Ethical points in caring for people nearing end-of-life

Introduction:
Issues linked to ageing and the end of life are complex and sometimes painful. The questions surrounding this topic are sensitive and cannot have a simple response. They challenge our sense of solidarity and our ingenuity in seeking ways and means to express true compassion and act appropriately.  

Several people have become household names as part of the debate on the end of life. Whether we like it or not, they have become part of our collective memory: Karen Ann Quinlan and Terri Schiavo from the United States, Ramón Sampedro and Immaculada Echevarría from Spain, Vincent Humbert and Chantal Sébire from France, Piergiorgio Welby and Eluana Englaro from Italy, Hugo Claus from Belgium, and many others.  

The media has focussed on extreme cases which have been brought to public attention because of their particularly dramatic nature. Thus, the discussion has largely been based around certain "unusual" situations with high emotional stakes. Because of this, the complex and sensitive public debate surrounding the end of life is all too often reduced to a few paltry clichés and stereotypes built on feelings rather than an exchange of rational arguments. There is no end to specialised publications on this topic; however, their distribution often remains limited to the narrow circles of legal expertise, philosophy and medicine. Meanwhile, public opinion oscillates between knowledge, misunderstandings and approximations, and rigorous examination often gives way to the feelings, spectres and fears surrounding death.