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Nursing Education 2018
Journal of Nursing and Health Studies
ISSN: 2574-2825
Page 62
April 23-25, 2018
Rome, Italy
27
th
Edition of World Congress on
Nursing Education &
Research
T
he Belgian model of integral end-of-life care consists of
universal access to palliative care (PC) and legally regulated
euthanasia. As a first worldwide, the Flemish PC organisation
has embedded euthanasia in its practice. However, some critics
have declared the Belgian-model concepts of integral PC and
palliative futility to fundamentally contradict the essence of PC.
This article analyzes the various essentialistic arguments for the
incompatibility of euthanasia and PC. The empirical evidence
from the euthanasia-permissive Benelux countries shows that
since legalization, carefulness of decisionmaking at the end of life
has improved and there have been no significant adverse slippery
slope effects. It is problematic that some critics disregard the
empirical evidence as epistemologically irrelevant in a normative
ethical debate. Next, rejecting euthanasia because its prevention
was a founding principle of PC ignores historical developments.
Further, critics’ ethical positions depart from the PC tenet of
patient-centeredness by prioritizing caregivers’ values over
patients’ values. Also, many critics’ canonical adherence to the
WHO definition of PC, which has intention as the ethical criterion
is objectionable. A rejection of the Belgian model on doctrinal
grounds also has nefarious practical consequences such as the
marginalization of PC in euthanasia-permissive countries, the
continuation of clandestine practices and problematic palliative
sedation until death. In conclusion, major flaws of essentialistic
arguments against the Belgian model include the disregard
of empirical evidence, appeals to canonical and questionable
definitions, prioritisation of caregiver perspectives over those
of patients, and rejection of a plurality of respectable views on
decision making at the end of life.
jan.bernheim@vub.ac.beEuthanasia embedded in palliative care: responses to essentialistic
criticisms of the Belgianmodel of integral end-of life care
Jan L Bernheim
End-of-Life Care Research Group - Vrije Universiteit Brussel, Belgium
J Nurs Health Stud 2018, Volume 3
DOI: 10.21767/2574-2825-C1-003