagnetic manganese ions to accumulate in excitable neurons and thereby enhance the T1-weighted signal in activated brain areas. Following 6 weeks of voluntary alcohol drinking, AA rats were allowed to drink alcohol for an additional week, during which they were administered manganese chloride (MnCl2 ) with subcutaneous osmotic minipumps before MEMRI. A second group with an identical alcohol drinking history received MnCl2 during the abstinence week following alcohol drinking. For comparing alcohol with a natural reinforcer, MEMRI was also performed in saccharin-drinking rats. A water-drinking group receiving MnCl2 served as a control. We found that alcohol drinking increased brain activity extensively in cortical and subcortical areas, including the mesocorticolimbic and nigrostriatal dopamine pathways and their afferents. Remarkably similar activation maps were seen after saccharin ingestion. Particularly in the prelimbic cortex, ventral hippocampus and subthalamic nucleus, activation persisted into early abstinence. These data show that voluntary alcohol recruits an extensive network that includes the ascending dopamine systems and their afferent connections, and that this network is largely shared with saccharin reward. The regions displaying persistent alterations after alcohol drinking could participate in brain networks underlying alcohol seeking and relapse.

  1. 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)

  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.

  3. Sex-dependent effects of developmental exposure to bisphenol A and ethinyl estradiol on metabolic parameters and voluntary physical activity

    PubMed Central

    Johnson, S. A.; Painter, M. S.; Javurek, A. B.; Ellersieck, M. R.; Wiedmeyer, C. E.; Thyfault, J. P.; Rosenfeld, C. S.

    2016-01-01

    Endocrine disrupting chemicals (EDC) have received considerable attention as potential obesogens. Past studies examining obesogenic potential of one widespread EDC, bisphenol A (BPA), have generally focused on metabolic and adipose tissue effects. However, physical inactivity has been proposed to be a leading cause of obesity. A paucity of studies has considered whether EDC, including BPA, affects this behavior. To test whether early exposure to BPA and ethinyl estradiol (EE, estrogen present in birth control pills) results in metabolic and such behavioral disruptions, California mice developmentally exposed to BPA and EE were tested as adults for energy expenditure (indirect calorimetry), body composition (echoMRI) and physical activity (measured by beam breaks and voluntary wheel running). Serum glucose and metabolic hormones were measured. No differences in body weight or food consumption were detected. BPA-exposed females exhibited greater variation in weight than females in control and EE groups. During the dark and light cycles, BPA females exhibited a higher average respiratory quotient than control females, indicative of metabolizing carbohydrates rather than fats. Various assessments of voluntary physical activity in the home cage confirmed that during the dark cycle, BPA and EE-exposed females were significantly less active in this setting than control females. Similar effects were not observed in BPA or EE-exposed males. No significant differences were detected in serum glucose, insulin, adiponectin and leptin concentrations. Results suggest that females developmentally exposed to BPA exhibit decreased motivation to engage in voluntary physical activity and altered metabolism of carbohydrates v. fats, which could have important health implications. PMID:26378919

  4. 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

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

    PubMed

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

    2015-02-01

    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.

  6. 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.

  7. Augmentation of Voluntary Locomotor Activity by Transcutaneous Spinal Cord Stimulation in Motor-Incomplete Spinal Cord-Injured Individuals.

    PubMed

    Hofstoetter, Ursula S; Krenn, Matthias; Danner, Simon M; Hofer, Christian; Kern, Helmut; McKay, William B; Mayr, Winfried; Minassian, Karen

    2015-10-01

    The level of sustainable excitability within lumbar spinal cord circuitries is one of the factors determining the functional outcome of locomotor therapy after motor-incomplete spinal cord injury. Here, we present initial data using noninvasive transcutaneous lumbar spinal cord stimulation (tSCS) to modulate this central state of excitability during voluntary treadmill stepping in three motor-incomplete spinal cord-injured individuals. Stimulation was applied at 30 Hz with an intensity that generated tingling sensations in the lower limb dermatomes, yet without producing muscle reflex activity. This stimulation changed muscle activation, gait kinematics, and the amount of manual assistance required from the therapists to maintain stepping with some interindividual differences. The effect on motor outputs during treadmill-stepping was essentially augmentative and step-phase dependent despite the invariant tonic stimulation. The most consistent modification was found in the gait kinematics, with the hip flexion during swing increased by 11.3° ± 5.6° across all subjects. This preliminary work suggests that tSCS provides for a background increase in activation of the lumbar spinal locomotor circuitry that has partially lost its descending drive. Voluntary inputs and step-related feedback build upon the stimulation-induced increased state of excitability in the generation of locomotor activity. Thus, tSCS essentially works as an electrical neuroprosthesis augmenting remaining motor control.

  8. 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

  9. Role of the dorsal medial habenula in the regulation of voluntary activity, motor function, hedonic state, and primary reinforcement.

    PubMed

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

    2014-08-20

    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.

  10. 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…

  11. 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)

  12. [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.

  13. [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

  14. [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

  15. 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

  16. Dying cancer patients talk about euthanasia.

    PubMed

    Eliott, Jaklin A; Olver, Ian N

    2008-08-01

    Within developed nations, there is increasing public debate about and apparent endorsement of the appropriateness of euthanasia as an autonomous choice to die in the face of intolerable suffering. Surveys report socio-demographic differences in rates of acceptance of euthanasia, but there is little in-depth analysis of how euthanasia is understood and positioned within the social and moral lives of individuals, particularly those who might be considered suitable candidates-for example, terminally-ill cancer patients. During discussions with 28 such patients in Australia regarding medical decisions at the end of life, euthanasia was raised by 13 patients, with the others specifically asked about it. Twenty-four patients spoke positively of euthanasia, 19 of these voicing some concerns. None identified euthanasia as a currently favoured option. Four were completely against it. Endorsement for euthanasia was in the context of a hypothetical future or for a hypothetical other person, or temporally associated with acute pain. Arguments supporting euthanasia framed the issue as a matter of freedom of choice, as preserving dignity in death, and as curbing intolerable pain and suffering, both of the patient and of those around them. A common analogy featured was that of euthanising a dog. These arguments were typically presented as self-evident justification for euthanasia, construed as an appropriate choice to die, with opposers positioned as morally inferior or ignorant. The difficulties of ensuring 'choice' and the moral connotations of 'choosing to die,' however, worked to problematise the appropriateness of euthanising specific individuals. We recommend further empirical investigation of the moral and social meanings associated with euthanasia.

  17. [Euthanasia: status report in 2014].

    PubMed

    Lossignol, D

    2014-09-01

    Since 2002, the Belgian legal framework authorizes the practice of euthanasia, under certain conditions. All cases have to be reported to the Assessment and Control Commission (ACC). To date, more than 6000 cases have been reported since 2002. To make a statement about the Belgian experience requires considering different points: data and evaluation from the ACC reports, their analysis, consequences on medical practice, legal and medical perspectives, critics and attacks about the legal framework, the concept of individual and institutional conscience clause. Regarding all these topics, we note that the Belgian experience is more than an example and shows that adequate answers may be provided to patients experiencing intolerable suffering.

  18. Attitudes to animal euthanasia do not correlate with acceptance of human euthanasia or suicide.

    PubMed

    Ogden, U; Kinnison, T; May, S A

    2012-08-18

    Several reasons have been suggested for the elevated risk of suicide experienced by those in the veterinary profession. The current study aimed to investigate possible links between veterinarians' attitudes to 'convenience' or non-justified animal euthanasia and attitudes towards human euthanasia and suicide. Veterinary students and graduates had a negative attitude towards convenience animal euthanasia, but their attitudes changed over time (pre-clinical studies, clinical studies and recently graduated). A greater tolerance to euthanasia was displayed in the later years of study and post qualification - primarily by males. Attitudes towards both human euthanasia and suicide, however, remained stable over time and indicated on average a neutral stance. No correlations were found between attitudes to convenience euthanasia and either human euthanasia or suicide, suggesting a tolerance to convenience euthanasia of animals does not lead to desensitisation in valuing human life and a changed attitude to human euthanasia or suicide, or vice versa. Attitudes to human euthanasia and suicide were predictably correlated, perhaps suggesting an overarching attitude towards control over human death. The results of the current study throw into question the argument that it is the changes in attitudes to animal life that affect veterinarian's attitudes to human life and contribute to the high suicide rate. PMID:22791520

  19. 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

  20. Voluntary exercise contributed to an amelioration of abnormal feeding behavior, locomotor activity and ghrelin production concomitantly with a weight reduction in high fat diet-induced obese rats.

    PubMed

    Mifune, Hiroharu; Tajiri, Yuji; Nishi, Yoshihiro; Hara, Kento; Iwata, Shimpei; Tokubuchi, Ichiro; Mitsuzono, Ryouichi; Yamada, Kentaro; Kojima, Masayasu

    2015-09-01

    In the present study, effects of voluntary exercise in an obese animal model were investigated in relation to the rhythm of daily activity and ghrelin production. Male Sprague-Dawley rats were fed either a high fat diet (HFD) or a chow diet (CD) from four to 16 weeks old. They were further subdivided into either an exercise group (HFD-Ex, CD-Ex) with a running wheel for three days of every other week or sedentary group (HFD-Se, CD-Se). At 16 weeks old, marked increases in body weight and visceral fat were observed in the HFD-Se group, together with disrupted rhythms of feeding and locomotor activity. The induction of voluntary exercise brought about an effective reduction of weight and fat, and ameliorated abnormal rhythms of activity and feeding in the HFD-Ex rats. Wheel counts as voluntary exercise was greater in HFD-Ex rats than those in CD-Ex rats. The HFD-obese had exhibited a deterioration of ghrelin production, which was restored by the induction of voluntary exercise. These findings demonstrated that abnormal rhythms of feeding and locomotor activity in HFD-obese rats were restored by infrequent voluntary exercise with a concomitant amelioration of the ghrelin production and weight reduction. Because ghrelin is related to food anticipatory activity, it is plausible that ghrelin participates in the circadian rhythm of daily activity including eating behavior. A beneficial effect of voluntary exercise has now been confirmed in terms of the amelioration of the daily rhythms in eating behavior and physical activity in an animal model of obesity.

  1. 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

  2. [Neuromuscular effects of superimposed and combined transcutaneous electrical stimulation with voluntary activity: a review].

    PubMed

    Paillard, T; Noé, F; Edeline, O

    2005-04-01

    With voluntary muscular contraction (VOL), small motor units (MUs) are recruited before large MUs are (a submaximal muscular contraction recruits only small MUs), whereas electrical stimulation (ES) tends to reverse the recruitment order. On the basis of this observation, some authors have tested the physiological effects of ES superimposed simultaneously with VOL (superimposed technique [ST]) or separately (combined technique [CT]). With healthy subjects, ST does not recruit more MUs than VOL, except with eccentric contractions. After health subjects undergo training programs, ST appears to be as efficient as VOL in enhancing subjects' neuromuscular qualities. Nevertheless, the use of CT seems more effective than VOL. In postsurgical rehabilitation, both ST and CT are more effective than VOL. Actually, following knee surgery, ST and CT compensate for volume and muscle strength deficits with more efficiency than does VOL.

  3. 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

  4. 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

  5. [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.

  6. Attitudes toward euthanasia among Swedish medical students.

    PubMed

    Karlsson, Marit; Strang, Peter; Milberg, Anna

    2007-10-01

    Attitudes toward euthanasia differ between individuals and populations, and in many studies the medical profession is more reluctant than the general public. Our goal was to explore medical students' attitude toward euthanasia. A questionnaire containing open-ended questions was answered anonymously by 165 first- and fifth-year medical students. Data were analysed using qualitative content analysis with no predetermined categories. The students' arguments opposing euthanasia were based on opinions of 1. euthanasia being morally wrong, 2. fear of possible negative effects on society, 3. euthanasia causing strain on physicians and 4. doubts about the true meaning of requests of euthanasia from patients. Arguments supporting euthanasia were based on 1. patients' autonomy and 2. the relief of suffering, which could be caused by severe illnesses, reduced integrity, hopelessness, social factors and old age. There are several contradictions in the students' arguments and the results indicate a possible need for education focusing on the possibility of symptom control in palliative care and patients' perceived quality of life.

  7. 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

  8. The euthanasia-religion nexus: exploring religious orientation and euthanasia attitude measures in a Muslim context.

    PubMed

    Aghababaei, Naser

    Using religious orientation paradigm, this twofold study examined the relationship between euthanasia attitude and religiosity, and compared single-item and multi-item scales of euthanasia attitude. Three hundred students were asked whether they view euthanasia as moral. In addition, participants completed the Euthanasia Attitude Scale (EAS) and Religious Orientation Scale-Revised. Results indicated that intrinsic religiosity was the strongest correlate of negative attitudes toward euthanasia. This type of religiosity explained additional variance when added to the two types of extrinsic religiosity (social, personal), but the reverse was not the case. The fairly strong correlation of intrinsic religiosity with the EAS provides evidence of construct validity for the EAS and proved it to be a better measure for assessing euthanasia attitude, rather than the single-item scale.

  9. 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…

  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.

  11. [Could infant euthanasia be ever acceptable?].

    PubMed

    Beca, J P; Leiva, A

    2014-10-01

    The recent enactment of a law that allows infant euthanasia in Belgium raises questions with varied answers. To contribute to a better understanding of the topic, euthanasia and legislation concepts are described. After a bioethical analysis, we propose as conclusion that children euthanasia could only be acceptable in very exceptional situations in which palliative measures have failed. The answer should be that it is not acceptable in our setting, not until we have public policies, protocols and palliative care services for terminally ill children.

  12. 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

  13. 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

  14. 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.

  15. 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

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

    PubMed

    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.

  17. Children's "euthanasia" in Nazi Germany.

    PubMed

    Benedict, Susan; Shields, Linda; O'Donnell, Alison J

    2009-12-01

    Children with disabilities were killed during the Nazi era, often by nurses. Some nurses killed children, saying that they were under orders. Propaganda about the need for "racial purity" was all pervasive and influenced much of the population, including nurses. The German people accepted the "mercy" killing of children with disabilities. We describe the children's "euthanasia" program, explore the influence of propaganda, ask why it was acceptable to kill children, and provide historical context demonstrating "slippery slopes" which can lead to abrogation of ethical principles. Discussion of such history is essential as the ethical principles which were breached are still the cornerstone of nursing practice today. Only by openly discussing past wrongs can we attempt to ensure that they do not happen again. Archival documents from Germany and Israel, including trial depositions and transcripts, provided material, supplemented by secondary classic sources.

  18. 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.

  19. Low-residue euthanasia of stranded mysticetes.

    PubMed

    Harms, Craig A; McLellan, William A; Moore, Michael J; Barco, Susan G; Clarke, Elsburgh O; Thayer, Victoria G; Rowles, Teresa K

    2014-01-01

    Euthanasia of stranded large whales poses logistic, safety, pharmaceutical, delivery, public relations, and disposal challenges. Reasonable arguments may be made for allowing a stranded whale to expire naturally. However, slow cardiovascular collapse from gravitational effects outside of neutral buoyancy, often combined with severely debilitating conditions, motivate humane efforts to end the animal's suffering. The size of the animal and prevailing environmental conditions often pose safety concerns for stranding personnel, which take priority over other considerations. When considering chemical euthanasia, the size of the animal also necessitates large quantities of euthanasia agents. Drug residues are a concern for relay toxicity to scavengers, particularly for pentobarbital-containing euthanasia solutions. Pentobarbital is also an environmental concern because of its stability and long persistence in aquatic environments. We describe a euthanasia technique for stranded mysticetes using readily available, relatively inexpensive, preanesthetic and anesthetic drugs (midazolam, acepromazine, xylazine) followed by saturated KCl delivered via custom-made needles and a low-cost, basic, pressurized canister. This method provides effective euthanasia while moderating personnel exposure to hazardous situations and minimizing drug residues of concern for relay toxicity.

