Legal Case 10 D.: A Case Study Of Euthanasia

Friday, December 31, 2021 6:07:42 AM

Legal Case 10 D.: A Case Study Of Euthanasia



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Assisted Death \u0026 the Value of Life: Crash Course Philosophy #45

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Institutions should have a formal written understanding e. Pilot studies may be appropriate to determine the technical feasibility of larger studies or to make initial assessments of the effect of procedures on animals Guide pages 26 , Peer review of the scientific and technical merit of an application is considered the purview of the NIH Scientific Review Groups SRG , which are composed of scientific experts from the extramural research community in a particular area of expertise.

However, SRGs also have authority to raise specific animal welfare concerns that can require resolution prior to a grant award. Although not intended to conduct peer review of research proposals, the IACUC is expected to include consideration of the U. Government Principles in its review of protocols. Principle II calls for an evaluation of the relevance of a procedure to human or animal health, the advancement of knowledge, or the good of society.

Other PHS Policy review criteria refer to sound research design, rationale for involving animals, and scientifically valuable research. Presumably a study that could not meet these basic criteria is inherently unnecessary and wasteful and, therefore, not justifiable. The two bodies have differing constitutions, mandates and functions. However, since it is not entirely possibly to separate scientific value from animal welfare some overlap is inevitable.

When the awardee is a domestic institution i. Accordingly, the awardee remains responsible for animal activity conducted at a foreign site and must provide verification of IACUC approval. That approval certifies that the activity, as conducted at the foreign performance site, is acceptable to the awardee. This document certifies that the institution will comply with the applicable laws, regulations, and policies of the jurisdiction in which the research will be conducted, and that the institution will be guided by the International Guiding Principles for Biomedical Research Involving Animals PDF. OLAW encourages, but does not require, foreign institutions to use the standards in the Guide.

PHS Policy is intentionally broad in scope and does not prescribe specifics about the care and use of any species, assigning that task to the IACUC and allowing for professional judgment. Many of the principles embodied in the Guide can generally be adapted to the care and use of various kinds of nontraditional research animals. IACUCs may seek the advice of experts when necessary, and refer to scientific-based publications prepared by professional organizations with interest in various species.

Appendix A of the Guide references many such publications. When substantive information is lacking from a protocol, the committee may have questions requiring a response from the PI. Approval is valid for a maximum of 3 years. A brief description of the animal activities planned for the 4 th and 5 th year of the award period should be provided in the animal protocol recognizing that the experimental details and procedures will be refined or amended at a later time or at the time of the 3-year renewal.

Because the scientific enterprise is not static, the need for changes to animal protocols is anticipated and can occur at any time during the life of the protocol. For guidance on what is considered a significant change, see FAQ D9. In rare cases, IACUC review of animal activities is conducted later in the life cycle of a grant or contract. IACUC review may be delayed if the animal activities will not occur until a year or later in the award period as part of the research design described in the grant application or contract proposal e. In these circumstances, the funding component will issue a Notice of Award with a special term and condition indicating that no funds may be drawn from the grant or contract for animal activities until a valid IACUC approval date has been provided to the funding component.

Program Review and Inspection of Facilities. Animal Use and Management. Although carbon dioxide CO 2 is generally considered an acceptable euthanasia agent for small animals when properly administered, its acceptability is predicated on a number of critical factors as described in the AVMA Guidelines for the Euthanasia of Animals page It is important to verify death after CO 2 exposure, and CO 2 narcosis must be followed by a secondary method of euthanasia where necessary. Because immature animals are resistant to the hypoxia-inducing effects of CO 2 and require longer exposure times to the agent, alternative methods should be considered, such as injection with chemical agents, cervical dislocation, or decapitation Guide page The IACUC is responsible for evaluating the potential adverse consequences of non-pharmaceutical-grade substances when used for research.

