Assisted suicide in the care of mentally ill patients: The Lucio Magri's case

Frati, Paola; Gulino, Matteo; Mancarella, Paola; Cecchi, Rossana; Ferracuti, Stefano

doi:10.1016/j.jflm.2013.10.017

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…His comments came in a letter to promote euthanasia (currently banned in Italy) advocated by the Luca Coscioni Association (6), whose documents affirm that the annual number of suicides among terminal patients in the last decade was around 1000 (7). Although the problem has recently roused the public attention, following the decision of the journalist Lucio Magri (8) to commit assisted suicide in 2011 in a Swiss clinic, and the suicides of film directors Mario Monicelli and Carlo Lizzani, who jumped to their deaths in 2010 and 2013 to end their suffering caused by disease and senility, there are no reliable analyses of this phenomenon. The Italian Institute for Social Statistics (ISTAT) does not report the suicide rates of terminal patients but only of sick persons (9).…”

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confidence: 99%

Life at all costs? Italian social representations of  end-of-life decisions after President Napolitano’s speech - margin notes on withdrawing artificial nutrition and hydration

Testoni¹,

Sposito²,

Cataldo³

et al. 2014

NTM

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Introduction:The current development of nutritional medical science and technology is a crucial part of an extensive strategy to promote well-being and to ensure longer and longer lifetimes in the wealthiest countries. However, a particular kind of feeding that can extend life creates considerable moral and psychosocial problems. This is artificial hydration and nutrition, and the problems are inherent to the practice of withholding and withdrawing it. The Oviedo Convention suggests to manage this through informed consent and advance directives, like any other medical intervention, even when end-of-life decisions are at stake. This article considers the Italian social representations of end-of-life decisions as they emerged from the social reaction to the speech President Giorgio Napolitano held on this topic on 18 March 2014. Materials and Methods: A qualitative textual analysis of nonspecialist comments on the President's speech was performed. The texts were collected by means of the Google search engine between 18 and 31 April 2014. The first 320 websites where the news about the speech appeared were examined, and the first 65 proved sufficiently coherent; all texts that we analyzed were published between 18 and 20 March 2014. Two hundred and six intelligible interventions were selected, many of which could be categorized in different ways. Each multiple intervention was partitioned into sentences or statements, each of which belonging to a single category. The total number of segmented comments was 364, which were classified by two different judges. Results: The literature on these issues often seems to present a conflict between religious and secular positions. Further explorative research has identified a third position close to the religious position but inscribed in the secular domain. It is a transverse representation which unifies opposite positions: atheists and Catholics. Conclusions: Both secular and Catholic websites represent the limitation of life utilizing the "slippery slope argument" and evoking economic aspect as the reason for adopting a Nazi strategy aimed at exterminating unproductive people. This kind of argumentation reveals a lack of social education on the issues of death and dying in Italy.

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confidence: 99%

Life at all costs? Italian social representations of  end-of-life decisions after President Napolitano’s speech - margin notes on withdrawing artificial nutrition and hydration

Testoni¹,

Sposito²,

Cataldo³

et al. 2014

NTM

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“…It can also be challenging for family members to accept that their loved one intends to request or has requested MAiD-MD [ 24 ]. Perception conflicts can arise between patients and healthcare professionals [ 71 , 73 ], whose training focuses mainly on preserving life, particularly when MAiD-MD is not considered a last resort because treatment options remain to be tried [ 22 ]. The way of receiving and responding to the request for MAiD-MD can be tinged with paternalism aimed at imposing healthcare professionals’ values on patients [ 48 ] or reveal a lack of empathy or sensitivity to their situation [ 39 ], which can increase the distress of applicants.…”

Section: Discussion On the Option Of Maid-mdmentioning

confidence: 99%

Medical assistance in dying for people living with mental disorders: a qualitative thematic review