  20. 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

  1. 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…

  2. Ontology or phenomenology? How the LVAD challenges the euthanasia debate.

    PubMed

    Kraemer, Felicitas

    2013-03-01

    This article deals with the euthanasia debate in light of new life-sustaining technologies such as the left ventricular assist device (LVAD). The question arises: does the switching off of a LVAD by a doctor upon the request of a patient amount to active or passive euthanasia, i.e. to 'killing' or to 'letting die'? The answer hinges on whether the device is to be regarded as a proper part of the patient's body or as something external. We usually regard the switching off of an internal device as killing, whereas the deactivation of an external device is seen as 'letting die'. The case is notoriously difficult to decide for hybrid devices such as LVADs, which are partly inside and partly outside the patient's body. Additionally, on a methodological level, I will argue that the 'ontological' arguments from analogy given for both sides are problematic. Given the impasse facing the ontological arguments, complementary phenomenological arguments deserve closer inspection. In particular, we should consider whether phenomenologically the LVAD is perceived as a body part or as an external device. I will support the thesis that the deactivation of a LVAD is to be regarded as passive euthanasia if the device is not perceived by the patient as a part of the body proper.

  3. [Euthanasia and other decisions at the end of life (Proposal for a more transparent terminology and some thoughts on the legal framework of medical treatment)].

    PubMed

    Vadász, Gábor

    2010-10-24

    Indication of euthanasia is only one of several medical decisions at the end of life. Precise definition of this topic related to the clinical events happening around the sick-bed is not complete in the legal and medical literature. The present review attempts to classify the different end of life events with the aim of clarifying which of these do not belong to the concept of passive euthanasia. Euthanasia is not a legal category. The everyday expressions of active and passive euthanasia are simplifications, which cover actions of different purposes. Use of these in medical and legal literature can be confusing and misleading. We differentiate decisions at the end of life on basis of their purpose. Based on the definition and category of the Hungarian Doctors' Chamber, euthanasia is the act or the lack of action in order to mercifully shorten or end the life of a suffering fellow-man to help him. Concepts of active, passive and forced euthanasia are defined. The terms of indirect and intermediate euthanasia are not used in order to avoid misunderstanding. Help and participation of non-professionals in the implementation cannot be completely excluded from the concept of euthanasia, and we believe euthanasia is not merely related to doctors. We outline those medical decisions at the end of life which do not belong to the category of passive euthanasia, namely: withdrawal of ineffective and life sustaining treatments, letting go of the patient, contra-indication of therapy escalation, use of palliative therapy, pain-relieving treatment, compromise medicine, consideration of reanimation and choosing cost-effective therapy. We touch upon the subject of the living will, why it cannot be applied, and its relation to active and passive euthanasia. With reference to the legal regulation of life saving and life sustaining treatment, we deal with the expected spirit of medical legislation.

  4. 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

  5. [EFFECT OF VOLUNTARY BREATH-HOLDING AND COGNITIVE LOADS ON REGIONAL CEREBRAL BLOOD FLOW AND BIOELECTRIC ACTIVITY OF THE BRAIN].

    PubMed

    Moreva, T I; Pasekova, O B; Kriushev, E S; Dobrokvashina, E I; Moreva, O V; Builov, S P; Smirnov, O A; Bragin, L Kh; Voronkov, Iu I

    2015-01-01

    Cerebral blood flow and bioelectric activity were studied in 10 normal volunteers in order to assess cerebrovascular reactivity during different types of functional testing. The transcranial Doppler was used to measure linear blood velocity (LBV) in the middle cerebral artery (MCA) during maximal voluntary breath-holding (apnea), controlled verbal association test and tactile memory test. Simultaneous electroencephalography (EEG) registered the bioelectric activity of the brain cortex. Both investigations were performed continuously in the course of each test. Breath-holding induced a smooth symmetric increase of CMA blood velocity; LBV rose to maximum values in the majority of the volunteered subjects. Two subjects with small focal changes in the brain's white matter displayed an asymmetric blood flow reaction to apnea. Gain in LBV was materially less during the cognitive tests; the verbal test decreased LBV in one half of the subjects and increased LBV in the other. The tactile memory test increased LBV which was particularly high in the left CMA of all subjects. LBV dynamics during the cognitive tests was essentially different from what was observed in apnea. Blood flow variations in the course of equally the verbal and tactile tests had a regular undulatory character. Concurrent LBV and EEG monitoring made it possible to compare and contrast dynamics of the cerebral blood velocity and bioelectric activity directly during testing and thus to reveal peculiar reactions of the cerebral blood flow to cognitive and physiological testing.

  6. 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).

  7. 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

  8. 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

  9. 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...

  10. 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.

  11. 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

  12. 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)

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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)

  19. [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.

  20. 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

  1. 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.

  2. 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

  3. 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.

  4. 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

  5. Gaze fixations predict brain activation during the voluntary regulation of picture-induced negative affect.

    PubMed

    van Reekum, Carien M; Johnstone, Tom; Urry, Heather L; Thurow, Marchell E; Schaefer, Hillary S; Alexander, Andrew L; Davidson, Richard J

    2007-07-01

    Recent studies have identified a distributed network of brain regions thought to support cognitive reappraisal processes underlying emotion regulation in response to affective images, including parieto-temporal regions and lateral/medial regions of prefrontal cortex (PFC). A number of these commonly activated regions are also known to underlie visuospatial attention and oculomotor control, which raises the possibility that people use attentional redeployment rather than, or in addition to, reappraisal as a strategy to regulate emotion. We predicted that a significant portion of the observed variance in brain activation during emotion regulation tasks would be associated with differences in how participants visually scan the images while regulating their emotions. We recorded brain activation using fMRI and quantified patterns of gaze fixation while participants increased or decreased their affective response to a set of affective images. fMRI results replicated previous findings on emotion regulation with regulation differences reflected in regions of PFC and the amygdala. In addition, our gaze fixation data revealed that when regulating, individuals changed their gaze patterns relative to a control condition. Furthermore, this variation in gaze fixation accounted for substantial amounts of variance in brain activation. These data point to the importance of controlling for gaze fixation in studies of emotion regulation that use visual stimuli.

  6. 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...

  7. 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

  8. [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.

  9. 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

  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. Activation of inflammatory signaling by lipopolysaccharide produces a prolonged increase of voluntary alcohol intake in mice

    PubMed Central

    Blednov, Y.A.; Benavidez, J.M.; Geil, C.; Perra, S.; Morikawa, H.; Harris, R.A.

    2011-01-01

    Previous studies showed that mice with genetic predisposition for high alcohol consumption as well as human alcoholics show changes in brain expression of genes related to immune signaling. In addition, mutant mice lacking genes related to immune function show decreased alcohol consumption (Blednov et al., in press), suggesting that immune signaling promotes alcohol consumption. To test the possibility that activation of immune signaling will increase alcohol consumption, we treated mice with lipopolysaccaride (LPS; 1 mg/kg, i.p.) and tested alcohol consumption in the continuous two-bottle choice test. To take advantage of the long-lasting activation of brain immune signaling by LPS, we measured drinking beginning one week or one month after LPS treatment and continued the studies for several months. LPS produced persistent increases in alcohol consumption in C57/Bl6 J (B6) inbred mice, FVBxB6F1 and B6xNZBF1 hybrid mice, but not in FVB inbred mice. To determine if this effect of LPS is mediated through binding to TLR4, we tested mice lacking CD14, a key component of TLR4 signaling. These null mutants showed no increase of alcohol intake after treatment with LPS. LPS treatment decreased ethanol-conditioned taste aversion but did not alter ethanol-conditioned place preference (B6xNZBF1 mice). Electro-physiological studies of dopamine neurons in the ventral tegmental area showed that pretreatment of mice with LPS decreased the neuronal firing rate. These results suggest that activation of immune signaling promotes alcohol consumption and alters certain aspects of alcohol reward/aversion. PMID:21266194

  12. Attitudes of Polish physicians and medical students toward breaking bad news, euthanasia and morphine administration in cancer patients.

    PubMed

    Leppert, Wojciech; Majkowicz, Mikolaj; Forycka, Maria

    2013-12-01

    Medical students and physicians should possess basic knowledge concerning medical ethics and palliative care. The aim of the study was to explore the knowledge on the end-of-life ethics and palliative care in third-year medical students and physicians during internal medicine specialty training and their attitude towards breaking bad news and euthanasia. A voluntary and anonymous questionnaire survey with the participation of 401 students and 217 physicians filled after lectures concerning ethics for medical students and after palliative medicine course for physicians during internal medicine specialty training. A total of 28 % students and 24 % physicians (p = 0.282) were ready to reveal full information to advanced cancer patients. A total of 82 % of students and 90 % of physicians (p = 0.008) would not practice euthanasia; 67 % of students and 75 % of physicians (p = 0.039) were opponents of euthanasia legalisation. A total of 70 % doctors and 23 % students indicated oral as the most preferable route of morphine administration. A total of 74 % physicians and 43 % students stated that there is no maximal dose of morphine; 64 % of doctors and 6 % of students indicated constipation as a constant adverse effect of morphine. Breaking bad news is a significant difficulty for both students and physicians. There is a small percentage of those tending to practice euthanasia and bigger accepting its legalisation with fewer physicians than students. In contrast to medical students, the majority of physicians have knowledge concerning chronic morphine use in the treatment of cancer patients.

  13. 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.

  14. Three-dimensional localization of SMA activity preceding voluntary movement. A study of electric and magnetic fields in a patient with infarction of the right supplementary motor area.

    PubMed

    Lang, W; Cheyne, D; Kristeva, R; Beisteiner, R; Lindinger, G; Deecke, L

    1991-01-01

    Previous studies by magnetoencephalography (MEG) failed to consistently localize the activity of the supplementary motor area (SMA) prior to voluntary movements in healthy human subjects. Based on the assumption that the SMA of either hemisphere is active prior to voluntary movements, the negative findings of previous studies could be explained by the hypothesis that magnetic fields of current dipole sources in the two SMAs may cancel each other. The present MEG study was performed in a patient with a complete vascular lesion of the right SMA. In this case it was possible to consistently localize a current dipole source in the intact left SMA starting about 1200 msec prior to the initiation of voluntary movements of the right thumb. Starting at about 600 msec prior to movement onset the assumption of a current dipole source in the left primary motor cortex was needed to account for the observed fields. Measurements of brain potentials were consistent with MEG findings of activity of the left SMA starting about 1200 msec prior to movement onset.

  15. Comparative adaptations in oxidative and glycolytic muscle fibers in a low voluntary wheel running rat model performing three levels of physical activity.

    PubMed

    Hyatt, Hayden W; Toedebusch, Ryan G; Ruegsegger, Greg; Mobley, C Brooks; Fox, Carlton D; McGinnis, Graham R; Quindry, John C; Booth, Frank W; Roberts, Michael D; Kavazis, Andreas N

    2015-11-01

    A unique polygenic model of rat physical activity has been recently developed where rats were selected for the trait of low voluntary wheel running. We utilized this model to identify differences in soleus and plantaris muscles of sedentary low voluntary wheel running rats and physically active low voluntary wheel running rats exposed to moderate amounts of treadmill training. Three groups of 28-day-old male Wistar rats were used: (1) rats without a running wheel (SEDENTARY, n = 7), (2) rats housed with a running wheel (WHEEL, n = 7), and (3) rats housed with a running wheel and exercised on the treadmill (5 days/week for 20 min/day at 15.0 m/min) (WHEEL + TREADMILL, n = 7). Animals were euthanized 5 weeks after the start of the experiment and the soleus and plantaris muscles were excised and used for analyses. Increases in skeletal muscle gene expression of peroxisome proliferator-activated receptor gamma coactivator 1 alpha and fibronectin type III domain-containing protein 5 in WHEEL + TREADMILL group were observed. Also, WHEEL + TREADMILL had higher protein levels of superoxide dismutase 2 and decreased levels of oxidative damage. Our data demonstrate that the addition of treadmill training induces beneficial muscular adaptations compared to animals with wheel access alone. Furthermore, our data expand our understanding of differential muscular adaptations in response to exercise in mitochondrial, antioxidant, and metabolic markers.

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

    PubMed

    Davis, J N; Sears, T A

    1970-08-01

    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 H(2)O 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. 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…

  18. 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…

  19. Voluntary Wheel Running in Mice.

    PubMed

    Goh, Jorming; Ladiges, Warren

    2015-12-02

    Voluntary wheel running in the mouse is used to assess physical performance and endurance and to model exercise training as a way to enhance health. Wheel running is a voluntary activity in contrast to other experimental exercise models in mice, which rely on aversive stimuli to force active movement. This protocol consists of allowing mice to run freely on the open surface of a slanted, plastic saucer-shaped wheel placed inside a standard mouse cage. Rotations are electronically transmitted to a USB hub so that frequency and rate of running can be captured via a software program for data storage and analysis for variable time periods. Mice are individually housed so that accurate recordings can be made for each animal. Factors such as mouse strain, gender, age, and individual motivation, which affect running activity, must be considered in the design of experiments using voluntary wheel running.

  20. Why is the ethics of euthanasia wrong?

    PubMed

    Narbekovas, Andrius; Meilius, Kazimieras

    2004-01-01

    Human beings are made in the image and likeness of God and are therefore of intrinsic worth or value, beyond all prices. Almost all Christian pro-life arguments spring from the fountain of personal dignity. Euthanasia would make moral sense only if it were possible to say, morally, that this dignity had vanished. To commit euthanasia is to act with the specific intention that somebody should be nobody. This is the fundamental error of all immorality in human relations. To commit euthanasia is to fail to see the intrinsic worth or dignity of the person. The judgement that what has worth, intrinsically, somehow does not have worth, is both logically and morally wrong. The ethics of euthanasia is based on dualistic anthropology and wrong moral presuppositions underlying the defence of euthanasia, namely, proportionalism and consequentialism. The basic claim of proponents of the ethics of euthanasia is that human persons are consciously experiencing subjects whose dignity consists of their ability to made choices and to determine their own lives. Bodily life, according to them, is a condition for personal life because without bodily life one cannot be a consciously experiencing subject. It means that bodily life is distinct from personal life. Thus, the body and bodily life are instrumental goods, goods for the person, not goods of the person. It thus follows that there can be such a thing as a life not worth living--one can judge that bodily life itself is useless or burdensome, and when it is, the person, i.e., the consciously experiencing subject, is at liberty to free himself of this useless burden. Today a key in fighting euthanasia and assisted suicide is better care for the sick and dying. The dignity of the sick cannot be erased by illness and suffering. Such procedures are not private decisions; they affect the whole society. Death with dignity, in the end, is the realisation that human beings are also spiritual beings. We have to promote the way of caring for

  1. Euthanasia: why people want to die earlier.

    PubMed

    Seale, C; Addington-Hall, J

    1994-09-01

    The results from two surveys in England of relatives and others who knew people in samples drawn from death certificates are reported. The main focus is on a sample of 3696 people dying in 1990 in 20 health authorities, with supporting analysis from an earlier national sample of 639 people dying in 1987. The incidence of people saying they wanted to die sooner, and of requests for euthanasia are reported. Excluding a proportion who did not wish to express a view, or did not know the answer, about a quarter of both respondents and the people who died expressed the view that an earlier death would be, or would have been, preferable. 3.6% of people in the 1990 study were said to have asked for euthanasia at some point in the last year of life. The extent to which such views were determined by the experience of pain, other distressing symptoms, dependency and social and cultural factors such as religious belief and social class is explored. The finding that dependency was important in causing the feeling that an earlier death would have been better, as well as requests for euthanasia, is related to the public debate about euthanasia, which often contains the assertion that fear of pain is a dominant factor. Pain was found to be a significant factor in death from cancer, but not as important for other causes of death. Social class, place of residence of the deceased, and strength and type of religious faith were found to be largely insignificant in influencing feelings about an earlier death and requests for euthanasia.

