Year

1983

Degree Name

Master of Arts (Hons.)

Department

Department of History and Philosophy of Science

Abstract

This thesis explores the influences, effects and results of improved life support technologies and of increased medical capabilities on terminal care and the care of the dying. It looks at the results of the application of these death-defying technologies and their effects on the definition of death, as well as the created need for new criteria for the determination of death when such technologies are used. Some legal, moral and ethical issues raised by these developments and their application, and the new medical problems and issues resulting from these 'medical successes' are also looked at.

The reasons behind the increasing tendency towards hospitalizing the dying, and death, are explored. Examination is made of available alternatives to hospital terminal care. The advantages and/or disadvantages of each are explored. Special attention is paid to the alternatives available in Australia.

Due to the ever-increasing powers of life-prolonging technologies, many people have come to dread the thought of prolonged suffering, pain, lingering decline, suspended dying or vegetative existence. This thesis looks at the euthanasia movement, which has articulated these concerns. It also examines the debate over euthanasia, and the legal, moral and ethical issues that it raises. Consideration is also given to some of the positive outcomes of this movement, such as the 'Patients' Bill of Rights', and the 'Living Will'.

It is argued that intensive technological intervention is not appropriate at the terminal stage and that the patient should be able to withhold consent for the use of such technology on him or to request withdrawal of it if already in use. The patient should also be able to choose where and how he ends his days. In the Australian context the choice, if available, remains mainly between institutions. Community support services require a massive upgrading before home care becomes a viable option.

Finally, on the basis of this analysis, some policy recommendations for terminal care in the Australian context are offered.

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.