The use of expired pharmaceuticals, biologics, and supplies is not consistent with acceptable veterinary practice or adequate veterinary care. Euthanasia, anesthesia and analgesia agents should not be used beyond their expiration date, even if a procedure is terminal. Other expired materials should not be used unless the manufacturer verifies efficacy beyond the expiration date, or the investigator is able to document to the satisfaction of the IACUC that such use would not negatively impact animal welfare or compromise the validity of the study.

The veterinarian and IACUC must maintain control over the use of expired medical materials in order to meet their responsibilities to avoid or minimize discomfort, pain or distress to animals. Institutions that conduct PHS-supported research, testing, or training have a responsibility to ensure animal welfare and an obligation to protect the federal investments in these activities. The Guide provides recommendations regarding temperature, humidity, and ventilation for common laboratory animals and discusses parameters regarding heating, ventilating, and air conditioning HVAC that must be considered. It is essential that life-threatening heat accumulation or loss be prevented during mechanical failure.

Institutions are strongly encouraged to consider using available electronic technology to measure temperature in each animal room on a continuous basis. Appropriately installed and powered sensors and electronic alarm systems can rapidly notify maintenance and animal care staff of the need to take immediate action to prevent harm to animals Guide page Sole reliance on employees to identify changes in animal room conditions or the use of high-low thermometers to track changes in temperature may not be sufficient to allow timely intervention and prevent catastrophic loss. Institutions are also responsible to ensure the welfare of fishes, amphibians, and other vertebrates whose environment is aquatic, with the emphasis on water temperature and quality, including oxygenation, circulation and filtration.

Guide pages The Guide requires that institutions develop a plan that can be instituted if a disaster occurs. Guide pages 35 , The disaster plan must include a scheme for relocating or euthanizing animals when power cannot be restored or repairs effected promptly. HVAC, alarm malfunctions, failures in primary and emergency power sources, mechanisms for maintaining appropriate temperatures and ventilation are important issues that must be considered and included in the disaster plan. OLAW provides a Disaster Planning and Response Resources web page to assist institutions in planning and responding to natural and other disasters affecting animal facilities.

The Guide requires that aseptic technique be followed for all survival surgical procedures. The manner in which asepsis is achieved varies by species. Modification of standard techniques may be desirable or even required, but should not compromise the well-being of the animals. Guide pages 30 , Multiple procedures that may induce substantial post-procedural pain or impairment may be conducted on a single animal only if justified by the PI, and reviewed and approved by the IACUC. Multiple major surgical procedures on a single animal are acceptable only if they are:. Cost savings alone are not an adequate justification for performing multiple major survival surgical procedures. Performance standards are to be applied to rodent housing issues.

See Guide pages While the Guide's space recommendations are accepted reference points for addressing space needs, performance standards allow flexibility to improve animal welfare and scientific research. Adjustments to recommendations for primary enclosures may be made at the institutional level by the IACUC. The Guide identifies examples of performance indices to assess adequacy of housing including:. Rodent cages of the size commonly used in the United States may be appropriate for pair or trio breeding.

The Guide does not add specific, additional engineering standards for breeding configurations. This empowers institutions to determine appropriate housing. The IACUC must consider relevant factors when assessing the adequacy of cage space according to performance standards. Examples of these factors may include:. Blanket, program-wide departures from the Guide for reasons of convenience, cost, or other non-animal welfare considerations are not acceptable. Cages that might be acceptable when litters are born may have insufficient space as pups grow. Whatever parameters are used to establish breeding configurations and weaning procedures, the IACUC must ensure that cage population does not negatively impact animal well-being and overcrowding does not occur.

The PHS Policy and the Guide are silent on the issue of private adoption of research animals for pets after a study has been completed and the animals are no longer required. For purposes of property standards under the uniform administrative requirements for HHS grant awards, animals purchased for research purposes are considered to be supplies. OLAW supports the safety and protection of animals and reminds institutions that their policies must clarify the disposition of animals acquired for research once the research has ended, which may include adoption. The PHS will not assume legal or financial responsibility for any adoption program or any matters arising from or related to the adoption of research animals. The institution should ensure that its policy meets pertinent state and local laws and regulations for the transfer of animal ownership and is encouraged to coordinate with local animal shelters.

