Ethics of end-of-life issues 3800-EELI25-BE-S-OG
The course is focused on the main moral problems of end of life and provides a relevant ethical knowledge (concepts, theories, principles, rules and arguments) as a general framework for interpreting and analysing moral issues arising in terminal care as well as teaches methods of case analysis. The course aims at making students aware of the normative aspects of medical decisions made in terminal care, clarifying the most important philosophical approaches to medico-moral reflection, that is the philosophical context of ethical theories and their practical application as well as normative positions in end-of-life ethics. The course aims at developing the students’ skills in recognizing the moral dimensions of end of life and their ability to think critically about moral issues arising in terminal care. The course develops students’ ability to analyze critically moral arguments, making them able to formulate and support with clear reasoning their medico-moral judgments concerning terminal care.
To sum up: The course aims at: (a) giving students a relevant ethical knowledge of main problems and discussions in terminal care; (b) stimulating their analytical skills and reasoning abilities; (c) enhancing their intellectual sensibility and awareness of the needs of dying patients; (d) enhancing their skills in construction arguments; (e) developing their habit of critical thinking; (f) developing their linguistic skills (B2+level).
Content: Problem of death in analytical philosophy and phenomenology. Evolution of the definition and criteria of death. Dying: changes in the attitudes to death and dying in Western culture according to Ph. Ariès. Is cultural thanatology just the science fiction to the Past? Michel Vovelle analyses of cultural thanatology. The phenomenon of medicalization of death. The dilemma of immortality and the transhumanist project. The concept of terminal stage and terminal phase. Ethical foundations of medical thanatology. The rule of informed consent, principle of proportionate and disproportionate means. The notion of medical futility. Futile treatment - definitional difficulties. The problem of the adequacy of the principle of double effect as an ethical justification for effective terminal analgesia. Palliative sedation. Ethical analyses of commissions and omissions, withholding and withdrawal. Ethical aspects of artificial feeding and hydrating in terminal care. Advance directives (living will, durable power of attorney, DNI/DNR). Ethical controversies concerning persistent vegetative state (PVS). Quality of life: theories and methods of assessment. Ethical and legal issues concerning euthanasia and physician assisted suicide: evolution of the argumentation. Palliative care and terminal care. Hospice movement: development of forms of hospice care.
Rodzaj przedmiotu
Tryb prowadzenia
Założenia (opisowo)
Koordynatorzy przedmiotu
Efekty kształcenia
has a profound knowledge of fundamental ethical problems of end-of-life care
(K_W02);
knows and understands multidisciplinary and interdisciplinary terminology of end-of-life ethical discussions
(K_W03);
has a clear in-depth knowledge of main philosophical ideas, normative approaches and argument strategies employed in today debates concerning terminal medicine and end-of-life care
(K_W09);
knows and understand the paradigm of philosophical thanatology
(K_W 10);
has an in-depth knowledge of the present day bioethical controversies and debates concerning end-of-life medicine
(K-W15).
is able to recognize, interpret and analyse problems and conflicting ethical stances in end-of-life discussions
(K_U01);
is able to perform a critical analysis of the subject literature, as well as views and opinions of relevant authors, including the seminar participants
(K_U02);
is able to construct and re-construct advanced factual and normative arguments, as well as address and refute the counterarguments;
is able to carry on advanced research under the seminar leader’s tutorship, involving data query, analysis and assessment;
is able to integrate the outcomes of multidisciplinary and interdisciplinary research into bioethical knowledge
(K_U03);
is able to perform a clear in-depth case analysis from ethical point of view and to formulate recommendation
(K_U04);
has a developed skill to write analytical and critical papers concerning the seminar issues
(K_U13);
has a developed skill to prepare oral presentations on the seminar subject matters
(K_U14);
has a good command of English (B2+level)
(K_U15).
is able to assess critically her/his knowledge and the reliability and relevance of the information and its sources
(K_K01);
recognizes the significance of ethical inquiry for the development of science, technology, civilization and society
(K_K02);
undertakes, initiates, plans and structures research proving reliability, prudence and commitment
(K_K06);
is able to co-operate as a leader as well as a member of a team
(K_K07).
Kryteria oceniania
Active participation in the seminars (attendance, preparation, participation in discussions) – 40%
Preparation & oral delivery of presentation – 30%
Critique of a book/paper concerning seminar subject or the case study or problem analysis (argumentative essay) in writing – 30%
Final assignment requirements: 3600 – 5400 characters with spaces (2-3 standard pages), the Student’s name given as a title of the file, sent via email, in Word format. Proper references are required.
Number of absences: 2
Literatura
Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death (1968).
A. Alichniewicz, Terapia daremna – problem definicyjne, Przegląd Prawa Medycznego, 3 (2024), 16, s. 5-32, DOI: 10.70537/p196w724
Ph. Ariès, Człowiek i śmierć, PIW, Warszawa 1989.
A.Bartkowska-Śniatkowska A, Byrska-Maciejasz E, Cettler M, et al. Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units. Anaesthesiol Intensive Ther 2021; 53, 5: 369–375.
DOI: https://doi.org/10.5114/ait.2021.111451 w jęz. polskim: Anestezjologia Intensywna Terapia 2021, 53, 5: 369–375.
G.S Belkin, Death before Dying, Oxford University Press, Oxford – New York 2014.
T. L. Beauchamp, J. F. Childress, Tradycyjne rozróżnienia i reguły rządzące zaprzestaniem leczenia, [w:] tychże, Zasady etyki medycznej, tłum. W. Jacórzyński, Książka i Wiedza, Warszawa 1996.