Favron-Godbout,

Racine

2023

BMC Med Ethics

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Background Medical assistance in dying (MAiD) sparks debate in several countries, some of which allow or plan to allow MAiD where a mental disorder is the sole underlying medical condition (MAiD-MD). Since MAiD-MD is becoming permissible in a growing number of jurisdictions, there is a need to better understand the moral concerns related to this option. Gaining a better understanding of the moral concerns at stake is a first step towards identifying ways of addressing them so that MAiD-MD can be successfully introduced and implemented, where legislations allow it. Methods Thus, this article aims (1) to better understand the moral concerns regarding MAiD-MD, and (2) to identify potential solutions to promote stakeholders’ well-being. A qualitative thematic review was undertaken, which used systematic keyword-driven search and thematic analysis of content. Seventy-four publications met the inclusion criteria. Results Various moral concerns and proposed solutions were identified and are related to how MAiD-MD is introduced in 5 contexts: (1) Societal context, (2) Healthcare system, (3) Continuum of care, (4) Discussions on the option of MAiD-MD, (5) MAiD-MD practices. We propose this classification of the identified moral concerns because it helps to better understand the various facets of discomfort experienced with MAiD-MD. In so doing, it also directs the various actions to be taken to alleviate these discomforts and promote the well-being of stakeholders. Conclusion The assessment of MAiD-MD applications, which is part of the context of MAiD-MD practices, emerges as the most widespread source of concern. Addressing the moral concerns arising in the five contexts identified could help ease concerns regarding the assessment of MAiD-MD.

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“…Only the appointment of the Guardian could rekindle the dialogue between doctor and patient, ensuring respect for the rights of a personal nature. Probably we may have missed an important opportunity to protect the dignity and freedom of the individual [16], placing Italy in countertrend with other European Countries, which attribute a significant value to patient autonomy and to the possibility of making advance health care decisions [17]. …”

Section: Discussionmentioning

confidence: 99%

Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

Busardò

Bello

Gulino

et al. 2014

BioMed Research International

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Advance health care decisions animate an intense debate in several European countries, which started more than 20 years ago in the USA and led to the adoption of different rules, based on the diverse legal, sociocultural and philosophical traditions of each society. In Italy, the controversial issue of advance directives and end of life's rights, in the absence of a clear and comprehensive legislation, has been over time a subject of interest of the Supreme Court. Since 2004 a law introduced the “Public Guardian,” aiming to provide an instrument of assistance to the person lacking in autonomy because of an illness or incapacity. Recently, this critical issue has once again been brought to the interest of the Supreme Court, which passed a judgment trying to clarify the legislative application of the appointment of the Guardian in the field of advance directives.

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Assisted suicide in the care of mentally ill patients: The Lucio Magri's case

Cited by 7 publications

References 18 publications

Life at all costs? Italian social representations of  end-of-life decisions after President Napolitano’s speech - margin notes on withdrawing artificial nutrition and hydration

Life at all costs? Italian social representations of  end-of-life decisions after President Napolitano’s speech - margin notes on withdrawing artificial nutrition and hydration

Medical assistance in dying for people living with mental disorders: a qualitative thematic review

Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

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Assisted suicide in the care of mentally ill patients: The Lucio Magri's case

Cited by 7 publications

References 18 publications

Life at all costs? Italian social representations of end-of-life decisions after President Napolitano’s speech - margin notes on withdrawing artificial nutrition and hydration

Life at all costs? Italian social representations of end-of-life decisions after President Napolitano’s speech - margin notes on withdrawing artificial nutrition and hydration

Medical assistance in dying for people living with mental disorders: a qualitative thematic review

Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

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Product

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Life at all costs? Italian social representations of  end-of-life decisions after President Napolitano’s speech - margin notes on withdrawing artificial nutrition and hydration

Life at all costs? Italian social representations of  end-of-life decisions after President Napolitano’s speech - margin notes on withdrawing artificial nutrition and hydration