Animals should be transported according to international, federal, state and local regulations summarized in the Guide page Needs of the animals and protection of personnel should be considered in advance of transportation and met during loading, transportation and unloading, as described in the Guide pages OLAW expects all parties involved in the transportation of animals to apply due diligence in assuring that animals are shipped under appropriate conditions to prevent morbidity or mortality due to temperature extremes or other adverse events.

When animals are shipped from an institution, that institution should consider and address all relevant factors to ensure safe transport of the animals. OLAW expects shipping institutions to report adverse events that occur to animals in transit. Receiving institutions should notify the shipping institution when animals are received in extremis or dead. Surgical procedures can be categorized as major or minor.

See Guide page Major survival surgery penetrates and exposes a body cavity, produces substantial impairment of physical or physiologic functions, or involves extensive tissue dissection or transection e. Minor survival surgery does not expose a body cavity and causes little or no physical impairment e. Animals undergoing a minor survival surgical procedure typically do not show significant signs of postoperative pain, have minimal complications, and quickly return to normal function.

In some cases, the classification by the IACUC of a procedure as major or minor may be readjusted post-procedurally depending on clinical outcome. If the IACUC, after thorough review, determines that the surgical procedure only penetrates but does not expose a body cavity and that the procedure does not produce substantial impairment, the IACUC may conclude that it is not a major operative procedure. Any laparoscopic surgery that produces substantial impairment of physical or physiological function must be considered a major operative procedure.

Whether the laparoscopic procedure is classified as major or minor, the IACUC must ensure that the appropriate analgesia, sterile technique, and perioperative monitoring is employed. Multiple major survival surgical procedures on a single animal are discouraged but may be permitted if they are related components of a research project, are scientifically justified by the investigator, or if they are needed for clinical reasons.

Cost savings alone is not an adequate reason for performing multiple major survival surgical procedures. There is universal agreement among oversight agencies that nonhuman primates should be socially housed. See U. The Guide endorses social housing as the default for nonhuman primates. Staff performing nonhuman primate socialization should be trained and competent in the procedure and knowledgeable about the animals. Behaviorally compatible animals should be used whenever possible in socialization attempts. Group composition is critical and numerous species-specific factors should be taken into consideration when forming a group.

Determination of the appropriate cage size is not based on body weight alone. Professional judgment is paramount in making such determinations. Exemptions to the social housing requirement must be based on strong scientific justification approved by the IACUC or for a specific veterinary or behavioral reason. Lack of appropriate caging does not constitute an acceptable justification for exemption. When necessary, single housing of social animals should be limited to the minimum period necessary. When single housing is necessary, visual, auditory, olfactory, and depending on the species protected tactile contact with compatible conspecifics should be provided, if possible.

Protected tactile contact is considered single housing by USDA, with rare exceptions. Institutions are encouraged to consult the Animal Welfare Act and Regulations on primate housing requirements. In situations where it is safe and feasible, nonhuman primates should be given positive reinforcement training to perform desired cooperative activities involved with research and husbandry. This type of training may also aid in reducing stress from capture and restraint and the need for chemical darts. The Guide comments on procedural habitation and training on pages Performance standards are to be applied to housing issues. Outcome-based performance standards are paramount when evaluating cage or pen space for housing animals used for research, research training, and biological testing.

While the Guide's space recommendations are accepted reference points for addressing space needs Guide pages , performance standards allow flexibility to improve animal welfare and scientific research. Some species are upset by the introduction of novel items. Animals should not be subjected to the presence of items that they find distressing. IACUCs may consider the use of a rabbit cage that is 14 inches in height, if appropriate for specific animals.

