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Purpose: To evaluate the effect of continuous perioperative clopidogrel treatment on the osseointegration of titanium implants. Materials and Methods: A total of 32 New Zealand rabbits were randomly divided between two groups: a clopidogrel group (n = 16) and a control group (n = 16). For 1 week prior to the surgical placement of a titanium implant in their medial femoral condyle, rabbits in the clopidogrel group received 3 mg/kg of clopidogrel daily, and the control group received only the vehicle. This treatment was continued for another 6 weeks postoperatively. At 6 weeks, the rabbits were euthanized and postmortem histologic and histomorphometric evaluation of the implants was performed. Results: The surgical procedures and postoperative period were uneventful and well tolerated by all animals without any surgical wound dehiscence, signs of infection, or other complication. No implant failure was observed in any of the groups. Histomorphometric analysis showed that bone-to-implant contact (BIC) was 48.77% for the clopidogrel group and 34.65% for the control group, with statistically significant difference between them (P < .001). Moreover, clopidogrel group had significantly greater bone tissue density (40.52% vs 28.74%, respectively; P <.001) and mean trabecular thickness (284.7 μm vs 180.7 μm, respectively; P < .001) in proximity to the implant surface than the control group, while the mean trabecular number had no difference between groups (1.56 vs 1.60, respectively; P = .961). Conclusions: The present study showed that continuous clopidogrel treatment does not negatively affect osseointegration, but rather promotes it in terms of BIC and bone density around the titanium implants. Further studies on the effect of the P2Y12 receptor and its antagonists on peri-implant bone homeostasis may provide useful information or applications for long-term success of dental implant therapy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of supraphysiologic administration of testosterone in an early and late model of implant osseointegration in rat tibiae. Materials and Methods: A total of 40 rats were randomly allocated into four groups (n = 10/group), which were divided according to the type of experiment and time of osseointegration: (1) vehicle (14 days), (2) testosterone (14 days), (3) vehicle (42 days), and (4) testosterone (42 days). Testosterone cypionate (7.5 mg/kg) administration started 4 weeks before implant placement, and the injections were performed daily until euthanasia. Machined-surface titanium implants (2.2 mm in diameter and 4 mm high) were placed bilaterally in the tibia of animals 28 days after the first testosterone injection. At days 14 and 42 after implant placement, euthanasia was performed and the tibiae were harvested to perform biomechanical evaluation and histomorphometric analysis of bone-to-implant contact (BIC%) and bone between the threads (BBT%). Results: There was no statistical difference in the removal torque of the implants between the groups treated with the vehicle (control group) or testosterone (P > .05). At 14 days of osseointegration, the BIC% and BBT% did not differ between vehicle or testosterone groups (P > .05), while at 42 days, both the BIC% and BBT% were significantly reduced by testosterone compared to the vehicle group (P < .05). Conclusions: Testosterone cypionate in supraphysiologic dose impaired late-phase osseointegration in rat tibiae. [ABSTRACT FROM AUTHOR]

Background: Dignity is omnipresent in Western ethics, but it also provokes dissension and controversy. One of the most striking examples is the debate on medically assisted death, where dignity is invoked to support antagonistic positions. While some authors conclude that the concept is useless as an ethical reference, many others invite us to deepen our analysis from a multidimensional perspective, to enrich it and make it useful. This scoping study is intended to provide an overview of the different conceptions of dignity used in the assisted dying debate, to better grasp the multiple facets of the concept. Methods: The Joanna Briggs Institute's JBI Manual for Evidence Synthesis guided the scoping review. Key words were based on the researchers' expertise and were used to identify relevant literature in French and English. Eleven databases covering the last six decades were consulted. Initially, 2,071 references were found in the databases. After excluding duplicates, screening titles, abstracts, and full texts, and after a specific literature search on the concept of relational dignity, 156 papers were found to match the identified inclusion criteria. Results: The literature highlights the stark confrontation between two dominant conceptions of dignity: ontological and autonomist. However, a lesser-known conceptualization of dignity integrates these two perspectives, underlining the relational and social dimensions of dignity. As a result, dignity emerges as a dynamic, experiential, and dialogical concept, that modulates itself according to circumstances. This raises the possibility of breaking through the binary debate and questioning the current frameworks that define dignity. Conclusions: This multidimensional conceptualization of dignity could lead to a more complete and nuanced understanding of the concept, as well as open richer normative horizons regarding the issue of medically assisted death. [ABSTRACT FROM AUTHOR]

Introduction Acute Compartment Syndrome (ACS) is a severe trauma caused by elevated intra-muscle-compartment pressure (ICP). The current standard method for diagnosis is to insert a needle into the muscle sterilely under anesthesia. However, to secure the environment is sometimes not easy and leads to delays in diagnosis. Recently, we have focused on shear wave ultrasound elastography (SWE) as an alternative, which can be done concisely in unclean environment and without anesthesia. We would like to report the usefulness of SWE for ACS diagnosis using 2-pedal walking turkey model recently developed in our lab. Materials and Methods A total of 32 1-year-old Bourbon turkeys were used. 5% solution of chicken albumin was infused continuously into the tibialis cranialis (TC) muscle using IV pump. The ICP was increased stepwise from 0 to 50 mmHg. During the rising of ICP, the correlation between values of SWE (kPa) and ICP (mmHg) was measured. After the ICP reached 50 mmHg, half of the turkeys were maintained at this pressure for 2 hours and the rest for 6 hours. After infusion, a fasciotomy was performed on the half turkey. Half of the turkeys were euthanized after 2 weeks and the rest after 6 weeks. SWE of TC muscle and walking gait data on turkeys using a portable walkway system were measured weekly until euthanasia. At euthanasia, isometric tetanic muscle force (ITF) tests to TC muscle and histological evaluations were performed. Results SWE value (kPa) was highly significantly correlated to the actual ICP (mmHg) (R2 = 0.91). Stance of ACS side leg were significantly extended, and swing of the control side shortened from the second to the third week after ACS in the 6 hours infusion-no-fasciotomy group (P  < 0.05*). ITF was significantly reduced mainly in the 6 hours infusion group (P  < 0.05*). Histological evaluation revealed that in the 6 hours infusion and 6 weeks survival group, both the muscle fiber and intercellular distances were significantly expanded (P  < 0.05). Conclusion SWE seems to be a substitute measure of ICP in diagnosing ACS. With regard to our in vivo ACS model using turkey, survival at 50 mmHg ICP for 6 hours and 6 weeks post ACS would be an appropriate situation. [ABSTRACT FROM AUTHOR]