  2. The biological control of voluntary exercise, spontaneous physical activity and daily energy expenditure in relation to obesity: human and rodent perspectives

    PubMed Central

    Garland, Theodore; Schutz, Heidi; Chappell, Mark A.; Keeney, Brooke K.; Meek, Thomas H.; Copes, Lynn E.; Acosta, Wendy; Drenowatz, Clemens; Maciel, Robert C.; van Dijk, Gertjan; Kotz, Catherine M.; Eisenmann, Joey C.

    2011-01-01

    Mammals expend energy in many ways, including basic cellular maintenance and repair, digestion, thermoregulation, locomotion, growth and reproduction. These processes can vary tremendously among species and individuals, potentially leading to large variation in daily energy expenditure (DEE). Locomotor energy costs can be substantial for large-bodied species and those with high-activity lifestyles. For humans in industrialized societies, locomotion necessary for daily activities is often relatively low, so it has been presumed that activity energy expenditure and DEE are lower than in our ancestors. Whether this is true and has contributed to a rise in obesity is controversial. In humans, much attention has centered on spontaneous physical activity (SPA) or non-exercise activity thermogenesis (NEAT), the latter sometimes defined so broadly as to include all energy expended due to activity, exclusive of volitional exercise. Given that most people in Western societies engage in little voluntary exercise, increasing NEAT may be an effective way to maintain DEE and combat overweight and obesity. One way to promote NEAT is to decrease the amount of time spent on sedentary behaviours (e.g. watching television). The effects of voluntary exercise on other components of physical activity are highly variable in humans, partly as a function of age, and have rarely been studied in rodents. However, most rodent studies indicate that food consumption increases in the presence of wheels; therefore, other aspects of physical activity are not reduced enough to compensate for the energetic cost of wheel running. Most rodent studies also show negative effects of wheel access on body fat, especially in males. Sedentary behaviours per se have not been studied in rodents in relation to obesity. Several lines of evidence demonstrate the important role of dopamine, in addition to other neural signaling networks (e.g. the endocannabinoid system), in the control of voluntary exercise. A

  3. "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

  4. 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.

  5. Death, dying, and euthanasia: Australia versus the Northern Territory.

    PubMed

    Fleming, J I

    2000-01-01

    The purpose of this article is to explain what has happened in the euthanasia debate in the Australian States and Territories, and to give a more detailed account of how the Northern Territory's euthanasia laws were overturned by the Federal Government. Dr. Fleming begins with a review of euthanasia legislation in each State and Territory, then proceeds with an analysis of the events in the Northern Territory leading to reversal of its euthanasia laws, and includes the effect of the euthanasia law on the Aboriginal people. He concludes that the repeal of the 1995 Northern Territory's Rights of the Terminally Ill Act was a significant setback for the pro-euthanasia movement not only in Australia, but worldwide.

  6. Exposure of research personnel to carbon dioxide during euthanasia procedures.

    PubMed

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

    2014-07-01

    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.

  7. 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

  8. 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

  9. [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

  10. 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.

  11. [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.

  12. Euthanasia in the Commonwealth of Australia.

    PubMed

    Quirk, P

    1998-01-01

    This article describes the debate over the euthanasia law of the Northern Territory of Australia in its constitutional context. After considering the juridical status of the Northern Territory and related topics, this article outlines the judicial and legislative challenges to the Rights of the Terminally Ill Act (RTI Act) of the Northern Territory and concludes by offering some justifications for the passing of the Euthanasia Laws Act 1997 (Commonwealth), which effectively repeals the RTI Act. In dealing with these issues special emphasis will be given to the problem of Commonwealth law overriding Territory law and the concept of fundamental common law rights. The appropriateness of a Parliamentary solution--as opposed to a resolution through the courts--is defended.

  13. Holocaust survivors' perspectives on the euthanasia debate.

    PubMed

    Leichtentritt, R D; Rettig, K D; Miles, S H

    1999-01-01

    The paper reports on a qualitative analysis of 15 personal interviews with holocaust survivors in Israel concerning their perceptions of similarities and differences between socially-assisted dying and the holocaust policies. The design of the study was exploratory/descriptive and asked the following questions: "Some discussions have expressed similarities between Nazi Germany and euthanasia. Do you believe the comparison is justified? In what ways are euthanasia and the holocaust similar? In what ways are they different?" Participants concluded that profound differences existed between Nazi Germany and socially assisted dying. These differences were established from four different perspectives in 10 different themes, and demonstrated by 24 different examples of the themes. Informants further cautioned philosophers about comparisons between the holocaust and other human behaviors. The survivors perceived that such a comparison has negative consequences for their own well-being, the dignity of their family members, the next generation and the Israeli society. PMID:10048777

  14. Attitudes toward euthanasia among Polish physicians, nurses and people who have no professional experience with the terminally ill.

    PubMed

    Glebocka, A; Gawor, A; Ostrowski, F

    2013-01-01

    Euthanasia is an issue that generates an extensive social debate. Euthanasia is generally classified as either active or passive. The former is usually defined as taking specific steps to cause the patient's death, while the latter is described as withdrawal of medical treatment with the deliberate intention of bringing the patient's life to an end. The dispute on euthanasia involves a multitude of aspects including religious, legal, cultural, ethical, medical, and spiritual issues. The purpose of the present study was to examine the views of medical professionals toward the highly controversial issue of euthanasia. Accordingly, the research has been conducted among a group of Polish nurses and physicians working in Intensive Care and Oncology Units. Their views have been compared to those of the control group, which included the members of the general public, who do not work in medical profession. It was expected that the education and training and the day-to-day exposure to vegetative patients might influence the views of medical personnel concerning euthanasia. The research demonstrated that the members of all groups supported liberal views. Conservative views were not popular among the respondents. The physicians turned out to be the least conservative group. The survey has also demonstrated that there is a broad consensus that informational and psychological support should be provided to terminally ill patients and their relatives. The attitude toward the passive form of euthanasia seems to have broad support. In particular doctors tend to approve this form of bringing a terminally ill patient's life to an end. The active euthanasia is regarded with much less favor and physicians, in particular, appear to disapprove of it.

  15. Effectiveness of recommended euthanasia methods in larval zebrafish (Danio rerio).

    PubMed

    Strykowski, Jennifer L; Schech, Joseph M

    2015-01-01

    The popularity of zebrafish and its use as a model organism in biomedical research including genetics, development, and toxicology, has increased over the past 20 y and continues to grow. However, guidelines for euthanasia remain vague, and the responsibility of creating appropriate euthanasia protocols essentially falls on individual facilities. To reduce variation in experimental results among labs, a standard method of euthanasia for zebrafish would be useful. Although various euthanasia methods have been compared, few studies focus on the effectiveness of euthanasia methods for larval zebrafish. In this study, we exposed larval zebrafish to each of 3 euthanasia agents (MS222, eugenol, and hypothermic shock) and assessed the recovery rate. Hypothermic shock appeared to be the most effective method for euthanizing zebrafish at 14 d after fertilization; however, this method may not be considered an efficient method for large numbers of larval zebrafish. Exposure to chemicals, such as MS222 and eugenol, were ineffective methods for euthanasia at this stage of development. When these agents are used, secondary measures should be taken to ensure death. Choosing a euthanasia method that is effective, efficient, and humane can be challenging. Determining a method of euthanasia that is suitable for fish of all stages will bring the zebrafish community closer to meeting this challenge.

  16. Anesthesia, analgesia, and euthanasia of invertebrates.

    PubMed

    Cooper, John E

    2011-01-01

    Invertebrate animals have long played an important role in biomedical research in such fields as genetics, physiology, and development. However, with few exceptions, scientists, veterinarians, and technicians have paid little attention to the anesthesia, analgesia, and euthanasia of these diverse creatures. Indeed, some standard research procedures are routinely performed without anesthesia. Yet various chemical agents are available for the immobilization or anesthesia of invertebrates, ranging from gases or volatile liquids that can be pumped into either an anesthetic chamber (for terrestrial species) or a container of water (aquatic species), to benzocaine and other substances for fish. Many invertebrates are not difficult to immobilize or anesthetize and the procedures recommended in this article appear to be safe; however, none should be considered totally risk-free. Analgesia of invertebrates is as yet a largely unexplored field; until scientific data are available, other measures can promote the well-being of these animals in the laboratory. For euthanasia, various methods (physical or chemical or a combination of both) have been recommended for different taxa of invertebrates, but most have not been properly studied under laboratory conditions and some can be problematic in the context of research procedures and tissue harvesting. Furthermore, relevant data are scattered, sometimes available only in languages other than English, and there is no international approach for seeking and collating such information. In this article I review various methods of anesthesia, analgesia, and euthanasia for terrestrial and aquatic invertebrates, as well as areas requiring further research. PMID:21709312

  17. Anesthesia, analgesia, and euthanasia of invertebrates.

    PubMed

    Cooper, John E

    2011-01-01

    Invertebrate animals have long played an important role in biomedical research in such fields as genetics, physiology, and development. However, with few exceptions, scientists, veterinarians, and technicians have paid little attention to the anesthesia, analgesia, and euthanasia of these diverse creatures. Indeed, some standard research procedures are routinely performed without anesthesia. Yet various chemical agents are available for the immobilization or anesthesia of invertebrates, ranging from gases or volatile liquids that can be pumped into either an anesthetic chamber (for terrestrial species) or a container of water (aquatic species), to benzocaine and other substances for fish. Many invertebrates are not difficult to immobilize or anesthetize and the procedures recommended in this article appear to be safe; however, none should be considered totally risk-free. Analgesia of invertebrates is as yet a largely unexplored field; until scientific data are available, other measures can promote the well-being of these animals in the laboratory. For euthanasia, various methods (physical or chemical or a combination of both) have been recommended for different taxa of invertebrates, but most have not been properly studied under laboratory conditions and some can be problematic in the context of research procedures and tissue harvesting. Furthermore, relevant data are scattered, sometimes available only in languages other than English, and there is no international approach for seeking and collating such information. In this article I review various methods of anesthesia, analgesia, and euthanasia for terrestrial and aquatic invertebrates, as well as areas requiring further research.

  18. 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.

  19. 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

  20. [The fringes of the euthanasia law].

    PubMed

    Boer, Theo A

    2015-01-01

    A survey published in the Dutch Journal of Medicine (NTvG) shows that doctors asked to assess the suffering of patients making a request for euthanasia may give very different opinions. In this paper, I argue that this stems from the subjective character of the term 'unbearable' and that differences are bound to occur even more frequently in 'borderline' cases, such as those presented here. In my opinion, such differences do not justify a plea to abandon the assessment of unbearable suffering altogether. Rather, differences in assessment may serve as indications that the boundaries of the Dutch law on euthanasia and physician-assisted suicide are within sight. Moreover, it is argued that advance directives can only be seen as euthanasia requests in a legal sense if, at the time of issue of the directive, the patient was informed about his or her diagnosis and had discussed different treatment options with the physician. Such a directive may never serve as a generic request which is valid under hypothetical conditions. PMID:25714773

  1. [The fringes of the euthanasia law].

    PubMed

    Boer, Theo A

    2015-01-01

    A survey published in the Dutch Journal of Medicine (NTvG) shows that doctors asked to assess the suffering of patients making a request for euthanasia may give very different opinions. In this paper, I argue that this stems from the subjective character of the term 'unbearable' and that differences are bound to occur even more frequently in 'borderline' cases, such as those presented here. In my opinion, such differences do not justify a plea to abandon the assessment of unbearable suffering altogether. Rather, differences in assessment may serve as indications that the boundaries of the Dutch law on euthanasia and physician-assisted suicide are within sight. Moreover, it is argued that advance directives can only be seen as euthanasia requests in a legal sense if, at the time of issue of the directive, the patient was informed about his or her diagnosis and had discussed different treatment options with the physician. Such a directive may never serve as a generic request which is valid under hypothetical conditions.

  2. 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

  3. 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.

  4. The debreather: a report on euthanasia and suicide assistance using adapted scuba technology.

    PubMed

    Ogden, Russel D

    2010-04-01

    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 data from nine cases where the debreather was used on humans, resulting in eight deaths. The covert properties of the debreather make it almost impossible for medical examiners and law enforcers to detect its use. Clandestine behavior circumvents legal forms of social control and challenges models for regulated, medicalized euthanasia and assisted suicide. The debreather compromises the ability of forensic investigators to assign an accurate cause and manner of death, and this raises implications for law enforcement, vital statistics, and research into the causes of death. The involvement of lay organizations in euthanasia and assisted suicide means that effective social policy on right-to-die issues must take into account their activities as well as those of other health professionals.

  5. 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.

  6. Electromyogram power spectrum and features of the superimposed maximal M-wave during voluntary isometric actions in humans at different activation levels.

    PubMed

    Linnamo, V; Strojnik, V; Komi, P V

    2001-11-01

    The frequency characteristics of the electromyogram (EMG) power spectrum, such as the median or the mean power frequency, as well as the duration of the muscle compound action potential response to a single supramaximal electrical stimulus (maximal M-wave) may both be related to the conduction velocity (CV) of the muscle fibre. To investigate this further, we studied in ten male subjects: the EMG of the vastus lateralis, vastus medialis and rectus femoris muscles during maximal isometric knee extensions at 40%, 60%, 80% and 100% of maximal voluntary contraction and also the maximal M-wave, elicited by a single supramaximal stimulus to the femoral nerve, of the same muscles at rest or superimposed on the same levels of voluntary contraction. The EMG was recorded during the constant force phase of the voluntary contractions, the duration of which was 2.5-4 s, with a 1.5 min pause between contractions. The average EMG (aEMG) and the median frequency (MF) were then calculated. The results indicated that as aEMG increased with increase in force, MF remained unchanged. However, while the amplitude of the M-wave was not affected, the duration of the M-wave was shorter as the force level increased. The duration of the M-wave may be affected by recruitment of faster motor units, by increased firing rate of the active units and by changes in the muscle fibre length. The shorter duration of the M-wave observed at higher force levels was not, however, accompanied by a corresponding increase in MF. The MF could not therefore be used as a parameter to reflect the changes in voluntary muscle activation and CV. When MF was calculated by overlapping the fast Fourier transform (FFT) windows (0.4 s long window moved data point by data point to the right) for 1 s periods of the isometric plateau phase at each force level, the difference between the lowest and the highest MF was quite substantial. These variations suggest that FFT window placement, i.e. which part of the signal is

  7. 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

  8. Home services or euthanasia: at the heart of the debate.

    PubMed

    Coleman, D

    1999-07-01

    Home care providers should be concerned about the mounting pressure to control health care expenditures and the reportedly growing public acceptance of assisted suicide and euthanasia. As the aging and disability communities organize politically for the expansion of flexible, consumer-driven, in-home support services, the euthanasia movement has begun to rally its forces behind accelerating death.

