End of life

Question 1

Definition of Bioethics

Answer 1

Bioethics is the systematic study of human conduct in the area of the sciences of life and health, as this conduct is examined in the light of moral values and principles

Question 2

What is the goal of medicine according to Hippocrates?

Answer 2

Not to extend human life but prevent suffering

Question 3

Where is euthanasia legal?

Answer 3

In Switzerland

Question 4

Is DNR euthanasia?

Answer 4

YES

Question 5

Why can doctors get away legally from euthanasia?

Answer 5

Because their intention must never be to kill a patient but to relive suffering, so doctors write down that the drugs administered relieve suffering

Question 6

What is active euthanasia?

Answer 6

The doctor causes the death

Question 7

When was active euthanasia first legalized?

Answer 7

In 2002 Netherlands

Question 8

Where can active euthanasia take place?

Answer 8

Luxembourg, Belgium, Spain and the Netherlands

Question 9

What are the types of active euthanasia?

Answer 9

1. Direct
2. Indirect [palliative care]

Question 10

When was palliative care entirely paid by the NHS in Italy?

Answer 10

2017

Question 11

What is passive euthanasia?

Answer 11

the disease causes death: the doctor stops treating the disease

Question 12

What is assisted suicide?

Answer 12

The patient expresses their own will and wants no longer to live and takes the drug prepared by the doctor/nurse

Question 13

How does assisted suicide take place?

Answer 13

The drug is administered in a little glass containing 2 drugs: you are given a little chocolate because the drug is bitter, in 2 minutes you start having problems eating.

Question 14

How does active euthanasia take place?

Answer 14

Through the administration of:
1. Thiopental sodium intravenously to induce general anaethesia or pharmacological coma
2. Pancuronium bromide to paralyse muscles and stop breathing; opium drugs are given to prevent suffering
3. Potassium chloride to induce cardiac arrest in 1 minutes

Question 15

Which method of captial punishment is used in US executions?

Answer 15

potassium chloride

Question 16

Describe the state of a patient in a coma

Answer 16

• non aware
• no responsiveness to stimuli
• eyes closed
• no sleep-awake cycle
• mechanical ventilation

Question 17

Describe the state of a patient in the vegetative state

Answer 17

• spontaneous breathing
• regular sleep pattern
• automotive response to stimuli
• non aware

Question 18

What is temporary vegetative state?

Answer 18

6-12 months

Question 19

What is persistent vegetative state?

Answer 19

up to years

Question 20

Give a brief description of vegetative state

Answer 20

An integrated condition in which parts of your brain works and others don’t.

Question 21

Describe the case study Eluana Englaro

Answer 21

Born in Lecco in 1970: victim of a critical road accident in 1992, at age 22. She was admitted to the ICU and diagnosed with vegetative state

Question 22

When did Eluana Englaro father ask to suspend nutrition and health (N&H) and what was the outcome of the request?

Answer 22

January 1999
The court rejects the request

Question 23

When did the Supreme Court authorise the suspension of the treatment and under which conditions?

Answer 23

2007
1. Clear consistency with patient’s will
2. No possibility based on scientific literature and previous cases to regain consciousness and environmental perception

Question 24

When did Eluana Englaro pass away?

Answer 24

June 2008

Question 25

What is fundamental in the case of vegetative state?

Answer 25

The living will

Question 26

When was the living will legalised in Italy?

Answer 26

2017

Question 27

What is the living will?

Answer 27

If you are over 18 and competent, you can choose which treatments would you not administered within certain healthcare conditions, by writing a document

Question 28

Describe the case of Fabiano Antoniani, DJ Fabiano

Answer 28

Milano 1977, he got into a critical car accident--> tethraplegia and blindness.In 2017, he was accompanied by Marco Cappato to a Swiss clinic to be administered assisted suicide. Cappato was then accused of aid to suicide. However, in 2019, the court deemed Cappato not punishable as art. 58 in constitution said that aid to suicide is legitimate to the benefit of patients who want to stop suffering

Question 29

When was the first assisted suicide approved in Italy?

Answer 29

2021

Question 30

Main determinants of brain death

Answer 30

interrupted blood flow to the brain: - 4/6 minutes first lesions - 8/10 minutes cerebral death

Question 31

Under which conditions did the Netherlands authorise active euthanasia?

Answer 31

1. the patient's suffering is unbearable 2. the request must be voluntary and persist over time 3. the patient must be fully aware of his/her condition 4. consultation with at least one other independent doctor who needs to confirm the consiitons 5. Must be carried out in a medically appropriate fashion 6. The patient is at least 12 years old and requires parental consent up to 16

Question 32

Which was the second country to legalise euthanasia?

Answer 32

Belgium

Question 33

When was euthanasia for babies legalised and where?

Answer 33

Netherlands 2007

Question 34

When was euthanasia for demented patients legalised and how?

Answer 34

2020 Netherlands Given Valium + Pentobarbital