Introduction Exposure to high doses of ionizing radiation can result in hematopoietic acute radiation syndrome. Currently, there is no radiation medical countermeasure approved by the U.S. FDA which can be used before radiation exposure to protect exposed individuals. Here we aimed to evaluate the therapeutic potential of an aqueous suspension of synthetic genistein nanoparticles (BIO 300) as a radioprotectant in a pilot efficacy study using a nonhuman primate model of total body irradiation. Materials and Methods Eight rhesus macaques were divided into two groups; four received vehicle and four received BIO 300 Injectable Suspension 24 h before 5.8 Gy total-body irradiation. Survival, blood cell counts, blood chemistry, and clinical parameters were monitored over the 60 days of the study. Tissues were collected at necropsy 60 days post-irradiation or from animals that met unscheduled euthanasia criteria and subjected to histopathological analysis. Tissues analyzed included the duodenum, jejunum, ileum, sternum, lung, heart, liver, kidney, spleen, gut-associated lymphoid tissue, and urinary bladder. Results In this pilot study, all BIO 300 Injectable Suspension treated animals survived to day 60, while only 50% of the vehicle-treated animals survived. We found that BIO 300 Injectable Suspension did not mediate an improvement in blood cell counts (e.g. neutrophils, platelets, white blood cells). However, BIO 300 Injectable Suspension treated animals had a lower incidence of fever and febrile neutropenia, were able to better maintain their body weight post radiation exposure, and exhibited less anemia and faster recovery from anemia. Histopathological analysis revealed that BIO 300-treated animals had less irradiation-induced damage to the sternum and other tissues compared to vehicle controls. Conclusions BIO 300's mechanism of action is complex and protection against irradiation is attainable without much improvement in the complete blood count (CBC) profile. BIO 300's mechanism for radioprotection involves multiple biological pathways and systems. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate methods for euthanizing cave cockroaches (CCs; Blaberus giganteus) and Madagascar hissing cockroaches (MHCs; Gromphadorhina portentosa). It was hypothesized that both suggested methods would be effective for humane mass euthanasia of both species. SAMPLE Approximately 800 CC. METHODS The CCs were separated into replicate groups of 25, 50, 75, 100, and 150 grams and placed into 3.8-L plastic bags. Twenty-seven MHCs were divided into groups of 2 to 3. The study took place from January to March 2023. All CC groups were exposed to 100% carbon dioxide (CO2) at a rate of 4 L/min until the bag was full. Madagascar hissing cockroaches were similarly anesthetized using either CO2 or 2 mL of isoflurane on a cotton ball in a 1-L container or a combination of CO2 and isoflurane. Once cockroaches were immobile, secondary euthanasia steps were performed. One bag of CCs per weight category was exposed to soapy water (5% Dawn dishwashing liquid), and the second was placed into a −80°C freezer. The containers of MHCs were evenly exposed to the 2 euthanasia methods. Individuals remained in their secondary euthanasia method for 30 minutes. RESULTS Regardless of the weight of the CCs within each bag, there was no impact on time (1.8 ± 0.4 minutes [mean ± SD]) to immobility. The failure rates for both species were 0.2% CI (−0.1% to 1.5% [1/413]) for soapy water and 0.5% CI (0.005% to 1.9% [2/414]) for the freezer method. These results support the use of both 2-step euthanasia methods in CCs and MHCs. CLINICAL RELEVANCE These methods will serve as an evidence-based alternative for humane mass euthanasia in cockroaches. [ABSTRACT FROM AUTHOR]

The article argues that bioethics should not merely reflect public opinion, as the gap between bioethicists' and public views often highlights valuable ethical insights and promotes more informed approaches. Topics discussed include differences between expert and public views on end-of-life care, organ donation, and reproductive rights.

Encounters with loss and death are an inherent part of human existence and a significant element in the tapestry of leisure. This article concludes the special issue of Leisure Sciences on 'Leisure, Loss, and Death.' It reflects upon the submitted manuscripts and introduces temporal approaches to the study of loss, highlighting distinctions between planning for and anticipating loss, the commodification and festivalization of loss, and the ways in which leisure can contribute to the recovery from loss and death. The article underscores that, by contemplating the event of loss and the temporal/experiential milieus before and after, numerous promising avenues for further inquiry emerge. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the current literature on healthcare policies and cost analyses around international Voluntary Assisted Dying (VAD) laws. The study design is a mapping literature review following Preferred-Reporting-Items-for-Systematic-Reviews-and-Meta-Analyses (PRISMA) guidelines. Methods: Original research articles published between January 1990 to March 2023, investigating the financial cost and healthcare budget effect of VAD laws internationally. Citations were screened for relevance and eligibility, and any non-full-text research that did not explore cost analysis was excluded. The following data sources were screened: MEDLINE, PubMed, EMBASE, CINAHL and any relevant international health authority annual reports were also reviewed. Results: Of the 2790 screened articles, eight studies met the inclusion criteria and three were included in the mapping review. The reviewed studies included prospective studies, two Canadian and one US. Only one of the Canadian studies provided a cost analysis using data from current VAD laws. All three studies showed VAD laws would reduce healthcare spending, with the US approximating $627million in 1995. Canada approximating $17.1 to $77.1million in 2017 and $86.9 to $149.0million in 2021, overall, leading to an average percentage reduction in costs of approximately 87% compared to original costs of end-of-life care. Conclusion: This review identifies a scarcity in cost-analysis literature and provides a summary of the latest international VAD laws, from which a potential cost reduction is apparent. The absence of retrospectively collated financial VAD data highlights a need for future research to inform policymakers of the economic factors affecting current policies with a need for annual fiscal reports and to optimise future legislative frameworks internationally. Key points: - This study highlights the absence of cost analysis reports on the provision of VAD globally, at a time when VAD is becoming an evolving part of end-of-life care particularly in developed countries base on the notion of patient autonomy. - The impact of this study is its ability to inform future research and policymakers of the economic factors affecting current VAD policies with a need for annual fiscal reports and to optimise future legislative frameworks internationally. [ABSTRACT FROM AUTHOR]