  9. "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)

  10. 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…

  11. 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)

  12. A Dutch perspective: the limits of lawful euthanasia.

    PubMed

    de Vries, Ubaldus

    2004-01-01

    Dutch author Ubaldus de Vries reviews the current state of the euthanasia law in the Netherlands. The legislation, enacted in 2001, creates a medical exception that allows for euthanasia in cases where patients experience "hopeless and unbearable suffering." A brief history of the Dutch approach to euthanasia is set forth, case law is reviewed, and the unique role of the doctor is examined in seeking to understand the extent of one's right to euthanasia in the Netherlands. Because the courts must determine what constitutes "hopeless and unbearable suffering," Professor de Vries analyzes the judicial interpretation of "suffering" and concludes that judicial interpretation has reached its limits, and thus by implication, the limits of lawful euthanasia have been reached.

  13. 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.

  14. Palliative sedation versus euthanasia: an ethical assessment.

    PubMed

    ten Have, Henk; Welie, Jos V M

    2014-01-01

    The aim of this article was to review the ethical debate concerning palliative sedation. Although recent guidelines articulate the differences between palliative sedation and euthanasia, the ethical controversies remain. The dominant view is that euthanasia and palliative sedation are morally distinct practices. However, ambiguous moral experiences and considerable practice variation call this view into question. When heterogeneous sedative practices are all labeled as palliative sedation, there is the risk that palliative sedation is expanded to include practices that are actually intended to bring about the patients' death. This troublesome expansion is fostered by an expansive use of the concept of intention such that this decisive ethical concept is no longer restricted to signify the aim in guiding the action. In this article, it is argued that intention should be used in a restricted way. The significance of intention is related to other ethical parameters to demarcate the practice of palliative sedation: terminality, refractory symptoms, proportionality, and separation from other end-of-life decisions. These additional parameters, although not without ethical and practical problems, together formulate a framework to ethically distinguish a more narrowly defined practice of palliative sedation from practices that are tantamount to euthanasia. Finally, the article raises the question as to what impact palliative sedation might have on the practice of palliative care itself. The increasing interest in palliative sedation may reemphasize characteristics of health care that initially encouraged the emergence of palliative care in the first place: the focus on therapy rather than care, the physical dimension rather than the whole person, the individual rather than the community, and the primacy of intervention rather than receptiveness and presence.

  15. 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

  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.

  17. 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

  18. [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.

  19. Palliative care, assisted suicide and euthanasia: nationwide questionnaire to Swedish physicians.

    PubMed

    Valverius, E; Nilstun, T; Nilsson, B

    2000-03-01

    The objective of this study was to investigate what actually happens between physicians and adult patients in difficult end-of-life situations. We circulated an anonymous questionnaire to a randomized sample of 952 Swedish physicians registered in specialties comprising care of dying adult patients, 122 palliative care physicians, and 130 physicians from the Swedish Association for the Study of Pain. Of special interest were themes in conversations between the physicians and the patients, desires expressed by the patients, and actions performed by the physicians that might affect the patients' expected survival. The overall response rate was 79%. Of these, 63% of the randomized physicians, 95% of the palliative care physicians, and 43% of the Association for the Study of Pain physicians had more than occasionally treated dying adult patients during the past year. About half of them had discussed palliative care with all their dying patients, and more than half of the physicians had heard their patients expressing a wish to die. About one-third of all the physicians had given analgesic or other drugs in such doses that some of their patients' deaths were hastened. The same proportion had also been asked for active euthanasia, while 10% had been asked to assist suicide. No case of euthanasia and only a few cases of assisted suicide were reported. By implication, the study suggests that improving patients' awareness of the possibilities to relieve pain, anxiety and dyspnoea during the final days of life is an important way to reduce requests for active euthanasia.

  20. 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

  1. Control of heart rate variability by cardiac parasympathetic nerve activity during voluntary static exercise in humans with tetraplegia.

    PubMed

    Takahashi, Makoto; Matsukawa, Kanji; Nakamoto, Tomoko; Tsuchimochi, Hirotsugu; Sakaguchi, Akihiro; Kawaguchi, Kotaro; Onari, Kiyoshi

    2007-11-01

    Heart rate (HR) is controlled solely by via cardiac parasympathetic outflow in tetraplegic individuals, who lack supraspinal control of sympathetic outflows and circulating catecholamines but have intact vagal pathways. A high-frequency component (HF; at 0.15-0.40 Hz) of the power spectrum of HR variability and its relative value against total power (HF/Total) were assessed using a wavelet transform to identify cardiac parasympathetic outflow. The relative contribution of cardiac parasympathetic and sympathetic outflows to controlling HR was estimated by comparing the HF/Total-HR relationship between age-matched tetraplegic and normal men. Six tetraplegic men with complete cervical spinal cord injury performed static arm exercise at 35% of the maximal voluntary contraction until exhaustion. Although resting cardiac output and arterial blood pressure were lower in tetraplegic than normal subjects, HR, HF, and HF/Total were not statistically different between the two groups. When tetraplegic subjects developed the same force during exercise as normal subjects, HF and HF/Total decreased to 67-90% of the preexercise control and gradually recovered 1.5 min after exercise. The amount and time course of the changes in HF/Total during and after exercise coincided well between both groups. In contrast, the increase in HR at the start of exercise was blunted in tetraplegic compared with normal subjects, and the HR recovery following exercise was also delayed. It is likely that, although the withdrawal response of cardiac parasympathetic outflow is preserved in tetraplegic subjects, sympathetic decentralization impairs the rapid acceleration of HR at the onset of exercise and the rapid deceleration following exercise. PMID:17761788

  2. 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

  3. Euthanasia, letting die and the pause.

    PubMed Central

    Gillett, G

    1988-01-01

    There is a marked disparity between medical intuitions and philosophical argument about euthanasia. In this paper I argue that the following objections can be raised. First, medical intuitions are against it and this is an area in which judgement and sensitivity are required in that death is a unique and complex process and the patient has many needs including the need to know that others have not discounted his or her worth. Also, part of the moral constitution of a good doctor is a devotion to the protection and preservation of life whatever reasons are produced to dissuade her. Finally, we do not know what the final events of a person's life might hold. PMID:3392719

  4. 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.

  5. 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)

  6. [Control of the legal practice of euthanasia in Belgium].

    PubMed

    Englert, M

    2015-01-01

    The Belgian law legalizing euthanasia under strict conditions came into effect September 22, 2002. Any physician performing euthanasia has to complete a registration document and to send it within four days to a federal commission whose mission is to verify that the legal conditions were fulfilled. From September 22, 2002 to December 31, 2013, 8.767 documents have been registered and analyzed by this commission. They are described in six reports referred to Parliament. The present paper analyzes the work of this commission and answers the criticisms concerning its quality and its efficiency. The allegations that clandestine euthanasia's escaping any control are performed are also discussed. In conclusion, it appears that the legal obligations concerning the practice of euthanasia in Belgium are fully effective.

  7. 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

  8. 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)

  9. Contributions of Health and Demographic Status to Death Anxiety and Attitudes toward Voluntary Passive Euthanasia.

    ERIC Educational Resources Information Center

    Devins, Gerald M.

    1980-01-01

    Greater death acceptance and anxiety were observed among rural as compared to urban-dwelling participants. Responses by a life-threatened geriatric subsample revealed differences in death fears related to type of medical disorder. Previous findings of no difference in the death fears of heart and cancer patients were replicated. (Author)

  10. [Interdisciplinary discussion about euthanasia--viewpoint of the clinical physicians].

    PubMed

    Briner, V

    1999-07-22

    In western cities more than 80% of deaths occur in the hospital. Thus, we should be familiar with the professional care for dying patients. However, reports of euthanasia in the Netherlands and interviews of patients in other countries demonstrate that medical care for patients with end stage diseases frequently is insufficient. The need for palliative care, which encloses medical, psychological, social and spiritual aspects of the dying becomes apparent. The physical symptoms (e.g. pain) are only one aspect of the suffering of the terminally ill. Following the WHO guidelines for use of analgesic drugs pain control is achieved in the majority of patients. Palliative care may individually tailor the treatment and care to achieve symptom control. Legalization of euthanasia will diminish the interest in practicing palliative care and may also limit the enthusiasm in research in this field as seen in the Netherlands. Data analysis report significant increase of physician-assisted suicide and euthanasia in the Netherlands within five years time from 1990 to 1995 (total: 3.7% to 4.7%, euthanasia: 1.7% to 2.4%). In addition, each year about 1000 patients were not competent at the time euthanasia was performed (euthanasia without request)! Furthermore, a patients illness did not have to be in end stage when he required euthanasia. This information should rise concern about future developments! The public enthusiasm for legalization of euthanasia in Switzerland may reflect the fear of dying and the belief that physicians and other medical professionals are not equipped to adequately care for the dying. Indeed, professional competence of palliative medicine to treat the symptoms of terminally ill patients particularly with cancer has frequently been insufficient. The majority of Swiss dying with assisted suicide (Switzerland belongs to the few countries where assisted suicide is not illegal) in 1996 and more than 80% in the Netherlands dying by euthanasia had cancer. For the

  11. 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

  12. 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)

  13. 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

  14. [Comments on the debate about euthanasia].

    PubMed

    Zwierlein, E

    1991-05-01

    On the one hand euthanasia raises the question of humane dying (1). On the other side it is connected with the question of "wrongful existence" (2). The ambiguity of the term "human/humane life" might be explained in the following way: in respect of group 1 one might say that nobody is privileged to define materially or pragmatically the one who holds the dignity of man. In consequence no one may be killed because he lacks this type of criteria. Concerning group 2: a) No one may be expected to kill an innocent, defenceless human being; and there does not exist any right of demanding such a thing. b) Everyone has the right to get medicine for lessening pain. c) In case of b) death may not be intended on purpose, but may be accepted as a side-effect of medical treatment. d) Though you can formulate a rule of thumb there will occur tragical dilemmas with regard to cases of coma. PMID:1719705

  15. 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

    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

  16. BOLD-contrast functional MRI signal changes related to intermittent rhythmic delta activity in EEG during voluntary hyperventilation-simultaneous EEG and fMRI study.

    PubMed

    Mäkiranta, Minna J; Ruohonen, Jyrki; Suominen, Kalervo; Sonkajärvi, Eila; Salomäki, Timo; Kiviniemi, Vesa; Seppänen, Tapio; Alahuhta, Seppo; Jäntti, Ville; Tervonen, Osmo

    2004-05-01

    Differences in the blood oxygen level dependent (BOLD) signal changes were studied during voluntary hyperventilation (HV) between young healthy volunteer groups, (1) with intermittent rhythmic delta activity (IRDA) (N = 4) and (2) controls (N = 4) with only diffuse arrhythmic slowing in EEG (normal response). Subjects hyperventilated (3 min) during an 8-min functional MRI in a 1.5-T scanner, with simultaneous recording of EEG (successful with N = 3 in both groups) and physiological parameters. IRDA power and average BOLD signal intensities (of selected brain regions) were calculated. Hypocapnia showed a tendency to be slightly lighter in the controls than in the IRDA group. IRDA power increased during the last minute of HV and ended 10-15 s after HV. The BOLD signal decreased in white and gray matter after the onset of HV and returned to the baseline within 2 min after HV. The BOLD signal in gray matter decreased approximately 30% more in subjects with IRDA than in controls, during the first 2 min of HV. This difference disappeared (in three subjects out of four) during IRDA in EEG. BOLD signal changes seem to depict changes, which precede IRDA. IRDA due to HV in healthy volunteers represent a model with a clearly defined EEG pattern and an observable BOLD signal change.

  17. 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

  18. 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

  19. 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

  20. Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain.

    PubMed

    Falla, D; Jull, G; Hodges, P W

    2004-07-01

    The objective of this study was to compare onset of deep and superficial cervical flexor muscle activity during rapid, unilateral arm movements between ten patients with chronic neck pain and 12 control subjects. Deep cervical flexor (DCF) electromyographic activity (EMG) was recorded with custom electrodes inserted via the nose and fixed by suction to the posterior mucosa of the oropharynx. Surface electrodes were placed over the sternocleidomastoid (SCM) and anterior scalene (AS) muscles. While standing, subjects flexed and extended the right arm in response to a visual stimulus. For the control group, activation of DCF, SCM and AS muscles occurred less than 50 ms after the onset of deltoid activity, which is consistent with feedforward control of the neck during arm flexion and extension. When subjects with a history of neck pain flexed the arm, the onsets of DCF and contralateral SCM and AS muscles were significantly delayed ( p<0.05). It is concluded that the delay in neck muscle activity associated with movement of the arm in patients with neck pain indicates a significant deficit in the automatic feedforward control of the cervical spine. As the deep cervical muscles are fundamentally important for support of the cervical lordosis and the cervical joints, change in the feedforward response may leave the cervical spine vulnerable to reactive forces from arm movement.

  1. 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.

  2. Circadian pattern of total and free corticosterone concentrations, corticosteroid-binding globulin, and physical activity in mice selectively bred for high voluntary wheel-running behavior.

    PubMed

    Malisch, Jessica L; Breuner, Creagh W; Gomes, Fernando R; Chappell, Mark A; Garland, Theodore

    2008-04-01

    In vertebrates, baseline glucocorticoid concentrations vary predictably on a diel basis, usually peaking shortly before the onset of activity. Presumably, circadian patterns in glucocorticoid secretion have evolved to match predictable rises in energetic need. In mice from lines selectively bred for high voluntary wheel-running, previous studies have reported that baseline plasma corticosterone concentrations at two different times during the photophase are elevated twofold above those of non-selected control lines. Here, we tested the hypothesis that the elevated daytime corticosterone levels could be explained by a shift in the circadian pattern of corticosterone levels. We measured baseline total plasma corticosterone levels, corticosteroid-binding globulin (CBG) capacity, and calculated free corticosterone levels (corticosterone not bound to corticosteroid-binding globulin and potentially biologically active) at six points during the 24-hour cycle in males on a 12:12 photoperiod. We also examined the daily pattern of both wheel-running and home-cage activity. Based on combined analysis of all six points, the circadian pattern of total corticosterone, corticosteroid-binding globulin, and free corticosterone levels did not significantly differ between high-runner and control mice (linetype * time interaction P=0.56, 0.45, and 0.55, respectively); however, all varied with time (all P<0.0001) and mice from the selected lines had significantly elevated total (P=0.0125) and free (P=0.0140) corticosterone, with no difference in CBG binding capacity (P=0.77). All mice were active primarily during the dark phase, and the factorial increase in activity of selected relative to controls lines was 2.33 for total daily wheel revolutions and 2.76 for total daily home-cage activity. The onset of the active period for both measures of locomotor activity coincided with peak total and free corticosterone levels in both selected and control lines. These findings lend support to

  3. 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

  4. 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

  5. 42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., and euthanasia. 9.6 Section 9.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... SYSTEM § 9.6 Animal care, well-being, husbandry, veterinary care, and euthanasia. (a) What are the... humans. The Facility Veterinarian may recommend euthanasia in those cases that do not respond to...

  6. 42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., and euthanasia. 9.6 Section 9.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... SYSTEM § 9.6 Animal care, well-being, husbandry, veterinary care, and euthanasia. (a) What are the... humans. The Facility Veterinarian may recommend euthanasia in those cases that do not respond to...

  7. 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)

  8. 42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., and euthanasia. 9.6 Section 9.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... SYSTEM § 9.6 Animal care, well-being, husbandry, veterinary care, and euthanasia. (a) What are the... humans. The Facility Veterinarian may recommend euthanasia in those cases that do not respond to...

