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Food for Thought Lunchtime Discussion

Food for Thought Lunchtime Discussion. June 15, 2010 Frank Chessa, Ph.D. Lauren Michalakes, MD. “It’s Over Debbie” Anonymous, 1988. Resident responding in the middle of the night. 20 year old Debbie actively dying of ovarian cancer 20 mg of Morphine administered.

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Food for Thought Lunchtime Discussion

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  1. Food for ThoughtLunchtime Discussion June 15, 2010 Frank Chessa, Ph.D. Lauren Michalakes, MD

  2. “It’s Over Debbie”Anonymous, 1988 • Resident responding in the middle of the night. • 20 year old Debbie actively dying of ovarian cancer • 20 mg of Morphine administered.

  3. “It’s Over Debbie”Anonymous, 1988 • Did the resident physician do the right thing? • Is voluntary active euthanasia ever ethical? • Should voluntary active euthanasia be legal?

  4. “Death and Dignity”Timothy Quill, 1991 • Diane: Adult newly diagnosed with AML. Past history of vaginal cancer, alcoholism, depression. Established relationship with physician. • Refused BMT with survival of 25% • Asked for help with suicide – extensive discussions with physician • Barbiturates prescribed with knowledge they might be used for suicide • After a period of decline, Diane apparently ended her life

  5. “Death and Dignity”Timothy Quill, 1991 • Did Quill’s actions in Diane’s case constitute physician-assisted suicide? • Is there a moral difference between voluntary active euthanasia and physician-assisted suicide? • Should physician-assisted suicide be legal in Maine?

  6. Palliative Sedation to Unconsciousness • Charles: 39 year old with end stage pancreatic cancer • Charles lacks capacity; Wife involved • Physical and emotional suffering • Refractory to conventional treatment

  7. Palliative Sedation to unconsciousness • Is palliative sedation to unconsciousness an ethical option in this case? • What is the relevance of emotional versus physical suffering in this case? • What is the relevance of the prognosis in this case? • Is there a moral difference between palliative sedation to unconsciousness and voluntary active euthanasia?

  8. Questions and Comments Thank You Frank Chessa Clinical Ethics Maine Medical Center Lauren Michalakes Pain and Palliative Care Maine Medical Center

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