Background: Assisted dying for reasons solely related to an eating disorder (ED) has occurred in multiple countries, including those which restrict the practice to individuals with a terminal condition. The aims of this systematic review were to (1) identify all known cases of assisted deaths among patients with EDs and (2) describe the clinical rationales used to grant patients' requests for assisted death. Methods: We conducted a systematic search of peer-reviewed studies and publicly available government reports to identify cases of assisted death in patients with EDs. In reports that included qualitative data about the case, clinical rationales were extracted and grouped into domains by qualitative content analysis. Results: We identified 10 peer-reviewed articles and 20 government reports describing at least 60 patients with EDs who underwent assisted dying between 2012 and 2024. Clinical rationales were categorized into three domains: irremediability, terminality, and voluntary request. Reports emphasized that patients with EDs who underwent assisted death had terminal, incurable, and/or untreatable conditions and had adequate decision-making capacity to make a life-ending decision. Most government reports did not include descriptiveenough data to verify psychiatric conditions. Conclusion: The results of our systematic review underscore considerable gaps in the reporting of assisted death in patients with psychiatric conditions, posing substantial concerns about oversight and public safety. In many cases, the clinical rationales that were used to affirm patients with EDs were eligible for assisted death lack validity and do not cohere with empirical understanding. [ABSTRACT FROM AUTHOR]

Background: Quality of life (QoL) provides a comprehensive concept underpinning veterinary decision-making that encompasses factors beyond physical health. It becomes particularly pertinent when seeking responsible choices for chronically ill or old horses that emphasise their well-being and a good QoL over the extension of life. How different stakeholders use the concept of QoL is highly relevant when considering the complexity of these decisions in real-life situations. Methods: Seven focus group discussions (N = 39) were conducted to gain insights into how stakeholders assess and use equine QoL in veterinary care decisions for chronically ill and/or old horses. The discussions included horse owners (n = 17), equine veterinarians (n = 7), veterinary officers (n = 6), farriers (n = 4), and horse caregivers (n = 5). The combination of deductive and inductive qualitative content analysis of the group discussions focused on identifying both similarities and differences in the views of these groups regarding QoL for old and/or chronically ill horses. Results: Findings show agreement about two issues: the importance of the individuality of the horse for assessing QoL and the relevance of QoL in making decisions about veterinary interventions. We identified differences between the groups with respect to three issues: the time required to assess QoL, stakeholders’ contributions to QoL assessments, and challenges resulting from those contributions. While owners and caregivers of horses emphasised their knowledge of a horse and the relevance of the time they spend with their horse, the veterinarians in the study focused on the differences between their own QoL assessments and those of horse owners. In response to challenges regarding QoL assessments and decision-making, stakeholders described different strategies such as drawing comparisons to human experiences. Conclusions: Differences between stakeholders regarding equine QoL assessments contribute to challenges when making decisions about the care of chronically ill or old horses. The results of this study suggest that individual and collaborative reflection about a horse’s QoL should be encouraged, for example by developing practicable QoL assessment tools that support relevant stakeholders in this process. [ABSTRACT FROM AUTHOR]

Background: End-stage renal disease (ESRD) is the final stage of chronic kidney disease. Yet dialysis is not suitable for all ESRD patients. Moreover, while shared decision-making (SDM) is the preferred model for making medical decisions, little is known about SDM between nephrology nurses and ESRD patients in Israel. Research Objective: Assessing the views, attitudes, practices, and ethical dilemmas of nephrology nurses in Israel regarding SDM with ESRD patients. Methods: Using the descriptive quantitative approach, questionnaires were completed by 444 nephrology nurses in Israel. In addition to conducting descriptive statistics, t-tests for independent samples, f-tests for analysis of variance, and both tests for independence were also performed. Ethical Considerations: The research aims, expected advantages and risks have been explained to respondents before completing the questionnaire to secure informed consent. Anonymity and confidentiality were ensured throughout the study. The study was approved by the Research Ethics Committee at the University of Haifa (Approval # 411/21). Results: About one-third (30%–36.5%) of nurses reported discussing quality of life issues with ESRD patients, asking about their advance directives/power of attorney, exploring cultural/religious beliefs in end-of-life care, and ask about their preferred place of death. Nurses who convey high levels of patient-centered care (68.9%, p <0.0001), have high end-of-life training (76.2%, p <0.0001), and report cooperating with interdisciplinary teams (63.8%, p = 0.0415), also reported higher SDM practices than others. Nurses who refer less patients to palliative care (70%, p <0.0001) reported higher involvement in SDM compared to other nurses. Conclusions: Nephrology nurses in Israel do not tend to implement the SDM model, despite its potential for improving quality of life for ESRD patients and their families and increasing conservative care options. Policy makers and educators in Israel should develop and implement training programs and support in the workplace, to enhance SDM between nephrology nurses and ESRD patients. [ABSTRACT FROM AUTHOR]

Background & objectives: Identifying the impacts of COVID-19 on patients' and practitioners' access to legal assisted dying and euthanasia (AD&E) services is vital to informing service continuity in an ongoing pandemic. Methods: An anonymous online survey collected qualitative and quantitative data from health practitioners and agencies providing legal AD&E services (n = 89), complemented by semi-structured interviews with 18 survey respondents who volunteered. Results: Following governments' responses to the dynamic pandemic context, rates of AD&E inquiries and requests fluctuated across and within jurisdictions, based on a complex interaction of factors affecting patient access to AD&E agencies and assessors as services were disrupted. Service flexibility and nimbleness became key elements in continuing service availability and included calculated 'rule-breaking' considered justifiable to adhere to established bioethics. Making innovative adjustments to usual practice led to reviewing the effectiveness of AD&E services and laws, resulting in providers now improving services and lobbying for legislative change. [ABSTRACT FROM AUTHOR]

Aim: To analyse the available evidence regarding refractory symptoms to treatment in patients receiving palliative/terminal healthcare. Design: A systematic review of various databases between September and December 2020; Pubmed; Cochrane; Scopus and ScienceDirect. Study eligibility criteria: Studies published between 1st January 2015 and 31st of March 2020, in Spanish, English or Catalan conducted in elderly people or terminal patients. The study included systematic reviews, clinical trials and interventions. Results: The search returned 782 articles, of which 22 articles were finally reviewed. Of the selected articles, 16 were systematic reviews and three were clinical trials. Three refractory symptoms are notable; breathlessness, delirium and existential suffering. There are various therapeutic approaches for the first two symptoms, but palliative sedation seems to be most effective for existential suffering. Conclusions: Although palliative care enables controlling these symptoms effectively, and following a multidisciplinary approach, there remains a group of patients for whom euthanasia could save foreseeable suffering that is difficult to manage. [ABSTRACT FROM AUTHOR]