The IACUC should establish, through performance indices related to animal well-being, that the cage provides sufficient space to meet the physical, physiologic and behavioral needs of the animal. For example, the rabbit must be able to hold its ears in an upright position if this is natural for the breed and ears must not be forced to fold over by contact with the cage ceiling. Ingestion of food and fluid are requirements for proper nutrition. When food or fluid is restricted, the amount of the regulated item earned during testing and the amount of the regulated item freely given should be recorded to ensure each animal receives its minimum daily requirements.

The IACUC must also evaluate the methods for assessing the health and well-being of animals involved in activities that regulate food or fluid consumption. The IACUC has the authority to approve scientific justifications for departures from the recommendations in the Guide. For instance, using scheduled access to food or fluid sources may be justified by describing procedures based on performance standards that assure adequate maintenance of hydration, body weight, and behavioral and clinical health. It may be necessary to monitor both food and fluid intake if regulation of one influences consumption of the other. The Guide discusses food and fluid restriction on pages Institutional Responsibilities.

Depending on the species of animal or the amount of animal exposure, the program may not affect all personnel equally. Minimally, the program must include:. Occupational Health and Safety in the Care and Use of Research Animals , published in by the National Research Council, includes helpful guidelines and references for establishing and maintaining an effective and comprehensive program. The Guide pages 35 , requires that institutions develop disaster plans that take into account the well-being of animals and personnel during unexpected events. Conducting a risk assessment will help to identify potential major hazards and threats, such as power outages, HVAC malfunctions, and natural disasters. Location-based risk should be accounted for in the disaster plan with mitigation strategies to address all known vulnerabilities.

Institutions may find consideration of the following components useful in the development of a comprehensive, effective plan:. Institutions should periodically review and update the plan to adapt to program changes, evolving risk, and lessons learned from drills and actual disasters. Recent hurricanes and tropical storms provide lessons on the unpredictable nature and devastating effects of extreme weather events.

Institutions are encouraged to continually re-assess their vulnerabilities as future climate changes are expected to cause higher sea levels and effect precipitation patterns and the severity of storms. Disasters can happen at any time. With advance preparation, institutions may be able to lessen or eliminate the impact before a disaster occurs. This offers no direct clash with our plan and our line of argumentation throughout the entire debate. We recognize that palliative care as a viable option for patients, but we also have pointed out some of the pitfalls of palliative care and how PAS can be a benefit to those who have to suffer in these pits in some countries currently.

Reform can be achieved in both PAS and palliative care under our plan. Fundamentally, we respect the preference of the patient to choose whichever option. The proposition is on the side of options and a death with dignity for citizens. While this concern is certainly respectable, it is based simply on predicative fears. These fears have been discredited with the empirical evidence that we have provided from countries and states in which PAS is already supported. It is time to break free from the shackles of these ideals into a world where citizens are individually empowered by supporting the right-to-die. Day by day more and more governments and citizens are recognizing this right and are strongly disavowing the antiquated positions that our opposition has argued for.

Both sides agree that laws can indeed change, but when should these laws should change is where the debate lies. We refuse to maintain archaic laws in which the consent of the patient and expertise of the doctor is largely ignored. We believe that to support PAS is supporting a flexible and ethical system that can address this complex situation with the patient and doctor in mind and at the forefront. We do not support an atmosphere where the state destroys options and makes the decision for its citizens, especially on the most sacred thing a person has, life. We are not advocating a vast increase in quantity but rather a quality increase in organ donation. We have stated that if these terminally ill patients are forced to live prolonged lives, vital organs will become increasingly weaker even if the disease does not directly affect specific organs.

The system allows organ donation to be completed more efficiently, effectively and even at all in some cases. The proposition offers quality of life over just mere quantity, choice on how to preserve this quality, and a way to preserve life of many people on organ donation waiting lists. We strongly believe we offer a far better system for these very reasons, masterpiece or not. Patients that are in comas and have not indicated that they wish to die have the right to continue thier lives until the natural end.

