Requests for assistance in dying are likely the most challenging requests made of clinical teams in spinal cord rehabilitation settings. This article describes how two such requests were addressed at a rehabilitation center in Canada. We propose an approach to persons with high-lesion spinal cord injury who want to die that is grounded in the experiences of two individuals and that balances benefits and burdens on a case-by-case basis.
Longmore PK. Medical decision making and people with disabilities: a clash of cultures. In: Why I Burned My Book and Other Essays on Disability. Philadelphia: Temple University Press; 2003:204–212.
,
Why I Burned My Book and Other Essays on Disability
, Medical decision making and people with disabilities: a clash of cultures
(pg. 204
-212
) Asch A. Disability: attitudes and sociological perspectives. In: Reich WT, ed. Encyclopedia of Bioethics. Vol. 2. New York: Simon & Schuster Macmillan; 1995:602–608.
,
Encyclopedia of Bioethics
, Disability: attitudes and sociological perspectives
(pg. 602
-608
) Coleman D, Drake S. A disability perspective from the United States on the case of Ms B. J Med Ethics. 2002;28:240–242.
,
A disability perspective from the United States on the case of Ms B
, J Med Ethics
, vol. 28
(pg. 240
-242
) Gill CJ. Suicide intervention for people with disabilities: a lesson in inequality. Issues Law Med. 1992;8(1):37–54.
,
Suicide intervention for people with disabilities: a lesson in inequality
, Issues Law Med.
, vol. 8
(pg. 37
-54
) Asch A. recognizing death while affirming life: can end of life reform uphold a disabled person’s interest in continued life? [special report]. Hastings Center Report. 2005; 35(6):S31–S36.
,
recognizing death while affirming life: can end of life reform uphold a disabled person’s interest in continued life? [special report]
, Hastings Center Report
, vol. 35
(pg. S31
-S36
) Batavia AI. The ethics of PAS: morally relevant relationships between personal assistance services and physician-assisted suicide. Arch Phys Med Rehabil. 2001;82(suppl 2):S25–S31.
,
The ethics of PAS: morally relevant relationships between personal assistance services and physician-assisted suicide
, Arch Phys Med Rehabil
, vol. 82
(pg. S25
-S31
) Bickenbach JE. Disability and life-ending decisions. In: Battin MP, Rhodes R, Silvers A, eds. Physician Assisted Suicide, Expanding the Debate. New York: Routledge; 1998:123–132.
,
Physician Assisted Suicide, Expanding the Debate
, Disability and life-ending decisions
(pg. 123
-132
) Bouvia v. Superior Court, 179 Cal. App. 3d 1127, 225 Cal. Rptr. 297 (1986).
Nancy B. v. Hotel-Dieu de Quebec, [1992] 86 D.L.R. (4th) 385 (Que.S.C.).
McKay v. Bergstedt, 106 Nev. 808, 801 P.2d 617 (1990).
Gill CJ. Health professionals, disability, and assisted suicide: an examination of relevant empirical evidence and reply to Batavia. Psychol Public Policy Law. 2000;6(2):526–545.
,
Health professionals, disability, and assisted suicide: an examination of relevant empirical evidence and reply to Batavia
, Psychol Public Policy Law
, vol. 6
(pg. 526
-545
) Gerhart KA, Corbet B. Uniformed consent: biased decisionmaking following spinal cord injury. HEC Forum. 1995;7(2-3):110–121.
,
Uniformed consent: biased decisionmaking following spinal cord injury
, HEC Forum
, vol. 7
(pg. 110
-121
) Gill CJ. Depolarizing and complicating the ethics of treatment decision-making in brain injury: a disability rights response to Nelson and Frader. J Clin Ethics. 2004;15(4):277–288.
,
Depolarizing and complicating the ethics of treatment decision-making in brain injury: a disability rights response to Nelson and Frader
, J Clin Ethics
, vol. 15
(pg. 277
-288
) Dresser R. Precommitment: a misguided strategy for securing death with dignity. Texas Law Rev. 2003;81(7):1823–1847.
,
Precommitment: a misguided strategy for securing death with dignity
, Texas Law Rev.