The integration of assisted dying into end-of-life care is raising reflections on bereavement. Patients and families may be faced with a choice between this option and natural death assisted by palliative care; a choice that may affect grief. Therefore, this study describes and compares grief experiences of individuals who have lost a loved one by medical assistance in dying or natural death with palliative care. A mixed design was used. Sixty bereaved individuals completed two grief questionnaires. The qualitative component consisted of 16 individual semi-structured interviews. We found no statistically significant differences between medically assisted and natural deaths, and scores did not suggest grief complications. Qualitative results are nuanced: positive and negative imprints may influence grief in both contexts. Hastened and natural deaths are death circumstances that seem to generally help ease mourning. However, they can still, in interaction with other risk factors, produce difficult experiences for some family caregivers. [ABSTRACT FROM AUTHOR]

Background: Preserving sufficient oxygen supply to the tissue is fundamental for maintaining organ function. However, our ability to identify those at risk and promptly recognize tissue hypoperfusion during abdominal surgery is limited. To address this problem, we aimed to develop a new method of perfusion monitoring that can be used during surgical procedures and aid surgeons' decision-making. Methods: In this experimental porcine study, thirteen subjects were randomly assigned one organ of interest [stomach (n = 3), ascending colon (n = 3), rectum (n = 3), and spleen (n = 3)]. After baseline perfusion recordings, using high-frequency, low-dose bolus injections with weight-adjusted (0.008 mg/kg) ICG, organ-supplying arteries were manually and completely occluded leading to hypoperfusion of the target organ. Continuous organ perfusion monitoring was performed throughout the experimental conditions. Results: After manual occlusion of pre-selected organ-supplying arteries, occlusion of the peripheral arterial supply translated in an immediate decrease in oscillation signal in most organs (3/3 ventricle, 3/3 ascending colon, 3/3 rectum, 2/3 spleen). Occlusion of the central arterial supply resulted in a further decrease or complete disappearance of the oscillation curves in the ventricle (3/3), ascending colon (3/3), rectum (3/3), and spleen (1/3). Conclusion: Continuous organ-perfusion monitoring using a high-frequency, low-dose ICG bolus regimen can detect organ hypoperfusion in real-time. [ABSTRACT FROM AUTHOR]

The article focuses on the complex ethical issues that ethicists face in medical-aid-in-dying (MAID) cases. Topics include the role of the American Clinicians Academy on Medical Aid in Dying (ACAMAID) Ethics Consultation Service in addressing ethical dilemmas; challenges faced by clinicians with limited access to ethics support; and the ethical considerations surrounding specific MAID scenarios.

Because facility dogs can provide comfort to vulnerable testifying witnesses, they are beginning to become commonplace in some courtrooms. However, certain dogs (and by extension the witness they testify with) might be discriminated against because of their coat color. Known as "Black Dog Bias" (BDB), black dogs are often reported to be discriminated against in animal adoption centers, resulting in higher rates of euthanasia. Black dogs are often viewed as less friendly, less emotionally stable, and more aggressive than their other-colored counterparts. Other research, however, argues that BDB does not exist; rather, bias against certain dogs is associated with phenotypic traits or breed. With the proliferation of facility dog employment in courtrooms, there is a possibility that BDB also could manifest in this setting. This study investigated whether BDB occurs in the courtroom and affects perceptions of the witness through the social psychological process of transference. A child witness, as they were testifying about a sexual assault, was either comforted by a black dog, a white dog, or no dog. Counterintuitively, community-member participants (n = 133) believed that the witnesses appeared less sad, less emotional, and happier when comforted by a black dog compared with a white dog. Furthermore, perceptions of the witness were not affected by the facility dog, suggesting that transference did not occur. A potential explanation for the findings posits that a stereotype violation occurs when a black dog serves as a facility dog, allowing the animal to be perceived positively. This finding adds a new caveat to BDB – that when a black dog fulfills a positive role, this might cause a stereotype violation that leads to positive evaluations of that dog. These findings also contribute to existing literature that the presence of facility dogs is more beneficial than harmful to courtroom settings, suggesting that they do not seem to unfairly sway juries. [ABSTRACT FROM AUTHOR]

Aim: To explore relatives' needs in terms of bereavement care during euthanasia processes, how healthcare providers respond to these needs, and the degree of commonality between relatives' and healthcare providers' reports. Design: A phenomenological design was employed, utilising reflexive thematic analysis to examine interviews conducted with relatives (N = 19) and healthcare providers (N = 47). Results: Relatives' needs throughout euthanasia processes are presented in five main themes and several subthemes, with similar findings between both sets of participants. Although relatives infrequently communicated their needs explicitly to healthcare providers, they appreciated it when staff proactively met their needs. Healthcare providers aimed to assist with the relatives' grief process by tending to their specific needs. However, aftercare was not consistently offered, but relatives did not have high expectations for professional follow‐up care. Conclusion: Our research offers important directions for healthcare professionals, empowering them to provide needs‐based bereavement care during euthanasia processes. Moreover, it emphasises the importance of recognising the unique needs of relatives and proactively addressing them in the period before the loss to positively contribute to relatives' grief process. Implications for the profession and/or patient care: Insights into relatives' needs in the context of euthanasia. Good practices on how healthcare providers can attend to relatives' needs before, during and after the loss Impact: Current literature and guidelines on needs‐based bereavement care in the context of euthanasia and, more generally, assisted dying, are limited. These findings provide concrete directions for practice in supporting (nearly) bereaved relatives in the context of euthanasia, potentially mitigating adverse health outcomes. Reporting method: Standards for Reporting Qualitative Research (SRQR checklist). Patient or Public contribution: Relatives of deceased cancer patients were involved in the conduct of the study. [ABSTRACT FROM AUTHOR]