Who are we to say that they should die when it is convenient to us? That should be left unto God to decide. This point should be erased. What is being advocated is the right of an individual to make a decision, not to have a say or coerce an individual to make the decision to want to die. Although in some cases, involuntary euthanasia has a dark region grey area. There are strong proponents on both sides of the debate for and against euthanasia. Opponents argue that euthanasia cannot be a matter of self-determination and personal beliefs, because it is an act that requires two people to make it possible and a complicit society to make it acceptable. They consider euthanasia the equivalent of murder, which is against the law everywhere in civilized society. So, we sould maintain the respect for human life in a secular pluralistic society.

The first argument was removed. An appeal to a dictionary or a definition does not make it right or justified in its position. This principle must be safeguarded by law, as moral absolutes of this kind are necessary for a functioning legal system. While religious morality may be precise on who sets decides when a person dies secular values also recognise if a person is suffering unncessarilly they should be helped to eliminate that suffering.

Futhermore a person may well be non religious and resent the imposition of religious or secular values on them, values which they may not belive in. If an individual does this, the individual believes that there is a morality outside of religious morality above the standard for which the biblical or context in which religion takes place and thus it is moot whether the bible says so or not. The problem that I have always had with euthanasia is that terminally ill patients may choose to die through feelings of guilt. They may feel guilty about the burden that they are putting on their families and choose to die for this reason alone.

Whatever their reasons, a person should be allowed to do as they see fit. It is their life and they have the right to choose how and when it ends. The prestigious position of doctors could quite easily be abused if euthanasia were to become legalised. A patient and his family would generally decide in favour of euthanasia according to the details fed to them by their doctor. These details may not even be well founded: diagnoses can be mistaken and new treatment developed which the doctor does not know about.

Surely it is wrong to give one or two individuals the right to decide whether a patient should live or die? On the contrary, the majority of doctors would make well-informed, responsible and correct decisions, but for those few like Harold Shipman, they can get away with murder, undetected, for 23 years. Harold Shipman committed his crimes when euthanasia was illegal, which illustrates that psychopaths can commit crimes whatever the legal situation. Legalising euthanasia would have no effect on the 0. In countries where euthanasia is currently legal, such as Switzerland and the Netherlands, strict legal guidelines are in place to ensure that the process does not include such problems.

All patients who request euthanasia require the diagnoses of at least two doctors to verify the terminal nature of their illness, and undergo psychological examination by these doctors and often other experts to examine the reasons for their choice. Ethical safe-guards may not be achieved in the time frame allotted by the affirmative. Oregon physicians, as well as the physicians of Netherland, have been given authority without being in a position to exercise it responsibly. They are expected to inform patients that alternatives are possible without being required to be knowledgeable enough to present those alternatives in a meaningful way, or to consult with someone who is.

Meaning that physicians or mental health professionals are advising patients without a complete understanding of end-of-life care available to them, which again goes against the Hippocratic Oath all medical personal must take. They are expected to make decisions about involuntariness without having to see those close to the patient who may be exerting a variety of pressures, from subtle to coercive. They are expected to do all of this without necessarily knowing the patient for longer than 15 days, which is clearly not long enough to fully gain perspective on a person.

Since physicians cannot be held responsible for wrongful deaths if they have acted in good faith, substandard medical practice is encouraged, physicians are protected from the con-sequences, and patients are left unprotected while believing they have acquired a new right, and ultimately defeats the purpose of legalizing PAS. The opposition stands with critics of PAS who have found that once assisted suicide is accepted as an available option for competent terminally ill adults, it may be permitted for ever-larger groups of persons, including the non-terminally ill, those whose quality of life is perceived to be diminished by a physical disability, persons whose pain is emotional instead of physical, and so forth.

