Between medicine, humanities and the law: compiling a living archive of assisted dying.

Stories about personal experiences of assisted dying, a term comprising both instances when a lethal substance is administered by a physician or by the patient themselves, are frequently cited in law-making processes. These experiences of healthcare systems and the laws governing end-of-life procedures thereby interactively influence the future of medicine at the deathbed. With more countries legalising some form of assisted dying or opening political debate about the issue, addressing how these personal stories shape public opinions and social institutions is timely. In this current controversy, we question how medical humanities researchers are to make sense of the role of these stories in law-making, and critically reflect on a digital archive that seeks to make these interconnections visible. At the methodological level, the reciprocal interactions in assisted dying between medicine, law and the arts urges us to reconsider the conceptual foundations of interdisciplinary research in the medical humanities.

"Accompanied Only by My Thoughts": A Kantian Perspective on Autonomy at the End of Life.

Within bioethics, Kant's conception of autonomy is often portrayed as excessively rationalistic, abstract, and individualistic, and, therefore, far removed from the reality of patients' needs. Drawing on recent contributions in Kantian philosophy, we argue that specific features of Kantian autonomy remain relevant for medical ethics and for patient experience. We use contemporary end-of-life illness narratives-a resource that has not been analyzed with respect to autonomy-and show how they illustrate important Kantian themes, namely, the duty to know oneself, the interest in elaborating universalizable principles, and the emphasis on ideals as points of orientation that guide behavior without ever being fully realized. As Kant does, the patient-authors discussed here perceive the end of life as a moment to reflect on the constitutive principles which have governed that life, thereby offering a privileged moment to pursue self-knowledge. We argue that bioethical conceptions of autonomy stand to gain if they revise their conception of Kantian moral philosophy as too formal, abstract, and detached from emotions and personal relationships to be helpfully applied.

After COVID-19: The Way We Die from Now On.

Ethical issues raised by the outbreak of COVID-19 have predominantly been addressed through a public health ethics lens. This article proposes that the rising COVID-19 fatalities and the World Health Organization's failure to include palliative care as part of its guidance on how to maintain essential health services during the pandemic have exposed palliative care as an underlying global crisis. It therefore calls for a different ethical framework that includes a care ethics perspective and thereby addresses the ways in which the pandemic has triggered new difficulties in ensuring the delivery of appropriate end-of-life care for the dying. The article analyses the structural weaknesses of palliative care accentuated by the pandemic and proposes solutions that could set in motion lasting changes in the way it is delivered beyond COVID-19.

Beyond Medical Paternalism: Undoing the Doctor-Patient Relationship in Simone de Beauvoir's A Very Easy Death.

In A Very Easy Death Simone de Beauvoir documents the illness, hospitalization, and death of her mother Françoise. Critics in the fields of bioethics and the medical humanities have concentrated on the text's paternalistic doctor-patient encounter, which culminates in the withholding of the cancer diagnosis from Beauvoir's mother and entails an unnecessary medical intervention to which the patient never consents. Reviewing the text's reception, this article argues that a focus on the ways in which it depicts breaches of several tenets of medical ethics have decontextualized A Very Easy Death and occluded the key role Beauvoir plays in the doctor-patient relationship. By situating the text within Beauvoir's œuvre and debates in French philosophy of medicine at the time of publication, this article proposes that Beauvoir's part in the withholding of the cancer diagnosis emerges less as a submission to medical paternalism than as a form of maternal caregiving.