Friday, September 30, 2005

End of Life: the humanitarist view

The Lancet 2005; 366:1235-1237
DOI:10.1016/S0140-6736(05)67486-7

Recommended by Marcelo Gustavo Colominas [mgcolominas@gigared.com] Full text available on request
End of life: the humanist view
Julian Baggini and Madeleine Pym
This is the seventh and final Viewpoint in a series about end-of-life issues for different religions.
A central tenet of humanist thought is that this world and this life are the only ones we have, and that, in the absence of an after-life and a soul, death brings a natural end to our existence. Broadly defined, a humanist is a morally concerned person who is not religious. However, individual humanist beliefs vary immensely—from atheists, who regard God as a human creation, to agnostics who might merely assert that although they can neither prove nor disprove God's existence, it is of no practical concern to them. But all humanists will tend to share a scepticism toward, and a rejection of, traditional religion and religious ritual, and a positive commitment to living a morally responsible life.
In view of this practical emphasis on the world, the community, and the individual, rather than a transcendental emphasis on God and the after-life of the soul, how can those in the medical profession best meet the needs of humanists as they approach death? In answering this question, we will begin with a brief introduction to humanism and its main tenets, going on to consider what differentiates the humanist approach to death from the religious one. We will explain the main criteria for what might constitute a good death for humanists and how medical staff can help them achieve this end.
The key issues are: the fundamental requirement to accord the needs and beliefs of humanists the same respect given to religious believers; the need to recognise that humanists vary in their attitude towards their own death and might or might not want to be informed of the full facts of their case, despite a genuine respect for truth and honesty in all matters; and the need for autonomy and control over the means of death and the treatment of their body after death. We also will discuss some of the difficulties incurred when the dying person's family neither respects nor shares his or her beliefs. We will include recommendations about how the needs of humanists can best be accommodated in the hospital.

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