Best practices on informed consent procedures in sensitive areas of medical practice

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Published: Mar 26, 2025
DOI: https://doi.org/10.12681/bioeth.40932
Keywords:
euthanasia assisted suicide dignified death informed consent health law
Aneta Schwarzová
Doctoral student at the Faculty of Law of the University of West Bohemia in Pilsen, at the Department of Civil Law, Czech Republic, and Intern, National Commission for Bioethics & Technoethics, Greece
Abstract

The contribution focuses on best practices regarding informed consent procedures in sensitive areas of medical practice, specifically death with dignity. Initially, attention is given to defining key terms such as active euthanasia, assisted suicide, dignity, and psychological suffering. Subsequently, the paper analyzes the current situation in selected states, examining legislation, draft laws, jurisprudence, etc. Finally, a comparison of the legislation of individual states is provided.

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References
Oxford Reference. Autonomy. Available at: https://www.oxfordreference.com/display/10.1093/oi/authority.20110803095436282.
School of Medicine University of Missouri. Euthana-sia. Available at: https://medicine.missouri.edu/centers-institutes-labs/health-ethics/faq/euthanasia.
Garrard E; Wilkinson, S. Passive euthanasia. Journal of Medical Ethics, 2005, 31: 64-68. Available at: http://dx.doi.org/10.1136/jme.2003.005777.
Picón-Jaimes YA, Lozada-Martinez ID, Orozco-Chinome JE, Montaña-Gómez LM, Bolaño-Romero MP, Moscote-Salazar LR, Janjua T, Rahman S. Eutha-nasia and assisted suicide: An in-depth review of rele-vant historical aspects. Elsevier, Annals of Medicine and Surgery. 2022, 75. Available at: https://www.sciencedirect.com/science/article/pii/S2049080122001406#section-cited-by.
National Library of Medicine. Inform consent. Avail-able at: https://www.ncbi.nlm.nih.gov/books/NBK430827/.
Andorno R. Human Dignity and Human Rights. In: Henk AMJ ten Have (ed) Handbook of Global Bioeth-ics. Springer Reference, 2014: 45-57. Available at: https://www.researchgate.net/profile/Francis-Masiye/publication/286484913_Toward_an_African_UbuntuologyuMunthuolo-gy_Bioethics_in_Malawi_in_the_Context_of_Globalization/links/5de52d1b4585159aa45c992c/Toward-an-African-Ubuntuology-uMunthuology-Bioethics-in-Malawi-in-the-Context-of-Globalization.pdf#page=68.
United Nations. Universal Declaration of Human Rights. Available at: https://www.un.org/en/about-us/universal-declaration-of-human-rights.
Andorno R. Human Dignity and Human Rights. In: Henk AMJ ten Have (ed) Handbook of Global Bioeth-ics. Springer Reference, 2014: 49-50. Available at: https://www.researchgate.net/profile/Francis-Masiye/publication/286484913_Toward_an_African_UbuntuologyuMunthuolo-gy_Bioethics_in_Malawi_in_the_Context_of_Globalization/links/5de52d1b4585159aa45c992c/Toward-an-African-Ubuntuology-uMunthuology-Bioethics-in-Malawi-in-the-Context-of-Globalization.pdf#page=68.
Shuster E. Fifty Years Later: The Significance of the Nuremberg Code. The New England Journal of Medi-cine, 1997, 337: 1436-1440 Available at: https://www.nejm.org/doi/full/10.1056/NEJM199711133372006?query=recirc_curatedRelated_article.
UNC. Nuremberg Code Available at: https://research.unc.edu/human-research-ethics/resources/ccm3_019064/. And: Pellegrino ED. Some things ought never be done: moral absolutes in clinical ethics. Theoretical Medicine Bioethics, 2005, 26: 469-486. Available At: https://link.springer.com/article/10.1007/s11017-005-2201-2.
Haekens A. Euthanasia for Unbearable Psychological Suffering. In: Devos T (ed) Euthanasia: Searching for the Full Story. Springer, 2021: 39-47. Available at: https://library.oapen.org/bitstream/handle/20.500.12657/48260/9783030567958.pdf?sequence=1#page=55.
For example Paul Alexander. The Guardian. The man in the iron lung. Available at: https://www.theguardian.com/society/2020/may/26/last-iron-lung-paul-alexander-polio-coronavirus.
For example Ramón Sampedro case. University of Minnesota, Human Rights Library. Manuela Sanlés Sanlés v. Spain. Available at: http://hrlibrary.umn.edu/undocs/html/1024-2001.html.
Haekens A. Euthanasia for Unbearable Psychological Suffering. In: Devos T (ed) Euthanasia: Searching for the Full Story. Springer, 2021: 41-43. Available at: https://library.oapen.org/bitstream/handle/20.500.12657/48260/9783030567958.pdf?sequence=1#page=55.
