Physicians' willingness to grant requests for assistance in dying for children: a study of hypothetical cases.

Objective: To study the willingness of Dutch physicians to use potentially life-shortening or lethal drugs for severely ill children.

Study Design: We asked 63 pediatricians about their approach to 10 hypothetical cases of children with cancer. The age of the child (15, 11, or 6 years), the child's (explicit) request, and the opinion of the parents varied.

Forgoing treatment at the end of life in 6 European countries.

Background: Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient's life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics.

"The good life" for demented persons living in nursing homes.

Background: This study investigated which concepts regarding "the good life" are used in mission statements of nursing homes providing care for demented patients.

Method: All 317 Dutch nursing homes caring for demented patients were asked to participate; of these, 69% responded. Their mission statements were qualitatively analyzed on content.

Ideals regarding a good life for nursing home residents with dementia: views of professional caregivers.

This study investigates what professional caregivers working in nursing homes consider to be a good life for residents suffering from dementia. Ten caregivers were interviewed; special attention was paid to the way in which they deal with conflicting values. Transcripts of the interviews were analysed qualitatively according to the method of grounded theory.

Is physician-assisted death only for developed countries? Latin America as a case study.

The achievements of modern medicine are manifold and impressive. However, there is a broad recognition of the fact that continuing medical treatment is not always beneficial to the patient, nor is it always what the patient wants. This has led to a debate about the way physicians may or may not be involved in the end of life of patients.

Tailor-made pharmacotherapy: future developments and ethical challenges in the field of pharmacogenomics.

Pharmacogenomics is the study of the myriad interactions between genes and pharmacotherapy. Developments in pharmacogenomics have changed and will affect pharmaceutical research, drug development and the practice of medicine in a significant way. In this article, we make an inventory of the ethical implications that might arise as a result of possible developments in pharmacogenomics and investigate whether the present ethical framework will be able to adequately answer arising questions.

Modified informed consent procedure: consent to postponed information.

How do you obtain a valid assessment of subjective outcomes in a trial in which the participants cannot be blinded to the intervention? Bias is inevitable from unblinded patients, but trials that have not told patients about treatment in all arms have been heavily criticised. Asking participants to consent to postponed information could be a solution

Dances with data.

Medical decisions concerning the end of life are a difficult matter and they evoke much emotional response. What is needed, however, is an open debate in order to improve the moral quality of decision making, not "dances with data". The central question in this debate should be, as Callahan aptly notes, whether medicine should involve itself only in that kind of "suffering which is brought on by illness and dying as biological phenomena" (emphasis added) or whether it should concern itself with the wellbeing of the patient.