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Protecting vulnerable life does not mean prolonging it regardless of suffering

  1. Paul J van der Maas, Professora
  1. a Department of Public Health, Erasmus University, Rotterdam, Netherlands

    The acid test for any society that claims to be civilised is whether it really protects the life and promotes the wellbeing of its most vulnerable citizens, including the very young, the very old, the chronically ill, and certainly the mentally impaired. Most seriously mentally disabled people have only a limited ability, or are entirely unable, to judge their own situation and make adequate decisions about it and are thus partly or entirely incompetent. All major decisions have to be made for them or, at least, have to be supported by carers and relatives. This sometimes includes difficult medical decisions at the end of life. Protecting vulnerable life does not mean prolonging it regardless of the amount of suffering this would entail.1 In this week's BMJ (p 88), van Thiel et al chart, for the first time, end of life decisions in …

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