  9. 42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., and euthanasia. 9.6 Section 9.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... SYSTEM § 9.6 Animal care, well-being, husbandry, veterinary care, and euthanasia. (a) What are the... humans. The Facility Veterinarian may recommend euthanasia in those cases that do not respond to...

  10. 42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., and euthanasia. 9.6 Section 9.6 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... SYSTEM § 9.6 Animal care, well-being, husbandry, veterinary care, and euthanasia. (a) What are the... humans. The Facility Veterinarian may recommend euthanasia in those cases that do not respond to...

  11. Use of tricaine methanesulfonate (MS222) for euthanasia of reptiles.

    PubMed

    Conroy, C J; Papenfuss, T; Parker, J; Hahn, N E

    2009-01-01

    Tricaine methanesulfonate (MS222) injected into the intracoelomic cavity of reptiles was evaluated as a chemical euthanasia method. Three western fence lizards, 2 desert iguanas, 4 garter snakes, and 6 geckos were euthanized by intracoelomic injection of 250 to 500 mg/kg of 0.7% to 1% sodium-bicarbonate-buffered MS222 solution followed by intracoelomic injection of 0.1 to 1.0 ml unbuffered 50% (v/v) MS222 solution. A simple 2-stage protocol for euthanasia of reptiles by using MS222 is outlined. In addition, the conditions for safe use of MS222 are discussed. MS222 offers an alternative to sodium pentobarbital for euthanasia of reptiles. PMID:19245747

  12. The 1942 'euthanasia' debate in the American Journal of Psychiatry.

    PubMed

    Joseph, Jay

    2005-06-01

    This paper discusses and analyses three articles appearing in a 1942 issue of the American Journal of Psychiatry. In the first, neurologist Foster Kennedy argued that 'feebleminded' people should be killed (an act which he referred to as 'euthanasia'). The rebuttal was written by psychiatrist Leo Kanner, who argued against 'euthanasia'. An unsigned editorial discussing these positions clearly sided with Kennedy: that 'euthanasia' would be appropriate in some cases, and that parents' opposition to this procedure should be the subject of psychiatric concern. The arguments are analysed and discussed within the context of eugenics and the murder of mental patients in Germany. Finally, the author points out that currently ascendant genetic theories in psychiatry could be a precursor for future proposals similar to Kennedy's.

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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.

  18. Masticatory muscle activity during maximum voluntary clench in different research diagnostic criteria for temporomandibular disorders (RDC/TMD) groups.

    PubMed

    Tartaglia, Gianluca M; Moreira Rodrigues da Silva, Marco Antonio; Bottini, Stefano; Sforza, Chiarella; Ferrario, Virgilio F

    2008-10-01

    The research diagnostic criteria for temporomandibular disorders (RDC/TMD) are used for the classification of patients with temporomandibular disorders (TMD). Surface electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 103 TMD patients subdivided according to the RDC/TMD into 3 non-overlapping groups: (a) 25 myogenous; (b) 61 arthrogenous; and (c) 17 psycogenous patients. Thirty-two control subjects matched for sex and age were also measured. During clenching, standardized total muscle activities (electromyographic potentials over time) significantly differed: 131.7 microV/muVs % in the normal subjects, 117.6 microV/microVs % in the myogenous patients, 105.3 microV/microVs % in the arthrogenous patients, 88.7 microV/microVs % in the psycogenous patients (p<0.001, analysis of covariance). Symmetry in the temporalis muscles was larger in normal subjects (86.3%) and in myogenous patients (84.9%) than in arthrogenous (82.7%), and psycogenous patients (80.5%) (p=0.041). No differences were found for masseter muscle symmetry and torque coefficient (p>0.05). Surface electromyography of the masticatory muscles allowed an objective discrimination among different RDC/TMD subgroups. This evaluation could assist conventional clinical assessments.

  19. 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

  20. Nursing and euthanasia: a review of argument-based ethics literature.

    PubMed

    Quaghebeur, Toon; Dierckx de Casterlé, Bernadette; Gastmans, Chris

    2009-07-01

    This article gives an overview of the nursing ethics arguments on euthanasia in general, and on nurses' involvement in euthanasia in particular, through an argument-based literature review. An in-depth study of these arguments in this literature will enable nurses to engage in the euthanasia debate. We critically appraised 41 publications published between January 1987 and June 2007. Nursing ethics arguments on (nurses' involvement in) euthanasia are guided primarily by the principles of respect for autonomy, nonmaleficence, beneficence and justice. Ethical arguments related to the nursing profession are described. From a care perspective, we discuss arguments that evaluate to what degree euthanasia can be considered positively or negatively as a form of good nursing care. Most arguments in the principle-, profession- and care-orientated approaches to nursing ethics are used both pro and contra euthanasia in general, and nurses' involvement in euthanasia in particular.

  1. 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

  2. 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

  3. 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

  4. 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)

  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. [Euthanasia, dysthanasia and orthothanasia: an integrative review of the literature].

    PubMed

    Felix, Zirleide Carlos; da Costa, Solange Fátima Geraldo; Alves, Adriana Marques Pereira de Melo; de Andrade, Cristiani Garrido; Duarte, Marcella Costa Souto; de Brito, Fabiana Medeiros

    2013-09-01

    There is currently widespread concern among researchers in debating questions that generate ethical conflicts within the scope of health care geared to the human being in the terminal phase, especially euthanasia, dysthanasia and orthothanasia. This study sought to characterize the scientific production at the national level on euthanasia, dysthanasia and orthothanasia. It involves an integrative review of the literature. The study universe consisted of 41 publications related to the theme in question by means of a survey conducted online in the Virtual Health Library in the Capes Portal and in the Bioethical Magazine. Of these, 25 articles comprised the sample taking into consideration the established inclusion and exclusion criteria. Data collection occurred in March 2013, by means of an instrument containing information pertinent to the proposed objective. The key words used were euthanasia, dysthanasia and orthothanasia. With respect to the focus of the publications, three themes emerged: Theme I - Euthanasia; Theme II - Dysthanasia and Theme III - Orthothanasia. The studies analyzed reflected the current concern in terms of ethical dilemmas concerning care of the human being in the end of life phase. Thus, it is hoped that this research can contribute to bolster the critical reading with respect to the theme.

  7. 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…

  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. Euthanasia of companion animals: a legal and ethical analysis.

    PubMed

    Passantino, Annamaria; Fenga, Carmela; Morciano, Cristina; Morelli, Chiara; Russo, Maria; Di Pietro, Carlotta; Passantino, Michele

    2006-01-01

    In Italy, the conditions under which euthanasia of small pets is justified are only partially regulated by law n. 281/1991, article 2 n. 6 and 9, by the later Ministry Circular n. 9 made on 10/03/1992 and by law n. 189/2004. Law n. 281/1991, besides delegating the job of birth control in cat and dog populations to the regions, has made it statutory that stray dogs may only be euthanised when they are 'seriously or incurably ill or proven to be dangerous'. The Ministry Circular underlines the fact that 'euthanasia of dogs is prohibited except in special justified cases'. On the other hand, due to the legal classification of animals as property, the owner has the right of ownership over his animal so that he can sell it and kill it (ius vitae ac necis). In this view a request for euthanasia is licit, whatever the animal's state of health may be. The authors feel that further legislation to regulate the question more completely would be opportune and thus they analyse the problems of legal-ethics and public health that a veterinarian faces when carrying out euthanasia, also bearing in mind the laws and codes of professional ethics. They suggest possible solutions which could be adopted by the competent authorities. PMID:17361075

  10. Euthanasia of companion animals: a legal and ethical analysis.

    PubMed

    Passantino, Annamaria; Fenga, Carmela; Morciano, Cristina; Morelli, Chiara; Russo, Maria; Di Pietro, Carlotta; Passantino, Michele

    2006-01-01

    In Italy, the conditions under which euthanasia of small pets is justified are only partially regulated by law n. 281/1991, article 2 n. 6 and 9, by the later Ministry Circular n. 9 made on 10/03/1992 and by law n. 189/2004. Law n. 281/1991, besides delegating the job of birth control in cat and dog populations to the regions, has made it statutory that stray dogs may only be euthanised when they are 'seriously or incurably ill or proven to be dangerous'. The Ministry Circular underlines the fact that 'euthanasia of dogs is prohibited except in special justified cases'. On the other hand, due to the legal classification of animals as property, the owner has the right of ownership over his animal so that he can sell it and kill it (ius vitae ac necis). In this view a request for euthanasia is licit, whatever the animal's state of health may be. The authors feel that further legislation to regulate the question more completely would be opportune and thus they analyse the problems of legal-ethics and public health that a veterinarian faces when carrying out euthanasia, also bearing in mind the laws and codes of professional ethics. They suggest possible solutions which could be adopted by the competent authorities.

  11. [Euthanasia, dysthanasia and orthothanasia: an integrative review of the literature].

    PubMed

    Felix, Zirleide Carlos; da Costa, Solange Fátima Geraldo; Alves, Adriana Marques Pereira de Melo; de Andrade, Cristiani Garrido; Duarte, Marcella Costa Souto; de Brito, Fabiana Medeiros

    2013-09-01

    There is currently widespread concern among researchers in debating questions that generate ethical conflicts within the scope of health care geared to the human being in the terminal phase, especially euthanasia, dysthanasia and orthothanasia. This study sought to characterize the scientific production at the national level on euthanasia, dysthanasia and orthothanasia. It involves an integrative review of the literature. The study universe consisted of 41 publications related to the theme in question by means of a survey conducted online in the Virtual Health Library in the Capes Portal and in the Bioethical Magazine. Of these, 25 articles comprised the sample taking into consideration the established inclusion and exclusion criteria. Data collection occurred in March 2013, by means of an instrument containing information pertinent to the proposed objective. The key words used were euthanasia, dysthanasia and orthothanasia. With respect to the focus of the publications, three themes emerged: Theme I - Euthanasia; Theme II - Dysthanasia and Theme III - Orthothanasia. The studies analyzed reflected the current concern in terms of ethical dilemmas concerning care of the human being in the end of life phase. Thus, it is hoped that this research can contribute to bolster the critical reading with respect to the theme. PMID:23989581

  12. 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.

  13. 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

  14. 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

  15. 75 FR 57477 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Services Research and Patient Safety (CHRP) Patient Safety Organization (PSO). The Patient Safety and... PSOs, which are entities or component organizations whose mission and primary activity is to...

  16. Awareness and Attitude of Select Professionals toward Euthanasia in Delhi, India

    PubMed Central

    Singh, Sheetal; Gupta, Shakti; Singh, IB; Madaan, Nirupam

    2016-01-01

    Introduction: The topic of euthanasia has induced differences not only among professionals in the medical fraternity but also in other fields as well. The dying process is being lengthened by the new state of art technologies erupting as such higher pace, and it is at the expense of standard quality of life and of a gracious death. Aim: To study the awareness and attitude toward euthanasia among select professionals in Delhi. Methodology: It was a questionnaire-based descriptive cross-sectional study. The study population included doctors, nurses, judges, lawyers, journalist, and social activists of Delhi. Tool included a sociodemographic questionnaire, two questions to know awareness regarding euthanasia and a modified euthanasia attitude scale used to measure attitude toward euthanasia. Data were analyzed using Stata 11.2. Results: Through our study, it is evident that professionals who participated in the study (judges, advocates, doctors, nurses, journalists, and social activists) in Delhi were familiar with the term euthanasia. No significant difference was seen in the attitude of professionals of different age group and sex toward euthanasia. Conclusion: Through this study, it is found that judiciary group most strongly endorsed euthanasia. The attitude of doctors was elicited from mixed group with doctors belonging to different specialties. Oncologists are not in favor of any form of euthanasia. However, doctors from other specialties did support euthanasia. PMID:27803572

  17. Comparison of carbon dioxide and argon euthanasia: effects on behavior, heart rate, and respiratory lesions in rats.

    PubMed

    Burkholder, Tanya H; Niel, Lee; Weed, James L; Brinster, Lauren R; Bacher, John D; Foltz, Charmaine J

    2010-07-01

    In this study we compared rat (n = 16) responses to euthanasia with either gradual-fill CO(2) or rapid induction argon gas by evaluating the animals' heart rate via radiotelemetry, behavior, and vocalizations. We also evaluated the histologic effects of the gases. Rats were placed in an open test chamber 24 h before the start of the experiment. During baseline tests, rats were exposed to oxygen to evaluate the effects of the noise and movement of gas entering the chamber; 1 wk later, rats were euthanized by gas displacement with either 10%/min CO(2) or 50%/min argon gas. Rats tended to have higher heart rats and were more active during the baseline test, but these parameters were normal before the euthanasia experiment, suggesting that the rats had acclimated to the equipment. Heart rate, behavior, and ultrasonic vocalizations were recorded for 2 min after gas introduction in both groups. All rats appeared conscious throughout the test interval. The heart rates of rats exposed to argon did not change, whereas those of rats exposed to CO(2) declined significantly. Unlike those exposed to CO(2), rats euthanized with argon gas gasped and demonstrated seizure-like activity. There were no differences in the pulmonary lesions resulting from death by either gas. Our results suggest that argon as a sole euthanasia agent is aversive to rats. CO(2) using a 10%/min displacement may be less aversive than more rapid displacements. Future research investigating methods of euthanasia should allow sufficient time for the rats to acclimate to the test apparatus.

  18. Comparison of carbon dioxide and argon euthanasia: effects on behavior, heart rate, and respiratory lesions in rats.

    PubMed

    Burkholder, Tanya H; Niel, Lee; Weed, James L; Brinster, Lauren R; Bacher, John D; Foltz, Charmaine J

    2010-07-01

    In this study we compared rat (n = 16) responses to euthanasia with either gradual-fill CO(2) or rapid induction argon gas by evaluating the animals' heart rate via radiotelemetry, behavior, and vocalizations. We also evaluated the histologic effects of the gases. Rats were placed in an open test chamber 24 h before the start of the experiment. During baseline tests, rats were exposed to oxygen to evaluate the effects of the noise and movement of gas entering the chamber; 1 wk later, rats were euthanized by gas displacement with either 10%/min CO(2) or 50%/min argon gas. Rats tended to have higher heart rats and were more active during the baseline test, but these parameters were normal before the euthanasia experiment, suggesting that the rats had acclimated to the equipment. Heart rate, behavior, and ultrasonic vocalizations were recorded for 2 min after gas introduction in both groups. All rats appeared conscious throughout the test interval. The heart rates of rats exposed to argon did not change, whereas those of rats exposed to CO(2) declined significantly. Unlike those exposed to CO(2), rats euthanized with argon gas gasped and demonstrated seizure-like activity. There were no differences in the pulmonary lesions resulting from death by either gas. Our results suggest that argon as a sole euthanasia agent is aversive to rats. CO(2) using a 10%/min displacement may be less aversive than more rapid displacements. Future research investigating methods of euthanasia should allow sufficient time for the rats to acclimate to the test apparatus. PMID:20819391

  19. 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

  20. 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…

  1. 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…

  2. 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.

  3. Attitudes toward palliative care, conceptions of euthanasia and opinions about its legalization among French physicians.

