Glossary

It is a way allowing a competent person to put in writing his will concerning the treatments he would want or he would not want to receive if he were to find himself in a situation where he could not express his will himself. The advance directive comes into force when the person becomes unable to make those decisions.

It is the help a person gives to someone who wants to end his life. The help is not restricted to the medical context. This means that the motive of the person who wants to die is not necessarily due to an illness. The help can be given by any person and the means used can be medical or not.

Ability to take voluntarily and without coercion, personal decisions and assume the consequences. Autonomy presumes the capacity to make a free decision as to what they consider their best choice.

It includes the hygiene, feeding and hydration measures and, where appropriate, the handling of oxygen supply provided by health personnel to a patient; however, the patient may refuse to be fed and hydrated, and this must be respected.

Set of maneuvers intended to replace and reestablish breathing and spontaneous circulation in someone who has stopped breathing or whose heart has ceased to beat, so he can survive.

It describes the kind of sedation administered to a patient whose death is expected within the next two weeks and whose suffering cannot be alleviated by any other means. This sedation implies the discontinuation of solid feeding and of hydration or keeping hydration at a minimum level. It can speed up the end of life, although that is not the purpose of sedation, but rather to cause unconsciousness so that the patient stops experiencing a pain that cannot be alleviated during the remaining time of his life.

It is the permanent absence of the individual’s cognitive relationship with himself and his environment, resulting from a cardiac arrest or irreversible brain damage.

Because it is an ambiguous term (it is equally used to defend euthanasia and to attack it), it is preferable to use it in a subjective sense, that is, according to what a patient establishes as minimum life acceptable conditions, which is what ultimately interests and can be defined by it.

Etymologically it means “good death”, and it refers to the action that a doctor performs to induce the death of a patient who has freely requested it because he is enduring an intolerable suffering for which there is no relief, and that is caused by a disease or a medical condition for which there are no healing options.

It is carried out by means of a painless method that produces a fast unconsciousness followed by an irreversible cardiorespiratory arrest.

Medical actions and therapeutic measures whose expected benefit is zero or almost zero. It is considered that the futile means are “disproportionate” and outside the clinical situation of the patient, so there is no moral obligation to maintain them.

It is the informed decision that a patient makes to accept the therapeutic options offered by his doctor.

It is the suspension or non-initiation of treatments when, according to medical evidence, such treatments are useless or futile, as they only prolong the biological life, delaying imminent death, but without any possibility of providing a functional recovery with a minimum quality of life.

It is the active and total care of those patients who do not respond to a healing treatment, in which it is a priority to provide relief through the treatment of pain and other symptoms, as well as to care for the psychological, social and spiritual aspects.

It is the administration of drugs, in the doses and combinations required, to reduce the awareness of a patient in a terminal situation, in order to mitigate one or more refractory symptoms causing him pain or distress, all of this performed with his consent or, if this is not possible, with the consent of his family or representative.

This term includes euthanasia and physician-assisted suicide.

It is the practice of providing a competent patient—who so requests it—the medication to put an end to his or her own life. The assisting doctor can prescribe a lethal dose of the medication or he can provide the medication. The patient is the one who carries out the final action causing his death.

Specific physical, psychological and social conditions that allow a terminally-ill patient to act according to his objectives, expectations and beliefs, within the context of his family and social relationships.

It is the entitlement every person has to decide on the acceptance or not of the interventions, procedures or treatments proposed by his doctors, even if, as a consequence of his decision, the person dies. If in the restraint of the therapeutic effort the weight of the decision rests on the doctor, in the rejection of treatment it rests on the patient.

It is also called “therapeutic cruelty”. It is the implementation or perpetuation of medical treatments or measures that are considered useless because they do not modify or improve the condition of the patient, and may extend unnecessary suffering, whether physical, moral or even economic*.

*Due to the pejorative connotation that these concepts imply for health personnel, it is preferable to use the term “futility”, included in this glossary, based on a clinical assessment and scientific evidence.

It is the decision of a patient to stop consuming food and drinking water. It is a voluntary act that the patient makes aware of its consequences, so it represents a rational way to end his life.

The above glossary terms definitions are taken from the book:

Álvarez del Rio, Asunción. (2017). Coordinator. La Muerte Asistida en México. Una Opción Más al Final de la Vida (pages 119-128). México: Por el Derecho a Morir con Dignidad, A. C.

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