We discuss the concept of a 'body', the individual body as the lived experience of the body, the social body, shaped by the tensions between the demands of a social/moral order and the egocentric drives, and the body politic, as an institutionalized and disciplined body. We describe the body as it was perceived in Classical Greek Antiquity at the time when the Hippocratic Oath was first conceived, and any changes that may have occurred by Late Antiquity, using the concept of a body-world as represented by everyday life, the arts, politics, philosophy, and religion. This 'recreated' body-world elucidates how a person of Classical or Late Antiquity perceived her/his body via their 'lived-in' world and relates it to medical and philosophical thinking about the body as well as to concepts of health and disease. We demonstrate how the institutional structures of the Roman Empire and the Church influenced the way a body was understood, how the administrative and governmental needs led to the first developments of Public Health, and how the Christian understanding of the body as the body and spirit of Christ changed the attitude towards suicide, euthanasia, and abortion. These changes are reflected in the understanding of bioethical thinking and affected the interpretation of the Hippocratic Oath. [ABSTRACT FROM AUTHOR]

Context: Palliative Care (PC) and Medically Assisted Death (MAD), specifically assisted suicide and euthanasia, are distinct practices characterized by differing objectives, methods, implementation and outcomes. Representatives of PC, including scientific societies or physicians, may, in certain cases, adopt a critical stance towards MAD. Objectives: The study aims to explore the underlying reasons for such opposition. Methods: To this end, the philosophical underpinnings and legal conditions of PC and MAD will be analyzed. Results: The ethical and philosophical landscape of PC and MAD leads us to identify, on one hand, the Hippocratic paradigm and, on the other hand, what we call Socratic medicine. From a legal analysis perspective, the presence of intolerable suffering serves as a common ground between the two practices, albeit risking being the subject of misunderstandings and instrumental objections. Conclusion: Preventing an instrumental use of PC in relation to MAD is crucial to enable the respect and the coexistence of the two practices. [ABSTRACT FROM AUTHOR]

In veterinary medicine, the relationship between empathy and mental health presents a complex and important aspect of professional well-being. Veterinarians are frequently exposed to numerous work-related stressors and are therefore more likely to experience mental health disorders and commit suicide. Due to the specific nature of the profession, veterinarians deal with negative patient outcomes, inform owners of unfavourable news, handle heavy workloads, and professional isolation. Psychological stress is a result of all these factors coming together, and it can lead to anxiety, depression, burnout, and even frequently reported suicide. Animal euthanasia has been recognised as a unique professional risk factor that can have harmful psychological effects on veterinary professionals. This paper explores the role of empathy in the mental health of veterinarians and other veterinary staff, and how this might contribute to their vulnerability to psychological stress and suicidal ideation. Empathy plays an important role in interpersonal interactions, while also influencing human-animal relationships, which adds a whole new level of complexity to the doctor-patient dynamic in this field. Veterinarians are responsible for providing compassionate care for both the animals they treat and their owners. They must manage the emotionally demanding work while preserving their mental health by balancing between providing empathetic care and sustaining their own emotional boundaries. To alleviate the negative effects of psychological stress, veterinary professionals require interventions such as peer support groups, stress management training, and mental health support programmes. [ABSTRACT FROM AUTHOR]

Background: The practice of mercy killing, also known as euthnasia or assisted suicide, is a contentious and morally complex issue in healthcare. Understanding the ethical dilemmas related to mercy killing within specific religious communities, such as Maranao Muslims, can provide valuable insights into the intersection of faith, culture, and healthcare decision-making.... [ABSTRACT FROM AUTHOR]

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Background: Bioethical dilemmas at the end of life have led to regularization processes for the provision of medical assistance in dying patients in different countries. Since the regulation of euthanasia in Spain in 2021, the euthanasia act has been included as one of the benefits of the health system, which has undergone uneven development and implementation in different autonomous communities. The aim of this study was to review the Spanish version of the Euthanasia Attitude Scale following the partial modification of four items. Methods: A cross-sectional study was conducted with a non-probabilistic sample of Spanish health workers from Islas Baleares. A self-reported sociodemographic questionnaire and the Euthanasia Attitude Scale were used for data collection. The psychometric properties of the scale were assessed, including reliability and validity, using a confirmatory factor analysis and a parallel analysis. Results: The Cronbach's alpha of the EAS was α = 0.892, which implies good internal consistency. According to the confirmatory factor analysis, a Kaiser–Meyer–Olkin–value of 0.938 was obtained, and the result of Bartlett's test of sphericity was < 0.001. The questionnaire included four loading factors, which explained up to 56.99% of the variance. The parallel analysis revealed three significant factors and a fourth, less interpretative factor. Conclusions: The EAS-ES-R is a valid instrument for assessing the attitudes toward euthanasia of both trainees and practicing health professionals. It may also be of vital importance in detecting training, support and implementation needs for laws regulating euthanasia in Spain. [ABSTRACT FROM AUTHOR]

Background: In the context of discussions between supporters and opponents of euthanasia, and legal regulations regarding this type of practices, the attitude of young people with respect to this phenomenon is a very interesting issue. According to Polish law, euthanasia is prohibited. The aim of this study was to determine the degree of acceptance of euthanasia among students from Polish universities across three different fields of study: psychology, medicine, and economic-technical disciplines, and to identify the factors associated with the acceptance of this phenomenon. Methods: The study included 627 persons studying in Lublin, Poland: medicine (280), psychology (170), and economic-technical studies (177). The study was conducted as a survey using questionnaire containing items concerning students' attitudes towards euthanasia. The analysis of the collected data was conducted using the SPSS software (version 29) with the following methods: Chi2, Student's t-test, Phi test, Cramer's V test, Kolmogorov-Smirnov test, one-way ANOVA with Dunnett's post hoc test, linear regression analysis, and categorical regression analysis using optimal scaling (CATREG). Results: Nearly half of the students participating in the study (45.9%) rated the practice of euthanasia as decidedly negative. The highest number of strongly negative evaluations was found among psychology students, and the least among students of economic-technical disciplines. The level of acceptance of euthanasia is significantly associated with religious involvement and studying psychology. Being religious and being a psychology student both contribute to lower acceptance of euthanasia and a lower willingness to consent to euthanasia. Consent to euthanasia is more commonly declared by individuals with experience of living with elderly people. Conclusions: Although nearly half of the respondents expressed a negative attitude towards euthanasia, considering the secularization process among Polish youth, it can be assumed that the level of acceptance of euthanasia in this social group will increase. The lower level of acceptance of euthanasia among psychology and medical students compared to students of economic-technical disciplines suggests that the curricula of these studies present alternative solutions to the problems of terminally ill patients other than euthanasia. [ABSTRACT FROM AUTHOR]