Original: Wet toetsing levensbeëindiging op verzoek en hulp bij zelfdoding. Available at: https://wetten.overheid.nl/BWBR0012410/2021-10-01.
Original: Wetboek van Strafrecht.
Decision of the Supreme Court of the Netherlands, Case No. 19/04910 CW, dated April 21, 2020. Availa-ble at: https://uitspraken.rechtspraak.nl/#!/details?id=ECLI:NL:HR:2020:712.
Original: Loi relative à l'euthanasie. Available at: https://www.ejustice.just.fgov.be/cgi_loi/change_lg.pl?language=fr&la=F&cn=2002052837&table_name=loi.
Parlament of Victoria. Voluntary Assisted Dying Bill 2017, Research Papers. Available at: https://www.parliament.vic.gov.au/publications/research-papers/download/36-research-papers/13834-voluntaryassisted-dying-bill-2017.
Judgment of the European Court of Human Rights in the case of Mortier v. Belgium, No. 78017/17. Available at: https://hudoc.echr.coe.int/fre#{%22itemid%22:[%22002-13802%22]}.
Original: Loi sur l'euthanasie et l'assistance au suicide. Available at: https://legilux.public.lu/eli/etat/leg/loi/2009/03/16/n2/jo.
University of Minnesota, Human Rights Library. Ma-nuela Sanlés Sanlés v. Spain, Communication No. 1024/2001. Available at: http://hrlibrary.umn.edu/undocs/html/1024-2001.html.
University of Minnesota, Human Rights Library. Ma-nuela Sanlés Sanlés v. Spain, Communication No. 1024/2001. Available at: http://hrlibrary.umn.edu/undocs/html/1024-2001.html.
Esanum. The faces and laws behind the euthanasia debate in Spain. Available at: https://www.esanum.com/today/posts/the-faces-and-laws-behind-the-euthanasia-debate-in-spain.
Original: Ley Orgánica 3/2021, de 24 de marzo de regulación de la eutanasia. Available at: https://www.boe.es/buscar/act.php?id=BOE-A-2021-4628.
Canada, Justice Laws Website. An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying). Available at: https://laws-lois.justice.gc.ca/eng/annualstatutes/2016_3/fulltext.html.
Tiedemann M. Executive Summary - Assisted Dying in Canada After Carter v. Canada. Library of Parlia-ment, 2020. Available at: https://hillnotes.ca/2020/01/27/executive-summary-assisted-dying-in-canada-after-carter-v-canada/.
Deutscher Bundestag. Geschäftsmäßige Hilfe zum Suizid wird bestraft. Available at: https://www.bundestag.de/webarchiv/textarchiv/2015/kw45_de_sterbebegleitung-392450.
Original: Bendesverwaltungsgericht.
Soliman T, Schiele K. Sterbehilfe: Vom Gericht er-laubt, vom Minister verhindert. Available at: https://daserste.ndr.de/panorama/archiv/2018/Sterbehilfe-Vom-Gericht-erlaubt-vom-Minister-verhindert,sterbehilfe272.html.
Original: Bundesverfassungsgericht.
Judgment of the Federal Constitutional Court dated February 26, 2020, case no. 2 BvR 2347/15. From: Bundesverfassungsgericht. Urteil vom 26. Februar 2020 - 2 BvR 2347/15. Available at: https://www.bundesverfassungsgericht.de/SharedDocs/Entschei-dungen/EN/2020/02/rs20200226_2bvr234715en.html.
Bundesministerium der Justiz und für Verbraucherschutz. Grundgesetz für die Bundesrepublik Deutschland. Available at: https: https://www.gesetze-im-internet.de/gg/.
Original: Die parlamentarischen Enquete-Kommission. And also: Republik Österreich Parlament. Enquete-Kommission zum Thema "Würde am Ende des Lebens" (491 d.B.). Available at: https://www.parlament.gv.at/PAKT/VHG/XXV/I/I_00491/index.shtml.
Republik Österreich Parlament. 491 der Beilagen zu den Stenographischen Protokollen des Nationalrates XXV. GP. Bericht der parlamentarischen Enquete-Kommission. Available at: https://www.parlament.gv.at/PAKT/VHG/XXV/I/I_00491/fnameorig_386917.html.
Original: Verfassungsgerichtshof Österreich.
Judgment of the Austrian Constitutional Court dated December 11, 2020, case no. G 139/2019-71. Available at: Verfassungsgerichtshof Österreich. Ausgewählte Entscheidungen 2020. VfGH 11.12.2020, G 139/2019: Tötung auf Verlangen und Mitwirkung am Suizid. Available at: https://www.vfgh.gv.at/rechtsprechung/Ausgewaehlte_Entscheidungen.de.html.
