In 2005, the American Counseling Association (ACA) introduced a new ethical standard for counselors working with clients with terminal illness who are considering hastened death options. The authors' purpose is to inform counselors of the Death With Dignity Act and explore relevant ethical guidelines in the "ACA Code of Ethics" (ACA, 2005).

We present, in a synthetic way, some of the main findings from five studies that were conducted in the field of empirical bioethics, using the Functional Measurement framework. These studies were about (a) the rationing of rare treatments, (b) adolescents' abortions, (c) end-of-life decision-making regarding damaged neonates, (d) end-of-life…

The first major revision of the "ACA Code of Ethics" in a decade occurred in late 2005, with the updated edition containing important new mandates and imperatives. This article provides interviews with members of the Ethics Revision Task Force that flesh out seminal changes in the revised "ACA Code of Ethics" in the areas of confidentiality,…

End-of-life care is continuously becoming an issue of paramount importance given an increase in medical advances, the aging of the population, and the movement toward contributing toward a quality of life among terminally ill patients. However, there is a dearth in literature related to this topic specifically in terms of preparing counselors to…

"Code status" is a prominent feature of end-of-life discussions in U.S. hospitals. This essay analyzes how the rhetoric of code status articulates the terms of end-of-life decision-making in one hospital's "Patient" Preferences Worksheet. The Worksheet signifies the abandonment of the technological fix as the preferred…

Presents sentiment argument, distinguishing artificial feeding from medical treatments which may be discontinued when there is little hope of recovery. Describes probable origins of feelings about food and drink and shows that such feelings cannot be transferred without distortion to the hospital world. Argues that authentic sentiment seems to…

Explores issues related to "right to die." Makes case for counselors to assist clients and families with concerns related to refusal or withdrawal of medical treatment in cases of terminal illness or in cases where quality of life is severely impaired such as permanent comatose state. Presents historical, ethical, and legal perspectives.…

Debates the question of suicide as a defensible choice, particularly for the terminally ill, examining the relevance of such issues as the mortality, rationality, and dynamics of the suicidal act, and the legitimacy of physician-assisted suicide. Contrasting perspectives are articulated by two prominent suicidologists as a spur to the reader's…

Based on nearly three years of participant-observation research in hospice settings, factors that interfere with the hospice philosophy of providing patient autonomy include efforts at symptom control, patient residence, patient disease state, and staff limit setting. Discusses examples, implications, and staff attempts at solutions. (JPS)

Explores many dimensions of suicide among the terminally ill, including preemptive, surcease, and rational suicide. The critical issues addressed are the incidence of suicide in HIV-positive individuals, contributing factors associated with the risk of suicide among people with HIV/AIDS, and the clinical and ethical implications of this issue for…

The pragmatic question of assessing a client's situation with regard to rational suicide is raised. A review of the nine criteria for a diagnosis of clinical depression is suggested as a good way to explore the possibility of clinical depression in a terminally ill person who is considering suicide. (Author/EMK)

Whether or not suicide may be considered a rational choice for clients with terminal illness is controversial. Rational suicide and the literature and statistics pertaining to suicide and terminal illness are reviewed. Implications of accepting rational suicide as a treatment option, including moral and ethical issues, are addressed. (Author/EMK)

The rational suicide paradigm is contrasted with the traditional view of the mental health professions. Historical background on suicide in western civilization is supplied and the concept of rationality elucidated. Parallels between the questions of refusing life-prolonging therapy and rational suicide are discussed, as are reasons for suicide.…

Logical analysis of arguments in favor of rational suicide reveals 11 commonly encountered premises. These premises are listed, analyzed, and discussed. The arguments of the rational suicide literature are criticized on historical and philosophical grounds. Consensus-based reasonableness is found to provide an insubstantial base for social policy.…

Alternative perspectives are presented on the issue of rational suicide. An operational definition is provided; areas needing clarification are highlighted. The meta-issues are reviewed with regard to specific points raised by Lokhandwala and Westefeld. Concerns with research often cited to question the possibility of rational suicide are…