AbstractThis study examines the reasons of people with dementia request euthanasia and how these reasons change over time with a special focus on reasons related to family. In addition, it examines how family relates to their loved one’s euthanasia wish. Seven people with dementia and a euthanasia wish in the Netherlands were interviewed, and three years later, two of them and five family members were interviewed again. Four themes were identified using thematic analyses: (1) Protecting the relationship from the impact of dementia; (2) Private domain as the primary setting to discuss euthanasia; (3) Implicit expectation to respect and agree with the euthanasia wish; (4) Experienced responsibilities of family regarding the euthanasia wish. Professionals should be aware of the position of family and the interrelatedness of the person’s concern for family happiness and families’ moral commitment to agree and support the wish. [ABSTRACT FROM AUTHOR]

A convenient and acceptable method of anaesthetisation is still unresolved in gastropods, particularly Cornu aspersum. The aim of this study was to determine the anaesthetic effects of freezing at −20°C for different periods, including 5, 10, 15, 20, 25, 30, 45, 60, 120, 180 and 240 min on C. aspersum. Following cold treatments, the snails were checked for anaesthesia and recovery behaviours using a 5-score evaluation based on the responses at 0, 5, 10, 15, 20, 25, 30, 45, 60, 120, 180, 240, 1440 and 2880 min. The responses evaluated were reflex, movement, mucus secretion and survival. The results showed that 60 min of cold exposure was stressful and that longer periods of freezing than this treatment were lethal for C. aspersum. The results indicate that the optimum duration of freezing for a desired anaesthesia evaluated based on the reflex and movement responses is 10 min. [ABSTRACT FROM AUTHOR]

Two revolutionary developments impacted the United States criminal justice system over the past 30 years that are now primed for an institutional reckoning—the legalization of medical marijuana at the state level and the exponential rise of adult drug treatment courts across the country. The states that have legalized medical marijuana also provide criminal immunity protections for qualifying medical marijuana patients, including those serving probationary sentences. Drug treatment courts are a form of intensive probation offering treatment services for participants plagued by substance use disorders. Most drug treatment courts operate on an abstinence‐based model and do not permit the use of medical marijuana. Consequently, challenges by drug court participants to the continued prohibition of medical marijuana are on the horizon. The purpose of this article is to highlight the contours of these knotty issues from a sociolegal perspective. The material for this article stems from a review of existing judicial decisions in addition to qualitative data collected during my case studies of three different adult drug treatment courts. [ABSTRACT FROM AUTHOR]

Colombia was one of the first countries to decriminalise euthanasia. However, what is known in the international academic literature about the country's regulations is scarce and outdated. Such lack of information on the situation in Latin America is even more evident in the case of Peru, where the Lima Superior Court of Justice set a precedent by allowing a person to have access to euthanasia in 2021. Ecuador, which has just decriminalised euthanasia for all its citizens in February 2024, risks being similarly absent from the international dialogue. This article summarises for the first time all the regulations in force regarding euthanasia in Latin America, through a study of primary sources in Spanish, and analyses some of the convergences between these three neighbouring countries. [ABSTRACT FROM AUTHOR]

Mitochondria, through oxidative phosphorylation, are crucial for energy production. Disease, genetic impairment, or deconditioning can harm muscle mitochondria, affecting energy production. Endurance training enhances mitochondrial function but assumes mobility. Individuals with limited mobility lack effective treatments for mitochondrial dysfunction because of disease or aging. Mitochondrial transplantation replaces native mitochondria that have been damaged with viable, respiration-competent mitochondria. Here, we used a rodent model selectively bred for low-capacity running (LCR), which exhibits innate mitochondrial dysfunction in the hind limb muscles. Hence, the purpose of this study was to use a distinct breed of rats (i.e., LCR) that display hereditary skeletal muscle mitochondrial dysfunction to evaluate the consequences of mitochondrial transplantation. We hypothesized that the transplantation of mitochondria would effectively alleviate mitochondrial dysfunction in the hind limb muscles of rats when compared with placebo injections. In addition, we hypothesized that rats receiving the mitochondrial transplantation would experience an improvement in their functional capacity, as evaluated through incremental treadmill testing. Twelve aged LCR male rats (18 months old) were randomized into 2 groups (placebo or mitochondrial trans- plantation). One LCR rat of the same age and sex was used as the donor to isolate mitochondria from the hindlimb muscles. Isolated mitochondria were injected into both hindlimb muscles (quadriceps femoris, tibialis anterior (TA), and gastrocnemius complex) of a subset LCR (n = 6; LCR-M) rats. The remaining LCR (n = 5; LCR-P) subset received a placebo injection containing only the vehicle without the isolated mitochondria. Four weeks after mitochondrial transplantation, rodents were euthanized and hindlimb muscles harvested. The results indicated a significant (p < 0.05) increase in mitochondrial markers for glycolytic (plantaris and TA) and mixed (quadricep femoris) muscles, but not oxidative muscle (soleus). Moreover, we found significant (p < 0.05) epigenetic changes (i.e., hypomethylation) at the global and site-specific levels for a key mitochondrial regulator (transcription factor A mitochondrial) between the placebo and mitochondrial transplantation groups. To our knowledge, this is the first study to examine the efficacy of mitochondrial transplantation in a rodent model of aging with congenital skeletal muscle dysfunction. [ABSTRACT FROM AUTHOR]

Copyright of Arcos: Design, Cultura e Visualidade is the property of Editora da Universidade do Estado do Rio de Janeiro (EdUERJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The literature on the ethics of conscientious objection focuses on objections to participating in morally contested practices. This literature emphasizes the potential for participation to undermine objecting clinicians' moral integrity. Significantly less attention has been given to conscientious objection to teaching morally contested practices. Thus, it is unclear whether teaching morally contested practices has the potential to undermine objecting educators' moral integrity, and to the extent that it does, what steps can be taken to address this concern. We accordingly examine the ethics of conscientious objection to teaching morally contested practices, with a focus on teaching physician-assisted death (PAD) to trainees in US palliative care programs. We focus on three primary components of teaching PAD: (1) teaching the history and context of PAD; (2) teaching trainees how to understand and respond to requests for PAD; and (3) teaching trainees how to provide PAD. We argue that teaching components one and two has little potential to undermine objecting educators' moral integrity. Moreover, permitting objecting educators to opt out of teaching components one and two might undermine the education of trainees. In contrast, allowing objecting educators to opt out of teaching how to provide PAD may be important to preserving their moral integrity, and is unlikely to undermine trainees' education. We argue that educators should be permitted to opt out of teaching trainees how to provide PAD and describe policies that training programs can adopt to implement this approach. [ABSTRACT FROM AUTHOR]