    PubMed

    Peretti-Watel, P; Bendiane, M K; Moatti, J P

    2005-04-01

    We assume that actors of the professionalization process of palliative care make a special effort to demarcate it from euthanasia, and that such an effort has a significant impact on beliefs and attitudes toward euthanasia among the whole medical profession. We investigated concurrently attitudes toward palliative care, conceptions of euthanasia and opinion toward its legalization among a sample of 883 French general practitioners, oncologists and neurologists. We found four contrasted profiles of attitudes toward palliative care, which were closely correlated with being in touch with palliative care providers. Attitudes toward palliative care were closely correlated with beliefs about which medical practices should be labelled euthanasia, and these beliefs were in turn strongly associated with opinions toward euthanasia legalization. Our results suggest that the relationship between palliative care and euthanasia mixes semantic and strategic aspects, beyond cognitive and conative ones. PMID:15686809

  4. The evolution of euthanasia and its perceptions in Greek culture and civilization.

    PubMed

    Mystakidou, Kyriaki; Parpa, Efi; Tsilika, Eleni; Katsouda, Emmanuela; Vlahos, Lambros

    2005-01-01

    Death has preoccupied humanity since before the dawn of civilization. As a multidimensional and moral problem, the end of life has concerned different civilizations, and different approaches to euthanasia, or "good death," have been developed in each culture. In Greece, there is a long record of the culture's evolving attitudes toward death and euthanasia.A more widespread knowledge of the views and traditions surrounding the act of euthanasia can contribute to a better understanding of the controversies surrounding modern attitudes and practice.

  5. [Conversations on the "good death": the bioethical debate on euthanasia].

    PubMed

    Siqueira-Batista, Rodrigo; Schramm, Fermin Roland

    2005-01-01

    Despite extensive current debate on euthanasia, many open and apparently unsolvable issues persist, awaiting a better conceptual treatment. The area includes "prejudices and fundamentalisms" in relation to the theme, still viewed as taboo by a major share of society, specifically in the case of Brazil, while semantic imprecision in the term and argumentative tensions surround the issue, focusing on the principles of sacredness of life, quality of life, and autonomy and the so-called "slippery slope" argument. The purpose of the current essay is thus to serve as a sphere of inquiry concerning euthanasia, moving from historical antecedents towards a better solution to the problem and the demarcation of necessary future perspectives for enhanced understanding of the issue. PMID:15692644

  6. Beyond regulations: industry voluntary ban in arsenic use.

    PubMed

    Hsueh, Lily

    2013-12-15

    Firms play a key role in pollution abatement and control by engaging in beyond-compliance actions without the force of law in voluntary programs. This study examines the effectiveness of a bilateral voluntary agreement, one type of voluntary programs, negotiated between the U.S. Environmental Protection Agency (EPA) and the pressure-treated wood industry to phase-out the use of chromated copper arsenate (CCA), a poisonous arsenic compound. Arsenic is ranked number one on the EPA's priority list of hazardous substances. Unlike a majority of earlier studies on voluntary programs, dynamic panel estimation and structural break analysis show that while a technological innovation in semiconductors is associated with arsenic use increases, the CCA voluntary agreement is associated with a reduction in arsenic use to levels not seen since the 1920s. A voluntary ban in arsenic acid by pesticide manufacturers in the agriculture sector has also contributed to arsenic reductions. Furthermore, the results suggest that environmental activism has played a role in curbing arsenic use. Increasing stakeholder pressures, as measured by membership in the Sierra Club, improves voluntary agreement effectiveness.

  7. Operant variability and voluntary action.

    PubMed

    Neuringer, Allen; Jensen, Greg

    2010-07-01

    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 of the voluntary act. The present article focuses on the second characteristic: a similar bidirectional relationship between reinforcement and the predictability/unpredictability of voluntary acts. Support for the theory comes from 2 areas of research. The first shows that levels of behavioral variability-from highly predictable to randomlike-are directly influenced by reinforcers. Put another way, variability is an operant dimension, analogous to response rate and force. The second source of support comes from psychophysical experiments in which human participants judged the degree to which "choices" by virtual actors on a computer screen appeared to be voluntary. The choices were intermittently reinforced according to concurrently operating schedules. The actors' behaviors appeared to most closely approximate voluntary human choices when response distributions matched reinforcer distributions (an indication of functionality) and when levels of variability, from repetitive to random, changed with reinforcement contingencies. Thus, voluntary acts are characterized by reinforcement-controlled functionality and unpredictability.

  8. Operant variability and voluntary action.

    PubMed

    Neuringer, Allen; Jensen, Greg

    2010-07-01

    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 of the voluntary act. The present article focuses on the second characteristic: a similar bidirectional relationship between reinforcement and the predictability/unpredictability of voluntary acts. Support for the theory comes from 2 areas of research. The first shows that levels of behavioral variability-from highly predictable to randomlike-are directly influenced by reinforcers. Put another way, variability is an operant dimension, analogous to response rate and force. The second source of support comes from psychophysical experiments in which human participants judged the degree to which "choices" by virtual actors on a computer screen appeared to be voluntary. The choices were intermittently reinforced according to concurrently operating schedules. The actors' behaviors appeared to most closely approximate voluntary human choices when response distributions matched reinforcer distributions (an indication of functionality) and when levels of variability, from repetitive to random, changed with reinforcement contingencies. Thus, voluntary acts are characterized by reinforcement-controlled functionality and unpredictability. PMID:20658860

  9. 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

  10. A comparison of attitudes toward euthanasia among medical students at two Polish universities.

    PubMed

    Leppert, Wojciech; Gottwald, Leszek; Majkowicz, Mikolaj; Kazmierczak-Lukaszewicz, Sylwia; Forycka, Maria; Cialkowska-Rysz, Aleksandra; Kotlinska-Lemieszek, Aleksandra

    2013-06-01

    The aim of the study conducted upon completion of obligatory palliative medicine courses among 588 medical students at two universities was to compare their attitudes toward euthanasia. Four hundred ninety-two (84.97 %) students were Catholics; 69 (11.73 %) declared they would practice euthanasia, 303 (51.53 %) would not, and 216 students (36.73 %) were not sure. The idea of euthanasia legalisation was supported by 174 (29.59 %) respondents, opposed by 277 (47.11 %), and 137 (23.30 %) were undecided. Five hundred fifty-six (94.56 %) students did not change their attitudes toward euthanasia after palliative medicine courses. Students from the two universities were found to have different opinions on practicing euthanasia, euthanasia law and possible abuse which might follow euthanasia legalisation, but they shared similar views on the choice of euthanasia if they themselves were incurably ill and the legalisation of euthanasia. Gender and religion influenced students' answers. Differences observed between medical students at the two universities might be related to gender and cultural differences.

  11. Experience with euthanasia is associated with fearlessness about death in veterinary students.

    PubMed

    Witte, Tracy K; Correia, Christopher J; Angarano, Donna

    2013-04-01

    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 experience with euthanasia and fearlessness about death, due to emotional habituation to the process of euthanasia. In a sample of 130 veterinary students, results conformed to expectation and indicated that the relationship with fearlessness about death was specific to euthanasia and did not generalize to experience with surgery or necropsy.

  12. Moral differences in deep continuous palliative sedation and euthanasia.

    PubMed

    Juth, Niklas; Lindblad, Anna; Lynöe, Niels; Sjöstrand, Manne; Helgesson, Gert

    2013-06-01

    In palliative care there is much debate about which end of life treatment strategies are legitimate and which are not. Some writers argue that there is an important moral dividing-line between palliative sedation and euthanasia, making the first acceptable and the latter not. We have questioned this. In a recent article, Lars Johan Materstvedt has argued that we are wrong on two accounts: first, that we fail to account properly for the moral difference between continuous deep palliative sedation at the end of life and euthanasia, and, second, that we fail to account properly for the difference between permanent loss of consciousness and death. Regarding the first objection, we argue that Materstvedt misses the point: we agree that there is a difference in terms of intentions between continuous deep palliative sedation and euthanasia, but we question whether this conceptual difference makes up for a moral difference. Materstvedt fails to show that it does. Regarding the second objection, we argue that if nothing else is at stake than the value of the patient's life, permanent unconsciousness and death are morally indifferent.

  13. On euthanasia: blindspots in the argument from mercy.

    PubMed

    Bachelard, Sarah

    2002-01-01

    In the euthanasia debate, the argument from mercy holds that if someone is in unbearable pain and is hopelessly ill or injured, then mercy dictates that inflicting death may be morally justified. One common way of setting the stage for the argument from mercy is to draw parallels between human and animal suffering, and to suggest that insofar as we are prepared to relieve an animal's suffering by putting it out of its misery we should likewise be prepared to offer the same relief to human beings. In this paper, I will argue that the use of parallels between human and animal suffering in the argument from mercy relies upon truncated views of how the concept of a human being enters our moral thought and responsiveness. In particular, the focus on the nature and extent of the empirical similarities between human beings and animals obscures the significance for our moral lives of the kind of human fellowship which is not reducible to the shared possession of empirical capacities. I will suggest that although a critical examination of the blindspots in these arguments does not license the conclusion that euthanasia for mercy's sake is never morally permissible, it does limit the power of arguments such as those provided by Rachels and Singer to justify it. I will further suggest that examination of these blindspots helps to deepen our understanding of what is at stake in the question of euthanasia in ways that tend otherwise to remain obscured.

  14. Evaluation of Carbon Dioxide Dissipation within a Euthanasia Chamber

    PubMed Central

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

    2014-01-01

    CO2 euthanasia is used widely for small laboratory animals, such as rodents. A common necessity in many animal research facilities is to euthanize mice in sequential batches. We assessed the effects of several variables on the time it took for CO2 to dissipate within a chamber. Using standard euthanasia time, changes in flow rate were compared between a slow 15% fill rate for 7 min, and a slow 15% followed by a rapid 50% filling for a total of 5 min. Additional variables assessed included the effects of opening the lid after the completion of chamber filling, turning the chamber over after completion of filling, and the use and removal of a cage from within the chamber. For all trials, CO2 levels in the chambers peaked between 50% and 80%. After the gas was turned off, the concentration of CO2 dropped to below 10% CO2 within 2 min, except when the lid was left on the chamber, where concentration levels remained above 10% after 20 min. CO2 dissipation was significantly faster when the chamber was turned upside down after filling. Significant interaction effects occurred among the factors of cage presence within the chamber, flow rate, and chamber position. Only leaving the lid on the chamber had any practical implication for delaying CO2 dissipation. We recommend that users allow 2 min for CO2 to clear from the chamber before subsequent euthanasia procedures, unless the chamber is manipulated to increase the dissipation rate. PMID:25199098

  15. 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

  16. Death education and attitudes toward euthanasia and terminal illness.

    PubMed

    Nagi, M H; Lazerine, N G

    1982-01-01

    The attitudes of a random sample of Cleveland clergy toward the experience of terminal illness and the circumstances justifying euthanasia are presented and analyzed. The clergy response patterns revealed that, although eager to prolong life as long as possible, terminally ill patients fear a prolonged period of illness more than death itself. They also agreed that most patients favor the disclosure of terminal illness. The clergy's response to a questionnaire exhibited a definite ranking (i.e., scaling) in the order of priority of the different circumstances justifying passive euthanasia. Using training in death counseling as a control variable produced sharper division in the response categories for each statement. The controversial nature of euthanasia and the problem of ascertaining the psychological needs of the terminally ill became more apparent with the group who had more training in death counseling. Interpretations of the findings are presented, and a need for a careful reexamination of the effects of death education on attitudes toward controversial subjects in death and dying is stressed.

  17. Dutch nurses' attitudes towards euthanasia and physician-assisted suicide.

    PubMed

    van Bruchem-van de Scheur, Ada; van der Arend, Arie; van Wijmen, Frans; Abu-Saad, Huda Huijer; ter Meulen, Ruud

    2008-03-01

    This article presents the attitudes of nurses towards three issues concerning their role in euthanasia and physician-assisted suicide. A questionnaire survey was conducted with 1509 nurses who were employed in hospitals, home care organizations and nursing homes. The study was conducted in the Netherlands between January 2001 and August 2004. The results show that less than half (45%) of nurses would be willing to serve on committees reviewing cases of euthanasia and physician-assisted suicide. More than half of the nurses (58.2%) found it too far-reaching to oblige physicians to consult a nurse in the decision-making process. The majority of the nurses stated that preparing euthanatics (62.9%) and inserting an infusion needle to administer the euthanatics (54.1%) should not be accepted as nursing tasks. The findings are discussed in the context of common practices and policies in the Netherlands, and a recommendation is made not to include these three issues in new regulations on the role of nurses in euthanasia and physician-assisted suicide.

  18. 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.

  19. 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)

  20. 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

  1. 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

  2. Euthanasia and assisted suicide: facts, figures and fancies with special regard to old age.

    PubMed

    Muller, M T; Kimsma, G K; van der Wal, G

    1998-09-01

    The objective of this paper is to describe the ethics and incidence of euthanasia and physician-assisted suicide (EAS) with special regard to old age. It is based on an assumption that if and when a practice of euthanasia and EAS is allowed, several vulnerable groups, including the elderly, may become a 'population at risk'. We describe some of these claims, and make an inventory of the arguments against a permissive policy concerning euthanasia and EAS which emphasise inherent dangers for the elderly. We then give an overview of the results of empirical studies about incidence of (request for) euthanasia and assisted suicide in the Netherlands, Australia, the UK, the US, Denmark and Norway. These results confirm that practitioners do receive requests for EAS and that EAS is performed in all these countries. However, there are large differences between these countries with regard to the numbers of requests and performances. Dutch findings concerning the age distribution of patients who received euthanasia or assisted suicide indicate that these procedures are rare in the elderly and in nursing homes. We conclude that, although euthanasia and assisted suicide are illegal, there is evidence that these practices occur in all countries studied. Most surveys on the incidence of euthanasia show lower figures than those in the Netherlands. Dutch studies do not provide any evidence for the elderly being in danger of becoming 'victims' of euthanasia or assisted suicide. PMID:9789722

  3. 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…

  4. 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.

  5. Expressed wishes and incidence of euthanasia in advanced lung cancer patients.

    PubMed

    Pardon, Koen; Deschepper, Reginald; Vander Stichele, Robert; Bernheim, Jan L; Mortier, Freddy; Schallier, Denis; Germonpré, Paul; Galdermans, Daniella; Van Kerckhoven, Willem; Deliens, Luc

    2012-10-01

    This study explores expressed wishes and requests for euthanasia (i.e. administration of lethal drugs at the explicit request of the patient), and incidence of end-of-life decisions with possible life-shortening effects (ELDs) in advanced lung cancer patients in Flanders, Belgium. We performed a prospective, longitudinal, observational study of a consecutive sample of advanced lung cancer patients and selected those who died within 18 months of diagnosis. Immediately after death, the pulmonologist/oncologist and general practitioner (GP) of the patient filled in a questionnaire. Information was available for 105 out of 115 deaths. According to the specialist or GP, one in five patients had expressed a wish for euthanasia; and three in four of these had made an explicit and repeated request. One in two of these received euthanasia. Of the patients who had expressed a wish for euthanasia but had not made an explicit and repeated request, none received euthanasia. Patients with a palliative treatment goal at inclusion were more likely to receive euthanasia. Death was preceded by an ELD in 62.9% of patients. To conclude, advanced lung cancer patients who expressed a euthanasia wish were often determined. Euthanasia was performed significantly more among patients whose treatment goal after diagnosis was exclusively palliative.

  6. 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…

  7. [National socialist "children's euthanasia" program in the province of Westphalia (1940-1945)].