Critics point to the fact that permitting euthanasia and assisted suicide, as is done in the Netherlands, does not prevent violation of procedures e. It is further contended by the opposition that adequate safeguards are not possible. Persons at the end of their lives typically have neither the energy nor the ability to meet such conditions. In addition, the option of assisted suicide for mentally competent, terminally ill people could give rise to a new cultural norm of an obligation to speed up the dying process and subtly or not-so-subtly influence end-of-life decisions of all sorts.

Which ultimately costs the patient one of the three inalienable rights, the pursuit of Life. We believe no person or government has a right to keep these people entangled in a web of suffering. We recognize that people can continue their lives even in dire situations, but we believe the government should not force them to continue a life of suffering.

Unfortunately we do not live in a world where the medical practice can be absolutely infallible. This is more an argument against any sort of medical procedure, life saving or life ending because these problems are not unique to any medical procedure, whether it be perceived as simple or complex. Involuntary euthanasia is not a problem with our safeguards and able and competent doctors in place. Any doctor that would commit involuntary euthanasia with any form of consent from their patient would do so even without a legal PAS system because they have no regard for ethics. We support the inalienable pursuit of Life but we do not support force-feeding life to citizens whom declare that they no longer want to participate in this pursuit for the ethically justifiable reasons stated in our case.

Where governments allow dissent, it would be ludicrous to demand that all citizens must dissent in order to exercise their right. The right to life has to be forfeited at some point, and we support the right for our citizens to choose when they want to forfeit it. We see this in the status quo already — governments have ceased to consider suicide a crime. Why should assisted suicide for terminally ill patients be any different? A patient may accurately judge their current quality of life to be unacceptable, but adequate care would always increase their quality of life to the point where they would reconsider. PAS limits the view of the patient to a mere biological mass. Palliative care providers emphasize compassion, and the will to care for the whole human being.

The importance of caring for the whole individual rather than for an organ is underlined, as is the importance of interactions between psychological and physical suffering. For both PAS and palliative care, the worst evil is a poor quality of life. For palliative care providers, however, the worst evil is a poor quality of life that is an obstacle to valuing the time that is left, rather than seeking to destroy the natural life-cycle.

The proposition strongly feels about the freedom of choice, but the opposition would like to eliminate options and funnel suffering people down a path they feel is the right one. I really like this article as it gives the pros and cons of mercy killing. How can we allow a person to suffer immense pain, and agony; to live each bit of his life cursing his fate? Why is it said that they have to suffer it all?????

In this I really disagree because life is one of the best things that God created. We must thank God for this very wonderful and Beutiful Gift that he has given to us…Thank you very much God. As we have no right to choose our birth ,so is our death also the matter of obligation?! Why should he tolerate pain and suffer?! Just to live a few more days or months. So what?!!! Surely anyone with compassion who has watched the agony of a friend or relative dying in front of them, sometimes over many days or weeks would agree with euthanasia?? After all, it is usually only the difference between a few more mls of morphine!!!

Shame on you! You obviously enjoy watching someone suffer. I would not and never have allow any animal I have owned to suffer this fate. I take care of my dad who has an end stage type of dementia. He can hardly keep his eyes open to see anymore. This case involved a patient named Martin Salgo who awoke paralyzed after aortography, having never been informed that such a risk existed. The defense argued that the doctor had been negligent in not warning Salgo that there was a risk of paralysis.

It enabled patients to participate in their health care. Respect for the patient's right of self-determination on a particular therapy demands a standard set by law for physicians rather than one which physicians may or may not impose upon themselves. It is unthinkable nowadays to perform a medical procedure without a signed consent by the patient. Clinicians are required to inform patients what the procedure is all about as well as explain its potential risks. The notion of informed consent is relatively recent. To achieve a cure, it was widely felt that authority must be coupled with obedience. Thus, it was deemed necessary that physicians make decisions for patients. This has been the old-style thinking in medicine, but this concept has changed with the advent of informed consent.