Background: Belgium is one of very few countries that legally allow euthanasia for suffering caused by psychiatric illness. In the first criminal trial in Belgium of physicians involved in euthanasia, three physicians recently faced the accusation of "murder by poisoning," for allegedly having failed to comply with several requirements of the Belgian Euthanasia Law in granting the euthanasia request a woman suffering from psychiatric illness. Although all three physicians were acquitted, the case generated much debate among policy makers, medical professionals, and the general public. Method: We use this trial as the starting point for a critical analysis of the adequacy of the three-level control system established in the Euthanasia Law, as it is applied in the evaluation of euthanasia requests from persons who suffer unbearably from a psychiatric illness. This analysis is based on information presented during the criminal trial as well as information on the euthanasia that was published in the press. Results: Our analysis highlights substantial problems in the assessment and granting of the euthanasia request. The patient was euthanized without it having been substantiated that her psychiatric illness had no prospect of improvement and that her suffering could not be alleviated. The threestep control system enshrined in the Law and promoted by the Federal Control and Evaluation Commission for Euthanasia appears to have failed at each level. Conclusion: To evaluate requests for euthanasia for mental suffering caused by psychiatric illness, the requirements of the Belgian Euthanasia Law should be complemented by mandating the advice of two psychiatrists, and face-to-face discussions between all physicians involved. In parallel with the process of evaluating the euthanasia request, a treatment track should be guaranteed where reasonable evidence-based treatments and recovery-oriented options are tried. [ABSTRACT FROM AUTHOR]

The autonomy of patients is generally recognized in practice and theory. However, there are many controversies on whether patients have the right of euthanasia, according to which they could choose the way of death of their own will, due to the traditional culture and emphasis on the priority of the tight of life. This essay recognizes that the right to euthanasia can be positively recognized in the light of the principle of human dignity and the right to autonomy, but its application should be subject to the principle of legal reservation and should be expressly regulated by the legislature. Although the case at hand is a dispute on whether the medical treatment is in accordance with medical practice, the court held that if the legal procedure is followed, the patient (and his legal representative) can choose to refuse the invasive intubation treatment in accordance with the right to autonomy, and accordingly there is no responsibility for the medical treatment, which is a substantial demonstration of respect for the patient's right to euthanasia. [ABSTRACT FROM AUTHOR]

Abstract Background Dignity is omnipresent in Western ethics, but it also provokes dissension and controversy. One of the most striking examples is the debate on medically assisted death, where dignity is invoked to support antagonistic positions. While some authors conclude that the concept is useless as an ethical reference, many others invite us to deepen our analysis from a multidimensional perspective, to enrich it and make it useful. This scoping study is intended to provide an overview of the different conceptions of dignity used in the assisted dying debate, to better grasp the multiple facets of the concept. Methods The Joanna Briggs Institute's JBI Manual for Evidence Synthesis guided the scoping review. Key words were based on the researchers' expertise and were used to identify relevant literature in French and English. Eleven databases covering the last six decades were consulted. Initially, 2,071 references were found in the databases. After excluding duplicates, screening titles, abstracts, and full texts, and after a specific literature search on the concept of relational dignity, 156 papers were found to match the identified inclusion criteria. Results The literature highlights the stark confrontation between two dominant conceptions of dignity: ontological and autonomist. However, a lesser-known conceptualization of dignity integrates these two perspectives, underlining the relational and social dimensions of dignity. As a result, dignity emerges as a dynamic, experiential, and dialogical concept, that modulates itself according to circumstances. This raises the possibility of breaking through the binary debate and questioning the current frameworks that define dignity. Conclusions This multidimensional conceptualization of dignity could lead to a more complete and nuanced understanding of the concept, as well as open richer normative horizons regarding the issue of medically assisted death.

Abstract Objectives To investigate the current literature on healthcare policies and cost analyses around international Voluntary Assisted Dying (VAD) laws. The study design is a mapping literature review following Preferred-Reporting-Items-for-Systematic-Reviews-and-Meta-Analyses (PRISMA) guidelines. Methods Original research articles published between January 1990 to March 2023, investigating the financial cost and healthcare budget effect of VAD laws internationally. Citations were screened for relevance and eligibility, and any non-full-text research that did not explore cost analysis was excluded. The following data sources were screened: MEDLINE, PubMed, EMBASE, CINAHL and any relevant international health authority annual reports were also reviewed. Results Of the 2790 screened articles, eight studies met the inclusion criteria and three were included in the mapping review. The reviewed studies included prospective studies, two Canadian and one US. Only one of the Canadian studies provided a cost analysis using data from current VAD laws. All three studies showed VAD laws would reduce healthcare spending, with the US approximating $627million in 1995. Canada approximating $17.1 to $77.1million in 2017 and $86.9 to $149.0million in 2021, overall, leading to an average percentage reduction in costs of approximately 87% compared to original costs of end-of-life care. Conclusion This review identifies a scarcity in cost-analysis literature and provides a summary of the latest international VAD laws, from which a potential cost reduction is apparent. The absence of retrospectively collated financial VAD data highlights a need for future research to inform policymakers of the economic factors affecting current policies with a need for annual fiscal reports and to optimise future legislative frameworks internationally.

Abstract Background Quality of life (QoL) provides a comprehensive concept underpinning veterinary decision-making that encompasses factors beyond physical health. It becomes particularly pertinent when seeking responsible choices for chronically ill or old horses that emphasise their well-being and a good QoL over the extension of life. How different stakeholders use the concept of QoL is highly relevant when considering the complexity of these decisions in real-life situations. Methods Seven focus group discussions (N = 39) were conducted to gain insights into how stakeholders assess and use equine QoL in veterinary care decisions for chronically ill and/or old horses. The discussions included horse owners (n = 17), equine veterinarians (n = 7), veterinary officers (n = 6), farriers (n = 4), and horse caregivers (n = 5). The combination of deductive and inductive qualitative content analysis of the group discussions focused on identifying both similarities and differences in the views of these groups regarding QoL for old and/or chronically ill horses. Results Findings show agreement about two issues: the importance of the individuality of the horse for assessing QoL and the relevance of QoL in making decisions about veterinary interventions. We identified differences between the groups with respect to three issues: the time required to assess QoL, stakeholders’ contributions to QoL assessments, and challenges resulting from those contributions. While owners and caregivers of horses emphasised their knowledge of a horse and the relevance of the time they spend with their horse, the veterinarians in the study focused on the differences between their own QoL assessments and those of horse owners. In response to challenges regarding QoL assessments and decision-making, stakeholders described different strategies such as drawing comparisons to human experiences. Conclusions Differences between stakeholders regarding equine QoL assessments contribute to challenges when making decisions about the care of chronically ill or old horses. The results of this study suggest that individual and collaborative reflection about a horse’s QoL should be encouraged, for example by developing practicable QoL assessment tools that support relevant stakeholders in this process.