    PubMed

    Walter, B

    2001-03-01

    As part of the organization structure of the "Reich committee for scientifically registering genetic and inherent serious illnesses" "childrens' special wards" were established in the province Westphalia in the child-psychiatry St. Johannesstift in Niedermarsberg (end of 1940), and then in the Provinzialheilanstalt Aplerbeck (end of 1941). The establishment thereof and personnel recruiting were done in close operation with provincial authorities. In Niedermarsberg external nurses were also employed. When the activities in the Marsberger ward became public despite efforts to keep them secret, the provincial association felt forced to establish a replacement ward in Dortmund-Aplerbeck. This ward was integrated stronger into the hospital-internal and regional care structures regarding personnel and institutional aspects than the previous ward. The actions of "child euthanasia" were based on a combination of hierarchical decision-making structures, limited responsibility, and scientific justification. The people performing these activities were provided action options withdrawal possibilities. For the affected parents the events were shifted into a psychological grey area which did not force decisions in principle. The internal conditions of the "childrens' special wards", the procedures and the "treatments" of the children were clearly regulated; the "euthanasia" activities themselves can be comprehended only in fragments from testimonies. By analyzing the reception books in connection with the medical files it is possible to make statements regarding the number of deaths, the death rate and cause, and also several social characteristics of the children. The fate of the children in the Westphalian "childrens' special wards" shows that the work in these regional "Reich committee wards" was limited to caring, observing, selecting and killing. The attempts of scientific justification are exposed as cover-ups.

  8. Euthanasia and international human rights law: prolegomena for an international debate.

    PubMed

    Van den Akker, B; Janssens, R M; Ten Have, H A

    1997-10-01

    In this paper we examine in what respects international human rights law can provide a basis for the establishment of an international debate on euthanasia. Such a debate seems imperative, as in many countries euthanasia is considered taboo in the context of medical practice, yet at the same time, supposedly, decisions are taken to intentionally shorten patients' lives. In the Netherlands, the act of euthanasia will not lead to the prosecution of the physician involved if the physician has complied with certain procedures. The Dutch debate centres on procedures marginalizing important moral aspects of euthanasia. An international debate, addressing the fundamental morality of euthanasia and of other medical decisions involving the end of life, will eventually enhance medical practice in the Netherlands as well as in other countries.

  9. 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

  10. News media coverage of euthanasia: a content analysis of Dutch national newspapers

    PubMed Central

    2013-01-01

    Background The Netherlands is one of the few countries where euthanasia is legal under strict conditions. This study investigates whether Dutch newspaper articles use the term ‘euthanasia’ according to the legal definition and determines what arguments for and against euthanasia they contain. Methods We did an electronic search of seven Dutch national newspapers between January 2009 and May 2010 and conducted a content analysis. Results Of the 284 articles containing the term ‘euthanasia’, 24% referred to practices outside the scope of the law, mostly relating to the forgoing of life-prolonging treatments and assistance in suicide by others than physicians. Of the articles with euthanasia as the main topic, 36% described euthanasia in the context of a terminally ill patient, 24% for older persons, 16% for persons with dementia, and 9% for persons with a psychiatric disorder. The most frequent arguments for euthanasia included the importance of self-determination and the fact that euthanasia contributes to a good death. The most frequent arguments opposing euthanasia were that suffering should instead be alleviated by better care, that providing euthanasia can be disturbing, and that society should protect the vulnerable. Conclusions Of the newspaper articles, 24% uses the term ‘euthanasia’ for practices that are outside the scope of the euthanasia law. Typically, the more unusual cases are discussed. This might lead to misunderstandings between citizens and physicians. Despite the Dutch legalisation of euthanasia, the debate about its acceptability and boundaries is ongoing and both sides of the debate are clearly represented. PMID:23497284

  11. 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

  12. Cultural differences affecting euthanasia practice in Belgium: one law but different attitudes and practices in Flanders and Wallonia.

    PubMed

    Cohen, Joachim; Van Wesemael, Yanna; Smets, Tinne; Bilsen, Johan; Deliens, Luc

    2012-09-01

    Since 2002, Belgium has had a national law legalising euthanasia. The law prescribes several substantive due care requirements and two procedural due care requirements, i.e. consultation with an independent physician and reporting of euthanasia to a Federal Control Committee. A large discrepancy in reporting rates between the Dutch-speaking (Flanders) and the French-speaking (Wallonia) parts of Belgium has led to speculation about cultural differences affecting the practice of euthanasia in both regions. Using Belgian data from the European Values Study conducted in 2008 among a representative sample of the general public and data from a large-scale mail questionnaire survey on euthanasia of 480 physicians from Flanders and 305 from Wallonia (conducted in 2009), this study presents empirical evidence of differences between both regions in attitudes towards and practice of euthanasia. Acceptance of euthanasia by the general population was found to be slightly higher in Flanders than in Wallonia. Compared with their Flemish counterparts, Walloon physicians held more negative attitudes towards performing euthanasia and towards the reporting obligation, less often labelled hypothetical cases correctly as euthanasia, and less often defined a case of euthanasia having to be reported. A higher proportion of Flemish physicians had received a euthanasia request since the introduction of the law. In cases of a euthanasia request, Walloon physicians consulted less often with an independent physician. Requests were more often granted in Flanders than in Wallonia (51% vs 38%), and performed euthanasia cases were more often reported (73% vs 58%). The study points out some significant differences between Flanders and Wallonia in practice, knowledge and attitudes regarding euthanasia and its legal requirements which are likely to explain the discrepancy between Wallonia and Flanders in the number of euthanasia cases reported. Cultural factors seem to play an important role in the

  13. 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

  14. 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

  15. Paul Braune confronts the National Socialists' "euthanasia" program.

    PubMed

    Walters, LeRoy

    2007-01-01

    On July 9, 1940, asylum director Paul Braune completed a twelve-page memorandum, or Denkschrift, on the National Socialists' T-4 "euthanasia" program. The memorandum identified three killing centers within a carefully planned, Reich-wide program and summarized what Braune's research had uncovered about the fate of asylum patients at various T-4 facilities. Braune estimated that several thousand disabled people had been murdered between February and June 1940. After Protestant church leaders formally submitted Braune's memorandum to the Reich Chancellery, Braune was arrested by the Gestapo-pursuant to a direct order by Reinhard Heydrich-for having "sabotaged measures of the state in an irresponsible way." Despite Braune's protest, the killing of German asylum patients continued unabated. This article shows what a determined German citizen, assisted by an extensive network of information sources, was able to learn about the "euthanasia" program during the first six months of its implementation, and reveals the formidable difficulties that opponents of the program faced in their efforts to stop the killing of disabled people. PMID:20795289

  16. Paul Braune confronts the National Socialists' "euthanasia" program.

    PubMed

    Walters, LeRoy

    2007-01-01

    On July 9, 1940, asylum director Paul Braune completed a twelve-page memorandum, or Denkschrift, on the National Socialists' T-4 "euthanasia" program. The memorandum identified three killing centers within a carefully planned, Reich-wide program and summarized what Braune's research had uncovered about the fate of asylum patients at various T-4 facilities. Braune estimated that several thousand disabled people had been murdered between February and June 1940. After Protestant church leaders formally submitted Braune's memorandum to the Reich Chancellery, Braune was arrested by the Gestapo-pursuant to a direct order by Reinhard Heydrich-for having "sabotaged measures of the state in an irresponsible way." Despite Braune's protest, the killing of German asylum patients continued unabated. This article shows what a determined German citizen, assisted by an extensive network of information sources, was able to learn about the "euthanasia" program during the first six months of its implementation, and reveals the formidable difficulties that opponents of the program faced in their efforts to stop the killing of disabled people.

  17. 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

  18. Evaluation of the aesthetics of physical methods of euthanasia of anesthetized rats.

    PubMed

    Hickman, Debra L; Johnson, Steven W

    2011-09-01

    Dissection of living brain tissue for in vitro experiments requires the use of a rapid euthanasia method. However, the method must not subject animals to unnecessary pain and must be aesthetically acceptable to experimenters. The purposes of the current study were to assess the aesthetics of 6 euthanasia methods, measure the procedure duration, and evaluate brain for pathology after each procedure. We digitally recorded euthanasia of isoflurane-anesthetized rats by 6 physical methods: anesthetic overdose, cardiac exsanguination, decapitation, closed intrathoracic transection of the great vessels and heart, thoracic percussion, and thoracotomy with rupture of great vessels. Volunteer researchers and animal caretakers watched the video and completed an associated questionnaire. Anesthetic overdose and cardiac exsanguinations were rated most aesthetically pleasing, although these procedures took the longest to complete. In contrast, decapitation and thoracic percussion were the least aesthetically pleasing, but these methods were the quickest. No demographic factor was identified that could predict whether a given euthanasia procedure would be favored for aesthetic reasons, and participants provided a wide variety of rationales for the aesthetic ratings they assigned. Although all of these euthanasia methods meet the criteria of approved methods of euthanasia of anesthetized rats as defined by the AVMA, aesthetic features and the scientific need for rapid euthanasia are both considerations in selecting a method.

  19. Descriptions of euthanasia as social representations: comparing the views of Finnish physicians and religious professionals.

    PubMed

    Jylhänkangas, Leila; Smets, Tinne; Cohen, Joachim; Utriainen, Terhi; Deliens, Luc

    2014-03-01

    In many western societies health professionals play a powerful role in people's experiences of dying. Religious professionals, such as pastors, are also confronted with the issues surrounding death and dying in their work. It is therefore reasonable to assume that the ways in which death-related topics, such as euthanasia, are constructed in a given culture are affected by the views of these professionals. This qualitative study addresses the ways in which Finnish physicians and religious professionals perceive and describe euthanasia and conceptualises these descriptions and views as social representations. Almost all the physicians interviewed saw that euthanasia does not fit the role of a physician and anchored it to different kinds of risks such as the slippery slope. Most of the religious and world-view professionals also rejected euthanasia. In this group, euthanasia was rejected on the basis of a religious moral code that forbids killing. Only one of the religious professionals - the freethinker with an atheist world-view - accepted euthanasia and described it as a personal choice, as did the one physician interviewed who accepted it. The article shows how the social representations of euthanasia are used to protect professional identities and to justify their expert knowledge of death and dying.

  20. "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

  1. 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.

  2. 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...

  3. 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...

  4. 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...

  5. 75 FR 63498 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

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

  6. 75 FR 57281 - Patient Safety Organizations: Voluntary delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-20

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

  7. 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…

  8. 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.

  9. 31 CFR 1027.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Money Laundering and Terrorist Activity § 1027.540 Voluntary information sharing among financial... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Voluntary information sharing among financial institutions. 1027.540 Section 1027.540 Money and Finance: Treasury Regulations Relating to...

  10. 31 CFR 1026.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... To Deter Money Laundering and Terrorist Activity § 1026.540 Voluntary information sharing among... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Voluntary information sharing among financial institutions. 1026.540 Section 1026.540 Money and Finance: Treasury Regulations Relating to...

  11. 31 CFR 1026.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... To Deter Money Laundering and Terrorist Activity § 1026.540 Voluntary information sharing among... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Voluntary information sharing among financial institutions. 1026.540 Section 1026.540 Money and Finance: Treasury Regulations Relating to...

  12. 31 CFR 1026.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... To Deter Money Laundering and Terrorist Activity § 1026.540 Voluntary information sharing among... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Voluntary information sharing among financial institutions. 1026.540 Section 1026.540 Money and Finance: Treasury Regulations Relating to...

  13. 31 CFR 1027.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Money Laundering and Terrorist Activity § 1027.540 Voluntary information sharing among financial... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Voluntary information sharing among financial institutions. 1027.540 Section 1027.540 Money and Finance: Treasury Regulations Relating to...

  14. 31 CFR 1027.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Money Laundering and Terrorist Activity § 1027.540 Voluntary information sharing among financial... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Voluntary information sharing among financial institutions. 1027.540 Section 1027.540 Money and Finance: Treasury Regulations Relating to...

  15. 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.

  16. [Euthanasia and physician assisted suicide: what is the problem?].

    PubMed

    Álvarez-Del Río, Asunción

    2014-01-01

    Some persons with refractory and unbearable suffering caused by an illness or medical condition wish to die by euthanasia or physician assisted suicide in order to have a certain and painless death. Physicians who agree to help a patient to die have previously confirmed that his/her illness cannot be cured, his/her suffering cannot be relieved and he/ she is of sound mind. Being well informed of his/her condition, the patient arrives to the conclusion that in his/her situation being death is better that being alive. How to explain that there are very few places in which physicians are allowed to help their patients to die? The main arguments against legalizing physician-assisted death are analyzed in this article.

  17. [Euthanasia and physician assisted suicide: what is the problem?].

    PubMed

    Álvarez-Del Río, Asunción

    2014-01-01

    Some persons with refractory and unbearable suffering caused by an illness or medical condition wish to die by euthanasia or physician assisted suicide in order to have a certain and painless death. Physicians who agree to help a patient to die have previously confirmed that his/her illness cannot be cured, his/her suffering cannot be relieved and he/ she is of sound mind. Being well informed of his/her condition, the patient arrives to the conclusion that in his/her situation being death is better that being alive. How to explain that there are very few places in which physicians are allowed to help their patients to die? The main arguments against legalizing physician-assisted death are analyzed in this article. PMID:25695246

  18. 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.

  19. 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

  20. 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'.

  1. Dutch perspectives on the British Medical Association's critique of euthanasia in the Netherlands.

    PubMed

    Cohen-Almagor, R

    2001-01-01

    During the summer of 1999, extensive interviews with some of the leading authorities on the euthanasia policy were conducted in the Netherlands. They were asked: The British Medical Association, in its memorandum before the House of Lords, held that in regard to Holland, "all seem to agree that the so-called rules of careful conduct (official guidelines for euthanasia) are disregarded in some cases. Breaches of rules range from the practice of involuntary euthanasia to failure to consult another practitioner before carrying out euthanasia and to certifying the cause of death as natural". What do you think? Most of the interviewees conceded that this assertion is, indeed, correct. Two interviewees didn't pay much notice to the issue and three others said that the British critique is both true and untrue. PMID:11817393

  2. 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.

  3. The voluntary control of facial action units in adults.

    PubMed

    Gosselin, Pierre; Perron, Mélanie; Beaupré, Martin

    2010-04-01

    We investigated adults' voluntary control of 20 facial action units theoretically associated with 6 basic emotions (happiness, fear, anger, surprise, sadness, and disgust). Twenty young adults were shown video excerpts of facial action units and asked to reproduce them as accurately as possible. Facial Action Coding System (FACS; Ekman & Friesen, 1978a) coding of the facial productions showed that young adults succeeded in activating 18 of the 20 target actions units, although they often coactivated other action units. Voluntary control was clearly better for some action units than for others, with a pattern of differences between action units consistent with previous work in children and adolescents.

  4. 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

  5. [Terminal sedation: consultation with a second physician as is the case in euthanasia and assisted suicide].

    PubMed

    Ponsioen, B P; Schuurman, W H A Elink; van den Hurk, A J P M; van der Poel, B N M; Runia, E H

    2005-02-26

    In terminally-ill patients in the Netherlands deep sedation by means of a continuous subcutaneous infusion with midazolam occurs more frequently than euthanasia and assisted suicide. Deep terminal sedation is applied to relieve symptoms during the phase of dying, but in contrast to euthanasia and assisted suicide, does not hasten death. In three terminally-ill patients, a 65-year-old man suffering from pulmonary carcinoma, a 94-year-old woman with general malaise, nausea and anorexia, and a 79-year-old woman in the final stage of ovarian carcinoma, a general-practitioner advisor was consulted about an end-of-life decision--deep terminal sedation versus euthanasia or assisted suicide. The first two patients were given deep sedation until death, in both cases a day and a half later. The third patient's request for euthanasia was considered to meet the legal criteria for euthanasia. Compliance with the Dutch statutory criteria for due care in euthanasia and assisted suicide might also be helpful when deciding about terminal deep sedation, but the role and responsibility of the attending physician may differ. However, the radical effects of sedation on the terminally-ill patient and the rapid changes in the clinical situation of the patient when the decision to sedate is taken, both emphasize the need for consultation with another physician.