Killing on Demand: „Who kills another at his earnest and urgent wish.." Original: Tötung auf Verlangen § 77 des Bundesgesetzes vom 23. Jänner 1974 über die mit gerichtlicher Strafe bedrohten Handlungen (Strafge-setzbuch - StGB), BGBl. 60/1974: „Wer einen anderen auf dessen ernstliches und eindringliches Verlangen tötet, ist mit Freiheitsstrafe von sechs Monaten bis zu fünf Jahren zu bestrafen.“
Participation in suicide: „Who induces or assists another to commit suicide..." Original: Mitwirkung am Selbstmord § 78 des Bundesgesetzes vom 23. Jänner 1974 über die mit gerichtlicher Strafe bedrohten Hand-lungen (Strafgesetzbuch - StGB), BGBl. 60/1974: „Wer einen anderen dazu verleitet, sich selbst zu töten, oder ihm dazu Hilfe leistet, ist mit Freiheitsstrafe von sechs Monaten bis zu fünf Jahren zu bestrafen."
Parlament Österreich. Regierungsvorlage. Bun-desgesetz, mit dem ein Sterbeverfügungsgesetz erlassen wird sowie das Suchtmittelgesetz und das Strafge-setzbuch geändert werden. Available at: https://www.parlament.gv.at/dokument/XXVII/I/1177/fnameorig_1012536.html.
Original: Sterbeverfügungsgesetz .
Parlament Österreich. Sterbeverfügungsgesetz; Suchtmittelgesetz, Strafgesetzbuch, Änderung (1177 d.B.). Available at: https://www.parlament.gv.at/gegenstand/XXVII/I/1177.
Bundesministerium Justiz. Sterbehilfe. Available at: https://www.bmj.gv.at/themen/Fokusthemen/Dialogforum-Sterbehilfe.html.
Moratti S. The Englaro Case: Withdrawal of treat-ment in Italy from a patient in a permanent vegetative state. European University Institute, 2012, 04. Available at: https://cadmus.eui.eu/bitstream/handle/1814/21757/MWP_2012_04_Moratti.pdf?sequence=1&isAllowed=y.
Corte suprema di cassazione, Sentenza 16 ottobre 2007, n. 21748. Available at: https://www.law.nova.edu/files/CassazioneOctober2007Italian.pdf. In english available at: https://www.law.nova.edu/files/CassazioneOctober2007English.pdf.
Corte Costituzionale, Ordinanza 8 ottobre 2008, n. 334. Available at: https://www.law.nova.edu/files/ConstitutionalCourtOctober2008Italian.pdf. In english available at: https://www.law.nova.edu/files/ConstitutionalCourtOctober2008English.pdf.
Original: Sentenza della Corte costituzionale 242/2019 sul caso Cappato-Antoniani.
Associazione Luca Coscioni. Il processo a Marco Cappato, punto per punto. Available at: https://www.associazionelucacoscioni.it/processo-marco-cappato-punto-punto.
Corte Costituzionale. Sentenza n. 242, anno 2019. Available at: https://www.cortecostituzionale.it/actionSchedaPronuncia.do?anno=2019&numero=242.
Quotidianosanità.it. Il suicidio assistito come diritto costituzionale. Un’analisi della sentenza della Consulta. Available at: https://www.quotidianosanita.it/studi-e-analisi/articolo.php?articolo_id=79083.
Original: Norme in materia di consenso informato e di disposizioni anticipate di trattamento.
Ministero della Salute. Norme in materia di consenso informato e di disposizioni anticipate di trattamento. (18G00006). Available at: https://www.trovanorme.salute.gov.it/norme/dettaglioAtto?id=62663.
Original: Loi relative aux droits des malades et à la fin de vie. Available at: https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000000446240/.
Ministère du Travail de la Santé et des Solidarités. Comprendre la loi Claeys-Léonetti de 2016: De nouveaux droits en faveur des personnes malades et des personnes en fin de vie. Available at: https://sante.gouv.fr/soins-et-maladies/prises-en-charge-specialisees/les-soins-palliatifs-et-la-fin-de-vie/la-prise-en-charge-palliative-et-les-droits-des-personnes-malades-et-ou-en-fin/article/comprendre-la-loi-claeys-leonetti-de-2016.
Original: Loi n. 2016-87 du 2 février 2016 créant de nouveaux droits en faveur des malades et des personnes en fin de vie. Available at: https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000031970253.
Fin de vie Soins Palliatifs. Exprimer ma volonté. Available at: https://www.parlons-fin-de-vie.fr/mes-droits/.
Vitale C, Nonneville A, Fichaux M, Salas S. Medical staff opposition to a deep and continuous palliative sedation request under Claeys-Leonetti law. BMC, 2019, 18. Available at: https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-018-0384-3.
République française. Code de la santé publique. Available at: https://www.legifrance.gouv.fr/codes/article_lc/LEGIARTI000041721056.
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