Language and Reality at the End of LifeLanguage and Reality at the End of Life

Raphael Cohen-Almagor

University of Haifa, ISRAEL

Every Profession Has Its

Keywords That Are Important to Help Categorize Phenomena, Save Time and Provide a Framework for Working Together.

The Thesis: The Keywords Primarily Serve the Physicians, at

Times at the Expense of the Patients’ Best Interests.

Death With Dignity» To have dignity means to look at

oneself with self-respect, with some sort of satisfaction.

‘Quality of Life’

• Positive connotations, for example, in rehabilitation, cosmetic treatments, psychiatry, and psychology

• However, when dealing with end of life issues, ethicists who support euthanasia use the term ‘quality of life’ in a negative sense more often than in a positive one, meaning that they do not seek to improve the patient’s life but to end it

• This phrase often serves to justify the termination of life

• A subjective concept, meaning that one’s quality of life is determined by one’s personal life circumstances

Patients in ‘Persistent Vegetative State’

• Prolonged unawareness and post-coma unawareness (PCU)

• The term ‘vegetative’ dehumanizes patients and therefore is offensive to patients and their beloved people

• We should strive to describe the condition without offending patients or their beloved people

• We should not strip patients of their human and moral characteristics

‘Double Effect’

• Two basic presuppositions: (1) the doctor’s motivation is to alleviate suffering

• (2) the treatment must be proportional to the illness

• The rule is not a necessary means to adequate pain relief because informed consent, the degree of suffering, and the absence of less harmful alternatives suffice

Conclusions• A need to introduce more ethics into the

medical school curriculum, equipping the medical staff with communication skills

• A need to invest more time talking with patients and their beloved people

• Clean the language and clarify it sincerely

• Use elaborate explanations instead of concise, obscure or unethical terms