  6. 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

  7. 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

  8. 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.

  9. An attitudinal survey of euthanasia in Windward Oahu. A cross-sectional pilot study of four age groups.

    PubMed

    Littlejohn, T; Burrows-Johnson, J

    1996-12-01

    Exploring the attitudes of 185 respondents toward euthanasia, this 1990 cross-sectional pilot study utilized 12 survey questions addressing participants' demographic profiles and 18 focusing on: abortion; capital punishment; euthanasia; sterilization; and suicide. Cross-tabulation of structural, behavioral and attitudinal variables revealed age and education were the key factors in this study's finding that the greater a person's life experience, the more favorable one's attitude toward euthanasia.

  10. 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.

  11. Personality factors and attitudes toward euthanasia in Iran: implications for end-of-life research and practice.

    PubMed

    Aghababaei, Naser; Wasserman, Jason Adam; Hatami, Javad

    2014-01-01

    This article reports on the relationship of personality and euthanasia attitudes. Results from a survey of 165 Iranian students showed that religiosity, honesty-humility, agreeableness, and extraversion were related to negative attitudes toward euthanasia, whereas openness was related to acceptance of euthanasia, with the unconventionality facet driving this relationship. Moreover, openness explained additional variance when added to a multivariate model containing religiosity and HEXACO factors. This study illustrates the possibility of accounting for variation beyond the traditional group level predictors of attitudes toward euthanasia and promoting future cross-cultural studies into personality and end-of-life issues and informing end-of-life conversations at the bedside.

  12. 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.

  13. 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

  14. 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.

  15. Voluntary intoxication and criminal responsibility.

    PubMed

    Marlowe, D B; Lambert, J B; Thompson, R G

    1999-01-01

    This paper reviews the law related to voluntary intoxication and criminal responsibility in the 50 United States, the District of Columbia, the US Virgin islands, and Puerto Rico. Statutory and case law citations are provided which govern the use of intoxication evidence in each jurisdiction to negate mens rea (i.e., to establish diminished capacity), to support an insanity defense, and to mitigate criminal sentencing. Factors that courts typically focus on when deciding whether to admit this evidence in a particular case are discussed, and these factors are related to clinically relevant criteria.

  16. 5 CFR 831.405 - Interest on voluntary contributions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Interest on voluntary contributions. 831... REGULATIONS (CONTINUED) RETIREMENT Voluntary Contributions § 831.405 Interest on voluntary contributions. (a) Interest on voluntary contributions is computed under § 831.105. (b) Voluntary contributions begin to...

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 31 CFR 1021.540 - Voluntary information sharing among financial institutions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 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...

  6. 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...

  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...

  8. 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...

  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. Opinions of private medical practitioners in Bloemfontein, South Africa, regarding euthanasia of terminally ill patients.

    PubMed

    Brits, L; Human, L; Pieterse, L; Sonnekus, P; Joubert, G

    2009-03-01

    The aim of this study was to determine the opinions of private medical practitioners in Bloemfontein, South Africa, regarding euthanasia of terminally ill patients. This descriptive study was performed amongst a simple random sample of 100 of 230 private medical practitioners in Bloemfontein. Information was obtained through anonymous self-administered questionnaires. Written informed consent was obtained. 68 of the doctors selected completed the questionnaire. Only three refused participation because they were opposed to euthanasia. Respondents were mainly male (74.2%), married (91.9%) and Afrikaans-speaking (91.9%). More were specialists (53.2%) than general practitioners (46.8%). A smaller percentage (35.5%) would never consider euthanasia for themselves compared to for their patients (46.8%). The decision should be made by the patient (50%), the patient's doctor with two colleagues (46.8%), close family (45.2%) or a special committee of specialists in ethics and medicine (37.1%). The majority (46.9%) indicated that euthanasia should be performed by an independent doctor trained in euthanasia, followed by the patient's doctor (30.7%). Notification should mainly be given to a special committee (49.9%). Only 9.8% felt that no notification was necessary. There was strong opposition to prescribing of medication to let the patient die. Withdrawal of essential medical treatment to speed up death was the most acceptable method. Although the responding group was fairly homogeneous, responses varied widely, indicating the complexity of opinions.

  11. A protocol for consultation of another physician in cases of euthanasia and assisted suicide

    PubMed Central

    van der

    2001-01-01

    Objective—Consultation of another physician is an important method of review of the practice of euthanasia. For the project "support and consultation in euthanasia in Amsterdam" which is aimed at professionalising consultation, a protocol for consultation was developed to support the general practitioners who were going to work as consultants and to ensure uniformity. Participants—Ten experts (including general practitioners who were experienced in euthanasia and consultation, a psychiatrist, a social geriatrician, a professor in health law and a public prosecutor) and the general practitioners who were going to use the protocol. Evidence—There is limited literature on consultation: discursive articles and empirical studies describing the practice of euthanasia. Consensus—An initial draft on the basis of the literature was commented on by the experts and general practitioners in two rounds. Finally, the protocol was amended after it had been used during the training of consultants. Conclusions—The protocol differentiates between steps that are necessary in a consultation and steps that are recommended. Guidelines about four important aspects of consultation were given: independence, expertise, tasks and judgment of the consultant. In 97% of 109 consultations in which the protocol was used the consultant considered the protocol to be useful to a greater or lesser extent. Although this protocol was developed locally, it also employs universal principles. Therefore it can be of use in the development of consultation elsewhere. Key Words: Euthanasia • assisted suicide • consultation • quality assurance • protocol PMID:11579191

  12. 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.

  13. Alexithymic Trait and Voluntary Control in Healthy Adults

    PubMed Central

    Gu, Xiaosi; Liu, Xun; Guise, Kevin G.; Fossella, John; Wang, Kai; Fan, Jin

    2008-01-01

    Background Alexithymia is a personality trait characterized by deficiency in understanding, processing, or describing emotions. Recent studies have revealed that alexithymia is associated with less activation of the anterior cingulate cortex, a brain region shown to play a role in cognitive and emotional processing. However, few studies have directly investigated the cognitive domain in relation to alexithymia to examine whether alexithymic trait is related to less efficient voluntary control. Methodology/ Principal Findings We examined the relationship between alexithymic trait and voluntary control in a group of healthy volunteers. We used the 20-item Toronto Alexithymia Scale (TAS-20) to measure alexithymic trait. Additionally, we examined state and trait voluntary control using the revised Attention Network Test (ANT-R) and the Adult Temperament Questionnaire (ATQ), respectively. Alexithymic trait was positively correlated with the overall reaction time of the ANT-R, and negatively correlated with the Effortful Control factor of the ATQ. Conclusions/Significance Our results suggest that alexithymic trait is associated with less efficient voluntary control. PMID:19002254

  14. 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

  15. 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…

  16. 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.

  17. 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…

  18. 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...

  19. 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...

  20. 76 FR 78814 - National Voluntary Laboratory Accreditation Program; Operating Procedures

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-20

    ... National Institute of Standards and Technology 15 CFR Part 285 RIN 0693-AB61 National Voluntary Laboratory... Voluntary Laboratory Accreditation Program, National Institute of Standards and Technology, 100 Bureau Drive... Chief, National Voluntary Laboratory Accreditation Program, National Institute of Standards...

  1. 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

  2. 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.

  3. Voluntary action and causality in temporal binding.

    PubMed

    Cravo, Andre M; Claessens, Peter M E; Baldo, Marcus V C

    2009-10-01

    Previous studies have documented temporal attraction in perceived times of actions and their effects. While some authors argue that voluntary action is a necessary condition for this phenomenon, others claim that the causal relationship between action and effect is the crucial ingredient. In the present study, we investigate voluntary action and causality as the necessary and sufficient conditions for temporal binding. We used a variation of the launching effect proposed by Michotte, in which participants controlled the launch stimulus in some blocks. Volunteers reported causality ratings and estimated the interval between the two events. Our results show dissociations between causality ratings and temporal estimation. While causality ratings are not affected by voluntary action, temporal bindings were only found in the presence of both voluntary action and high causality. Our results indicate that voluntary action and causality are both necessary for the emergence of temporal binding.

  4. Method of euthanasia influences the oocyte fertilization rate with fresh mouse sperm.

    PubMed

    Hazzard, Karen C; Watkins-Chow, Dawn E; Garrett, Lisa J

    2014-11-01

    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.

  5. 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

  6. Anticipatory control of center of mass and joint stability during voluntary arm movement from a standing posture: interplay between active and passive control.

    PubMed

    Patla, Aftab E; Ishac, Milad G; Winter, David A

    2002-04-01

    Anticipatory control of upright posture is the focus of this study that combines experimental and modeling work. Individuals were asked to raise or lower their arms from two initial postures such that the final posture of the arm was at 90 degrees with respect to the body. Holding different weights in the hand varied the magnitude of perturbation to postural stability generated by the arm movement. Whole body kinematics and ground reaction forces were measured. Inverse dynamic analysis was used to determine the internal joint moments at the shoulder, hip, knee and ankle, and reaction forces at the shoulder. Center of mass (COM) of the arm, posture (rest of the body without the arms) and whole body (net COM) were also determined. Changes in joint moment at the hip, knee and ankle revealed a significant effect of the direction of movement. The polarities of the joint moment response were appropriate for joint stabilization. Net COM change showed a systematic effect of the direction of movement even though the arm COM was displaced by the same amount and in the same direction for both arm raising and lowering conditions. In order to determine the effects of the passive forces and moments on the posture COM, the body was modeled as an inverted pendulum. The model was customized for each participant; the relevant model parameters were estimated from data obtained from each trial. The ankle joint stiffness and viscosity were adjusted to ensure postural equilibrium prior to arm movement. Joint reactive forces and moments generated by the arm movements were applied at the shoulder level of this inverted pendulum; these were the only inputs and no active control was included. The posture COM profile from the model simulation was calculated. Results show that simulated posture COM profile and measured posture COM profile are identical for about 200 ms following the onset of arm movement and then they deviate. Therefore, the initial control of COM is passive in nature and the

  7. 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.

  8. 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

  9. The euthanasia and physician-assisted suicide debate: issues for nursing.

    PubMed

    Coyle, N

    1992-08-01

    The role of nursing has yet to be defined in relationship to the controversial issue of euthanasia and physician-assisted suicide. This may be one of the most important issues facing oncology nurses during the next five years. With recent advances in medical technology, patients are fearful that suffering and death will be prolonged. The option of euthanasia and physician-assisted suicide is seen by some to be a right. Oncology nurses, as patient advocates, need to understand the basic issues surrounding this controversy.

  10. 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

  11. 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.

  12. Mesolimbic transcriptional response to hedonic substitution of voluntary exercise and voluntary ethanol consumption.

    PubMed

    Darlington, Todd M; McCarthy, Riley D; Cox, Ryan J; Ehringer, Marissa A

    2014-02-01

    The mesolimbic dopaminergic pathway has been implicated in many rewarding behaviors, including the consumption of ethanol and voluntary exercise. It has become apparent that different rewarding stimuli activate this pathway, and therefore it is possible for these behaviors to influence each other, i.e. hedonic substitution. Using adult female C57BL/6J mice, we demonstrate that voluntary access to a running wheel substantially reduces the consumption and preference of ethanol. Furthermore, we examined gene expression of several genes involved in regulating the mesolimbic dopaminergic pathway, which we hypothesized to be the main pathway involved in hedonic substitution. In the striatum, we observed a reduction in mRNA expression of Drd1a due to exercise. Hippocampal Bdnf mRNA increased in response to exercise and decreased in response to ethanol. Furthermore, there was an interaction effect of exercise and ethanol on the expression of Slc18a2 in the midbrain. These data suggest an important role for this pathway, and especially for Bdnf and Slc18a2 in regulating hedonic substitution. PMID:24239693

  13. Mesolimbic transcriptional response to hedonic substitution of voluntary exercise and voluntary ethanol consumption.

    PubMed

    Darlington, Todd M; McCarthy, Riley D; Cox, Ryan J; Ehringer, Marissa A

    2014-02-01

    The mesolimbic dopaminergic pathway has been implicated in many rewarding behaviors, including the consumption of ethanol and voluntary exercise. It has become apparent that different rewarding stimuli activate this pathway, and therefore it is possible for these behaviors to influence each other, i.e. hedonic substitution. Using adult female C57BL/6J mice, we demonstrate that voluntary access to a running wheel substantially reduces the consumption and preference of ethanol. Furthermore, we examined gene expression of several genes involved in regulating the mesolimbic dopaminergic pathway, which we hypothesized to be the main pathway involved in hedonic substitution. In the striatum, we observed a reduction in mRNA expression of Drd1a due to exercise. Hippocampal Bdnf mRNA increased in response to exercise and decreased in response to ethanol. Furthermore, there was an interaction effect of exercise and ethanol on the expression of Slc18a2 in the midbrain. These data suggest an important role for this pathway, and especially for Bdnf and Slc18a2 in regulating hedonic substitution.

  14. 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

  15. Career Education: The Role of School-Related Youth Groups and Voluntary Organizations. Information Series No. 108.

    ERIC Educational Resources Information Center

    Hylton, V. Wendell

    Purposes and activities of existing youth groups and voluntary organizations are reviewed in this information analysis paper to determine their relationship to career education. Addressed to youth groups and voluntary organization leaders and sponsors, school administrators and state department vocational education personnel, the paper also…

  16. 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

  17. Combined application of neuromuscular electrical stimulation and voluntary muscular contractions.

    PubMed

    Paillard, Thierry

    2008-01-01

    Electromyostimulation (EMS) and voluntary muscle contraction (VC) constitute different modes of muscle activation and induce different acute physiological effects on the neuromuscular system. Long-term application of each mode of muscle activation can produce different muscle adaptations. It seems theoretically possible to completely or partially cumulate the muscle adaptations induced by each mode of muscle activation applied separately. This work consisted of examining the literature concerning the muscle adaptations induced by long-term application of the combined technique (CT) [i.e. EMS is combined with VC - non-simultaneously] compared with VC and/or EMS alone in healthy subjects and/or athletes and in post-operative knee-injured subjects. In general, CT induced greater muscular adaptations than VC whether in sports training or rehabilitation. This efficiency would be due to the fact that CT can facilitate cumulative effects of training completely or partially induced by VC and EMS practiced alone. CT also provides a greater improvement of the performance of complex dynamic movements than VC. However, EMS cannot improve coordination between different agonistic and antagonistic muscles and thus does not facilitate learning the specific coordination of complex movements. Hence, EMS should be combined with specific sport training to generate neuromuscular adaptations, but also allow the adjustment of motor control during a voluntary movement. Likewise, in a therapeutic context, CT was particularly efficient to accelerate recovery of muscle contractility during a rehabilitation programme. Strength loss and atrophy inherent in a traumatism and/or a surgical operation would be more efficiently compensated with CT than with VC. Furthermore, CT also restored more functional abilities than VC. Finally, in a rehabilitation context, EMS is complementary to voluntary exercise because in the early phase of rehabilitation it elicits a strength increase, which is necessary

  18. 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

  19. 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

  20. 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)