, vol. 81
(pg. 1823
-1847
) State v. McAfee, 259 Ga. 579, 385 S.E.2d 651 (1989).
Scofield GR. Ethics and rehabilitation: what are we doing and why are we doing it? SCI Psychosoc Process. 1993;6(4):147–149.
,
Ethics and rehabilitation: what are we doing and why are we doing it?
, SCI Psychosoc Process
, vol. 1993
(pg. 147
-149
) Carpenter C. The experience of spinal cord injury: the individual’s perspective — implications for rehabilitation practice. Phys Ther. 1994;74(7):614–629.
,
The experience of spinal cord injury: the individual’s perspective — implications for rehabilitation practice
, Phys Ther
, vol. 74
(pg. 614
-629
) Hammell KW. Quality of life among people with high spinal cord injury living in the community. Spinal Cord. 2004;42:607–620.
,
Quality of life among people with high spinal cord injury living in the community
, Spinal Cord
, vol. 2004
(pg. 607
-620
) Halpern J. From Detached Concern to Empathy. Oxford: Oxford University Press; 2001.
,
From Detached Concern to Empathy
Kuczewski M, Fiedler I. Ethical issues in rehabilitation: conceptualizing the next generation of challenges. Am J Phys Med Rehabil. 2001;80(11):848–851.
,
Ethical issues in rehabilitation: conceptualizing the next generation of challenges
, Am J Phys Med Rehabil
, vol. 80
(pg. 848
-851
) Batavia AI. The relevance of data on physicians and disability on the right to assisted suicide: Can empirical studies resolve the issues? Psychol Public Policy Law. 2000;6(2):546–558.
,
The relevance of data on physicians and disability on the right to assisted suicide: Can empirical studies resolve the issues?
, Psychol Public Policy Law
, vol. 6
(pg. 546
-558
) Jennings B. Healing the self: the moral meaning of relationships in rehabilitation. Am J Phys Med Rehabil. 1993;74(suppl 1):S25–S28.
,
Healing the self: the moral meaning of relationships in rehabilitation
, Am J Phys Med Rehabil
, vol. 74
(pg. S25
-S28
) Bach JR, Tilton MC. Life satisfaction and wellbeing measures in ventilator assisted individuals with traumatic tetraplegia. Arch Phys Med Rehabil. 1994;75:626–632.
,
Life satisfaction and wellbeing measures in ventilator assisted individuals with traumatic tetraplegia
, Arch Phys Med Rehabil
, vol. 75
(pg. 626
-632
) Hall KM, Knudsen ST, Wright J, Charlifue SW, Graves DE, Werner P. Follow-up study of individuals with high tetraplegia (C1-C4) 14 to 24 years postinjury. Arch Phys Med Rehabil. 1999;80:1507–1513.
,
Follow-up study of individuals with high tetraplegia (C1-C4) 14 to 24 years postinjury
, Arch Phys Med Rehabil
, vol. 80
(pg. 1507
-1513
) Trieschmann RB. Long-term adjustment issues. In: Spinal Cord Injuries: Psychological, Social, and Vocational Rehabilitation. 2nd ed. New York: Demos; 1988:237–287.
,
Spinal Cord Injuries: Psychological, Social, and Vocational Rehabilitation
, Spinal Cord Injuries: Psychological, Social, and Vocational Rehabilitation
(pg. 237
-287
) Gardner BP, Theocleous F, Watt JWH, Krishnan KR. Ventilation or dignified death for patients with high tetraplegia. Br Med J. 1985;291:1620–1622.
,
Ventilation or dignified death for patients with high tetraplegia
, Br Med J
, vol. 291
(pg. 1620
-1622
) Feinberg J. The Moral Limits of the Criminal Law: Harm to Self. Vol. 3. New York: Oxford University Press: 1986:117–124.
,
The Moral Limits of the Criminal Law: Harm to Self
Maynard FM, Muth AS. The choice to end life as a ventilator-dependent quadriplegic. Arch Phys Med Rehabil. 1987;68:862–864.
,
The choice to end life as a ventilator-dependent quadriplegic
, Arch Phys Med Rehabil
, vol. 68
(pg. 862
-864
)
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