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Glossary of Terms Concerning "End of Life" Issues

Euthanasia: Help with a good death. (Legally vague but useful as a broad, descriptive term.)

Passive euthanasia: The deliberate disconnection of life support equipment, or cessation of any life-sustaining medical procedure, permitting the natural death of the patient.

Active euthanasia: Deliberate action to end the life of a dying patient to avoid further suffering.

Active voluntary euthanasia: A lethal injection by a doctor into a dying patient to end life by request of the sufferer.

Active involuntary euthanasia: Lethal injection by a doctor into a dying patient without that person's express request.

Assisted suicide: Providing the means (drugs or other agents) by which a person can take his or her own life.

Physician-assisted suicide: A doctor providing the lethal drugs with which a dying person may end their life.

Physician aid-in-dying: Euphemistic term for medical doctor assisting the suicide of a dying patient.

Self-deliverance: A person irreversibly ill who makes a rational decision to end his or her own life. This term is preferred by those who consider it mistaken to equate this type of action with suicide.

Suicide: Deliberately ending one's life.

Rational suicide: Ending one's own life for considered reasons, as opposed to emotional or psychological ones.

Silent suicide: Starving oneself to death. Usually carried out in extreme old age.

Kill: Deliberately ending the life of a person or creature. May or may not be unlawful.

Murder/Homicide: Unlawfully slaying a person who wished to live.

Mercy killing: Term loosely used to describe all acts of euthanasia. Best defined as ending another person's life without explicit request in the belief that it is the only compassionate thing to do.

Heroic Measures: Medical procedures which are pointless because the patient is certain to die shortly.

Double effect: Giving large amounts of opiate drugs to a patient to relieve pain while at the same time recognizing that these will hasten death.

Negotiated death: A formal agreement between family, physicians, hospital management, etc, that life support systems to an incompetent person are better disconnected in the best interest of the patient. All parties agree not to bring lawsuits.

Snow: (Slang). Administering heavy doses of opiate drugs to completely sedate a person who is dying painfully. Person dies whilst unconscious.

CPR (Cardiopulmonary resuscitation): Non-surgical massage of a heart which has stopped to try to get the organ working again. Procedure will almost always be started unless there is a D N R order.

DNR (Do not resuscitate): An order on the patient's medical chart advising health professionals that extraordinary measures should not be used to attempt to save this person's life.

Slow code (or Blue Code): The deliberate slow response to a medical alert of heart or breathing stoppage which is designed to make resuscitation impossible.

Advance directives: Legally accurate name for the next two documents dealing with passive euthanasia.

Living Will: Popular name for an advance directive by which a person requests in writing a physician not to connect, or to disconnect, life-supporting equipment if this procedure is merely delaying an inevitable death. Legal in all U S states.

Durable Power of Attorney for Health Care: An advance directive by which a person nominates another person to make health care decisions if and when she/he becomes incompetent, thus allowing by proxy decision a treating physician to obtain informed consent to a medical procedure or withdrawal of treatment.

Health Care Proxy: A combination of the above two documents and phrased differently. Likely to be encountered in the states of Massachusetts and New York.

Terminal illness: The condition of a sick person for whom there is no known cure.

Irreversibly ill: Another way of saying terminally ill but also likely to be a lengthier dying process.

Hopelessly ill: Patient with a disease which has no known cure but is not immediately life-threatening.

Ethics: A system of moral standards or values.

Bioethics: Study of the moral problems which face modern medicine.

Rule ethics: Obeying the moral standards dictated by a religion.

Situation ethics: Moral standards as dictated by the prevailing circumstances.

Medical ethicist: Person with philosophical and/or legal training who offers opinions on the moral dilemmas which face physicians and psychiatrists.

Hospice: A formal program of palliative care for a person in the last six months of life, providing pain management, symptom control, and family support.

Palliative care: Medical term for hospice. Measures which do not attempt to treat the illness but to relieve the pain and other discomfort accompanying it.

Right to die: Popular general term reflecting a basic belief that end-of-life decisions should be an individual choice.

Right to choose to die: A more accurate term for the above.

Right to life: Popular general term for belief that death should only come about by the will of a deity, or the belief that life is the prevailing value, regardless of medical conditions or desires to end it for whatever reason.

Slippery slope: Theory that the sanctioning of an act which in itself may not be morally repugnant or illegal on a small scale, but could lead to other similar and wider actions which are.

"Nazi euthanasia": Term of abuse hurled against modern believers in euthanasia, referring to German murder of approximately 100,000 handicapped people during World War Two. Combined with the Jewish Holocaust (6 million died), this was part of the Nazi Party program for racial purity.

"A vegetable": Crude but popular way of describing a person who is in a long-term coma. Correct term below.

Persistent Vegetative State: Severely brain-damaged person in a permanent coma from which they will not recover. Almost always on life-support systems.

Brain damage: Injury to the brain causing impairment. Life support systems optional.

Coma: Prolonged unconsciousness from which a patient may recover.

Brain dead: Complete cessation of cognitive function. Life support systems could keep the body operating but pointless. The point of death is defined by what is known as "the Harvard criteria".

ICU: Intensive care unit which fights to bring people back from the brink of death.

Miracle cure: A sudden healing occasioned by a deity or a new medical discovery. Rare.

Trauma: An accident or incident which affects body or mind.

Competent/competency: The ability of a person to communicate with a physician and understand the implications and consequences of medical procedures.

Informed consent: A patient giving permission to a physician to carry out a medical procedure after she/he is made fully aware of the benefits, risks, and any alternatives.

Incompetent: The opposite of the two previous definitions.



© copyright l995, Derek Humphry.
This glossary may be reprinted or downloaded for use in scholarly papers only provided the source is given as follows: 'From LAWFUL EXIT: The Limits of Freedom for Helping in Dying' by Derek Humphry, Norris Lane Press, l993.

 

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