Physicians felt that any disclosure of possible difficulties might erode patient trust. However, physicians are now required to disclose to the patient what the risks and adverse effects of a contemplated procedure or treatment plan. For thousands of years, the medical profession has regulated its conduct through the Oath of Hippocrates , a body of ethical statements developed primarily for the benefit of the patient.

The oath has historically guided physician's professional conduct. As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to the society, to other health professionals, and to self. Physicians are respected for their knowledge and moral standing. New physicians take the Oath of Hippocrates which was adopted by the medical profession as a guide of professional conduct through the centuries. It is still being used today in graduation ceremonies of many medical schools. The oath was written over years ago.

Although the oath bears the name of Hippocrates, there is no evidence that he wrote it. It is claimed that it was written years after his death. No one knows who wrote it. In , a German medical school University of Wittenberg incorporated taking the oath for its graduating medical students. However, it was not until the s, when the document was translated into English that Western medical schools began regularly incorporating the oath in convocations. In its original form, the oath requires a new physician to swear, by a number of healing Gods, to uphold specific ethical standards. Physicians breathed the oath in their daily life: Treat the sick to the best of one's ability, preserve patient privacy, teach one's knowledge of medicine to the next generation, etc.

These are lofty ideals. These prohibitions make it clear that the physician is surrounded with certain moral standards which take precedence over the individual physician's judgment. There are two versions of the oath — classical and modern. These are reproduced here for comparison. The classical version of the oath is outdated. Most graduating medical school students swear to a modern version.

Baltimore: Johns Hopkins Press, It appears in many websites. Undoubtedly, there are many modern ethical issues today that did not exist in the past, such as abortion and euthanasia. The pros and cons of these two topics dominate our world today. Most physicians take the oath upon graduation from medical school. Is the oath still relevant? There are many ethical issues in medicine which cannot be resolved or mediated by signing a consent form alone or swearing to an oath. The ethical landscape has changed. Physicians are faced with a lot of tough ethical issues that never existed in the past.

The oath has generated a lot of controversies, with some claiming that the oath is a meaningless relic of a distant past as it does not address the realities of modern medicine such as abortion, physician-assisted killing which falls under the broad term euthanasia , and end-of-life issues. It is felt that the oath offers no guidance to the ethical dilemmas in today's medical practice. Many updated versions of the Hippocratic Oath have been published which use many basic principles of the original, which medical students commonly swear to upon graduation. In some medical schools, the Declaration of Geneva physician's oath is used.

These maxims were held sacred in the classical version. The Hippocratic Oath covers several important ethical issues between doctors and patients. However, many people believe that the oath does not help resolve modern issues. Some examples are: 1 government and health-care organizations demand more patient information; this makes one wonder how a doctor can maintain a patient's privacy. With such unanswered issues, many physicians feel that the Hippocratic Oath is inadequate to address the realities of modern medicine. In post-World War II, the WMA in Geneva, Switzerland, was concerned because of revelations that doctors in Nazi Germany conducted wicked and atrocious human experimentation on prisoners of war and civilians of occupied countries; the doctors were also accused of planning and performing the mass murder of prisoners of war and civilians of occupied countries under the guise of euthanasia.

There was a Euthanasia Program where the human patients were branded as aged, insane, incurably ill, deformed, and were in nursing homes and asylums. The doctors were reported to have performed medical experiments on such people without the patient's consent. It was proven also that, in the course of such experiments, the defendants committed murders, brutalities, cruelties, tortures, atrocities, and other inhuman acts. Japan wanted to develop weapons of biological warfare including plague, anthrax, cholera, and a dozen other pathogens.

These horrible atrocities were committed by some of the Japan's most distinguished doctors. The US Army granted immunity from war crimes prosecution the Japanese doctors involved in such shameful research practices in exchange for data that were gathered through human experimentation. The information and experience gained in the bio-weapons' research were incorporated into the US biological warfare program.

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