D. Birnbacher, E. Dahl (eds.), Giving Death a Helping Hand, International Library of Ethics, Law, and the New Medicine 38, Springer 2008.
D. Callahan, The Troubled Dream of Life. In Search of a Peaceful Death, Simon&Schuster, New York-London 1993;
D. Callahan, The Tyranny of Survival and Other Pathologies of Civilized Life, Macmillan Publishing Co., New York 1973.
M.J. Cholbi (ed.), Euthanasia and Assisted Suicide, Praeger, Santa Barbara-Denver 2017.
J. Drążkiewicz, W stronę człowieka umierającego - o ruchu hospicyjnym w Polsce, Uniwersytet Warszawski, Instytut Socjologii, 1983.
A. Kübler, Siewiera J, Durek G, Kusza K, Piechota M, Szkulmowski Z., Wytyczne postępowania wobec braku skuteczności podtrzymywania funkcji narządów (terapii daremnej) u pacjentów pozbawionych możliwości świadomego składania oświadczeń woli na oddziałach intensywnej terapii, Anestezjologia Intensywna Terapia 2014, 46, 4, 229–234; in English: Kübler A, Siewiera J, Durek G, Kusza K, Piechota M, Szkulmowski Z: Guidelines regarding the ineffective maintenance of organ functions (futile therapy) in ICU patients incapable of giving informed statements of will. Anaesthesiol Intensive Ther 2014; 46: 215–220.
J. M. Fischer (red.), The Metaphysics of Death, Stanford University Press, Stanford 1993
E. Kübler-Ross, Rozmowy o śmierci i umieraniu, tłum. I. Doleżal - Nowicka, PAX, Warszawa 1979.
P. Lee, Total Brain Death and the Integration of the Body Required of a Human Being. Journal of Medicine and Philosophy, 2016,41, 300 – 314. doi:10.1093/jmp/jhw005
J.P. Lizza, Defining death: beyond biology. Diametros 2018, 55, 1–19. DOI: 10.13153/diam.1172
P. Łuków (red. nauk.), Zrozumieć śmierć człowieka , Polskie Stowarzyszenie Koordynatorów Transplantacyjnych 2015
McMahan, The Ethics of Killing: Problems at the Margins of Life, Oxford University Press 2003.
Jeff Malpas i R. C. Solomon (red.), Death and Philosophy, Routledge, London - New York 1998
D. Marquis, Death is a biological phenomenon. Diametros 2018, 55, 20–26. DOI: 10.13153/diam.1173
F. G. Miller, R.D. Truog, Death, Dying, and Organ Transplantation. Reconstructing Medical Ethics at the End of Life. Oxford University Press, Oxford – New York 2012.
Nair- Collins, M. (2018) A biological theory of death: characterization, justification, and implications. Diametros 55, 27–43. DOI: 10.13153/diam.1174
President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1981). Defining Death. https://repository.library.georgetown.edu/bitstream/handle/10822/559345/defining_death.pdf?sequence=1&isAllowed=y
President’s Council of Bioethics. (2008). Controversies in the Determination of Death. A White Paper. https://repository.library.georgetown.edu/bitstream/handle/10822/559343/Controversies%20in%20the%20Determination%20of%20Death%20for%20the%20Web.pdf?sequence=1&isAllowed=y
M.Pabst Battin, Ending Life, Oxford University Press, Oxford 2005.
Polskie Towarzystwo Pediatryczne, Zaniechanie i wycofanie się z uporczywego leczenia podtrzymujacego zycie u dzieci, Warszawa 2011.
L.A. Roscoe, D.P. Schenck, Communication and Bioethics at the End of Life. Real Cases, Real Dilemmas, Springer International Publishing AG 2017.
J. Różyńska, W. Chańska (red), Bioetyka, Wolters Kluwer, Warszawa 2013.
P. Singer, O życiu i śmierci. Upadek etyki tradycyjnej, przeł. A. Alichniewicz i A. Szczęsna, PIW, Warszawa 1997.
M. Świderska, Aspekty prawne terapii daremnej w okresie końca życia, Białostockie Studia Prawnicze 2023, 28, 3.
Uniform Determination of Death Act (1981). http://www.lchc.ucsd.edu/cogn_150/Readings/death_act.pdf
M. Vovelle, Śmierć w cywilizacji Zachodu. Od roku 1300 po współczesność, Słowo/Obraz Terytoria, Gdańsk 2005.
M. Warnock, E. Macdonald, Easeful Death, Oxford University Press, Oxford 2009
M. Webb, The Good Death. The New American Search to Reshape the End of Life, Bantam Books, New York 1999.
S.J. Youngner, G.K. Kimsma, Physician-Assisted Death in Perspective. Assessing the Dutch Experience, Cambridge University Press, Cambridge 2012.
R. Zaner (ed.), Death: Beyond Whole-Brain Criteria, Kluwer Academic Publishers, Dordrecht-Boston-London 1988.
I. Ziemiński, Zagadnienie śmierci w filozofii analitycznej, TN KUL Lublin 1999;
I. Ziemiński Metafizyka śmierci, Wydawnictwo WAM, Kraków 2010.
Więcej informacji
Dodatkowe informacje (np. o kalendarzu rejestracji, prowadzących zajęcia, lokalizacji i terminach zajęć) mogą być dostępne w serwisie USOSweb: