Ethics, Position Statements

Pediatrics

• See the Pediatric Palliative Care Links on the site for the Canadian Network of Palliative Care for Children

Palliative / End-of-Life Care Position Statements

• Academy of Psychosomatic Medicine (A.P.M.) Position Statement: Psychiatric Aspects of Excellent End-of-Life Care
• Alberta Association of Registered Nurses (AARN) Position Paper on Palliative Care  
• American Academy of Family Physicians (AAFP) Position Statements on Issues Related to Palliative and End of Life Care
• American Academy of Pediatrics: Policy Statement RE0007 on Palliative Care for Children
• American Geriatrics Society (AGS) Position Statement THE CARE OF DYING PATIENTS
• American Nurses Association Position Statements on Ethics and Human Rights
•   American Society of Clinical Oncology (ASCO) Statement on Palliative Care
•   American Society of Clinical Oncology (ASCO) Statement on Cancer Care During the Last Phase of Life  
• American Society of Pain Management Nurses(ASPMN)Position Statement on Pain Management at the End of Life  
• Australian and New Zealand Society of Palliative Medicine: Joint Position Statement on Palliative Medicine in General Practice
•   Australian Medical Association Position Statement: The Role of the Medical Practitioner in End of Life Care - 2007
• European Society for Medical Oncology (ESMO) Policy on Supportive and Palliative Care
• Royal College of Nursing, Australia: The Role of the Nurse in Palliative Care  
• University of Toronto Joint Centre for Bioethics: Consensus guidelines on analgesia and sedation in dying Intensive Care Unit patients

General Palliative Care Ethics Resources

• 
  • End of Life Decisions - 1. Contemporaneous and advance refusal of treatment; 2. Withholding and withdrawing life-prolonging medical treatment; 3. Assisted dying: euthanasia and assisted suicide
• BMJ Article: Singer PA  Recent Advances: Ethics  BMJ 2000;321:282-285 ( 29 July )
•   Center for Applied Ethics and Professional Practice (CAEPP)
  
  "CAEPP conducts research to better understand the clinical, psychological, organizational, cross-cultural, and ethical complexities associated with advances in medical knowledge and technology..."
• NIH End-of-Life / Palliative Care - Bioethics Resources on the Web
• University of Toronto Joint Centre for Bioethics

Pain Control

• Canadian Pain Society Position Statement on Pain Relief
• International Society of Nurses in Cancer Care (ISNCC) Position Statement on Cancer Pain   

Withholding or Withdrawing Life-Sustaining Medical Treatment

•  American Medical Association Policy E-2.20 Withholding or Withdrawing Life-Sustaining Medical Treatment
  
  Search the AMA Policy Finder for E-2.20 and you will be directed to the policy statement.
• Australian and New Zealand Society of Palliative Medicine - Guide to Ethical Principles on Limitations of Treatments
•   British Medical Association
  • Withholding and withdrawing life-prolonging medical treatment: guidance for decision making (3rd edition 2007)
  • Treatment decisions for patients in persistent vegetative state; Revised Oct. 2006
• Canadian Association of Critical Care Nurses (CACCN) position statement on withholding or withdrawing of life support
• Dying Patients in the ICU: Forgoing Treatment, Maintaining Care
  Kathy Faber-Langendoen, MD and Paul Lanken, MD, FACP, for the ACP-ASIM End-of-Life Care Consensus Panel
  Ann Intern Med 2000;133:886-893

Futility / Conflicts in Care Provision

•  American Medical Association
  • American Medical Association: Policy E-2.037 Medical Futility in End-of-Life Care.
    
    Search the AMA Policy Finder for E-2.037 and you will be directed to the policy statement.
  • American Medical Association: Policy E-2.035 Futile Care
    
    Search the AMA Policy Finder for E-2.035 and you will be directed to the policy statement.
  • American Medical Association: Policy E-8.041 Second Opinions
    
    Search the AMA Policy Finder for E-8.041 and you will be directed to the policy statement.
•  Canadian Medical Association
  • Canadian Medical Association: Joint Statement on Preventing and Resolving Ethical Conflicts Involving Health Care Providers and Persons Receiving Care
• College of Physicians and Surgeons of Manitoba
  • Statement on Unproven Therapies

Resuscitation

•  American Medical Association Policy E-2.22: Do-Not-Resuscitate Orders
  
  Search the AMA Policy Finder for E-2.22 and you will be directed to the policy statement.
•  Canadian Medical Association: Joint statement on resuscitative interventions (update 1995)
• Australian and New Zealand Society of Palliative Medicine - Guide to Ethical Principles of Cardiopulmonary Resuscitation
• Decisions Relating to Cardiopulmonary Resuscitation - A joint statement from the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing; October 2007
  
  "These guidelines identify the key ethical and legal issues that should inform all CPR decisions. These basic principles are the same for all patients, in all settings, but differences in clinical and personal circumstances make it essential that all CPR decisions are made on an individual basis. The guidelines provide a framework to support decisions relating to CPR and communicating them effectively."

Nutrition and Hydration

• Australian and New Zealand Society of Palliative Medicine - Guide to Ethical Principles of Hydration and Nutrition
• Tube Feeding Options At The End Of Life - A Consumer And Caregiver's Guide by JM Hoefler, PhD
  
  "This web site is designed to help patients, family members, and care givers make thoughtful, informed decisions about the option of tube feeding at the end of life."

Euthanasia and Assisted Suicide

•  American Medical Association Policy E-2.21 Euthanasia
  
  Search the AMA Policy Finder for E-2.21 and you will be directed to the policy statement.
• American Society of Pain Management Nurses(ASPMN)Position Statement on Assisted Suicide  
• Australian and New Zealand Society of Palliative Medicine - Guide to Ethical Principles on Voluntary Euthanasia
• 
  • Euthanasia and physician assisted suicide: do the moral arguments differ?  A discussion paper from the BMA's Medical Ethics Department
  • Assisted Dying – a summary of the BMA's position
• Canadian Medical Association Policy Statement: Euthanasia and assisted suicide (update 1998)
• Royal College of Nursing, Australia - Position Statement on Voluntary Euthanasia and Assisted Suicide  
  
• When Death Is Sought: Assisted Suicide and Euthanasia in the Medical Context - New York State Department of Health
  
  "In May 1994, the New York State Task Force on Life and the Law published a 217 page report titled 'When Death Is Sought: Assisted Suicide and Euthanasia in the Medical Context'. Since this particular issue has received so much public attention, we are making the report available electronically. The report is posted in individual Chapters."

Resource Allocation

• Resource Allocation and the Terminally Ill - The Australian and New Zealand Society of Palliative Medicine