Background: The practice of mercy killing, also known as euthnasia or assisted suicide, is a contentious and morally complex issue in healthcare. Understanding the ethical dilemmas related to mercy killing within specific religious communities, such as Maranao Muslims, can provide valuable insights into the intersection of faith, culture, and healthcare decision-making. This study aimed to explore the practice of mercy killing among Muslim Maranao nurses in the critical care setting. Methods: A qualitative research design based on descriptive phenomenology and criterion sampling was used to select 10 Muslim Maranao nurses with at least five years of working experience in intensive care units (ICUs) in the southern Philippines. In-depth semi-structured face-to-face interviews were conducted with the participants and Colizzi’s thematic analysis was employed to analyze the obtained data. Results: Thematic analysis revealed three main themes with three corresponding subthemes: Religious beliefs (Islamic teachings, religious duties and moral responsibility), cultural norms (community values, stigma and taboo, sense of identity), and professional ethics (duty to the patient, team collaboration and ethical considerations). Conclusion: The perspectives of Muslim Maranao nurses on mercy killing are strongly influenced by their religious beliefs, cultural norms and professional ethics. Islamic teachings guide their rejection of mercy killing, emphasizing compassionate care and respect for the natural course of life. Family and community values, fear of social judgment and the preservation of cultural identity shape their perspectives. Professional ethics highlight their commitment to patient well-being, autonomy, and collaborative decision-making. Culturally sensitive and ethically sound healthcare practices are essential, and ongoing dialogue, education and policy development are needed to address the complexities surrounding mercy killing within specific cultural and religious contexts.

Abstract Background Bioethical dilemmas at the end of life have led to regularization processes for the provision of medical assistance in dying patients in different countries. Since the regulation of euthanasia in Spain in 2021, the euthanasia act has been included as one of the benefits of the health system, which has undergone uneven development and implementation in different autonomous communities. The aim of this study was to review the Spanish version of the Euthanasia Attitude Scale following the partial modification of four items. Methods A cross-sectional study was conducted with a non-probabilistic sample of Spanish health workers from Islas Baleares. A self-reported sociodemographic questionnaire and the Euthanasia Attitude Scale were used for data collection. The psychometric properties of the scale were assessed, including reliability and validity, using a confirmatory factor analysis and a parallel analysis. Results The Cronbach's alpha of the EAS was α = 0.892, which implies good internal consistency. According to the confirmatory factor analysis, a Kaiser–Meyer–Olkin–value of 0.938 was obtained, and the result of Bartlett's test of sphericity was

Abstract Background In the context of discussions between supporters and opponents of euthanasia, and legal regulations regarding this type of practices, the attitude of young people with respect to this phenomenon is a very interesting issue. According to Polish law, euthanasia is prohibited. The aim of this study was to determine the degree of acceptance of euthanasia among students from Polish universities across three different fields of study: psychology, medicine, and economic-technical disciplines, and to identify the factors associated with the acceptance of this phenomenon. Methods The study included 627 persons studying in Lublin, Poland: medicine (280), psychology (170), and economic-technical studies (177). The study was conducted as a survey using questionnaire containing items concerning students’ attitudes towards euthanasia. The analysis of the collected data was conducted using the SPSS software (version 29) with the following methods: Chi2, Student’s t-test, Phi test, Cramer’s V test, Kolmogorov-Smirnov test, one-way ANOVA with Dunnett’s post hoc test, linear regression analysis, and categorical regression analysis using optimal scaling (CATREG). Results Nearly half of the students participating in the study (45.9%) rated the practice of euthanasia as decidedly negative. The highest number of strongly negative evaluations was found among psychology students, and the least among students of economic-technical disciplines. The level of acceptance of euthanasia is significantly associated with religious involvement and studying psychology. Being religious and being a psychology student both contribute to lower acceptance of euthanasia and a lower willingness to consent to euthanasia. Consent to euthanasia is more commonly declared by individuals with experience of living with elderly people. Conclusions Although nearly half of the respondents expressed a negative attitude towards euthanasia, considering the secularization process among Polish youth, it can be assumed that the level of acceptance of euthanasia in this social group will increase. The lower level of acceptance of euthanasia among psychology and medical students compared to students of economic-technical disciplines suggests that the curricula of these studies present alternative solutions to the problems of terminally ill patients other than euthanasia.

The use of experimental animals is widely conducted in the medical field, both for research on the processes of disease occurrence (pathogenesis), the causes of disease (etiology), and research on therapy. Therefore, it is important to understand how euthanasia in experimental animals affects the integrity of the sample and its influence on research results. This article was compiled from several literature sources searched from Google Schoolar and PubMed published within the last 10 years, with keywords such as "code of ethics in experimental animals", "methods of euthanasia in experimental animals", "overdose anesthesia methods in animal euthanasia", "barbiturate injection methods in rats", "inhalation methods in animal euthanasia", "biochemical effects of euthanasia", and "histological effects of euthanasia". This paper discusses euthanasia methods, namely overdose anesthesia, inhalation, and injection. This paper aims to discuss how the method of euthanasia and the choice of drugs can impact the biochemical and histological changes in animals after the euthanasia process. Choosing the right euthanasia method is essential, as the species of animals involved and the research goals are considered. Using methods that align with the biological characteristics and behavior of the animals can help ensure the success of the research while also considering ethical aspects and animal welfare.

Background and Aim of Study: Depression severity can be profoundly impacting the life of individuals, while its persistence can provoke the conviction that recovery is unattainable. One of the extreme consequences is the request for euthanasia. However, during major depression cognition can be significantly impaired. In this study, we comment on the exemplar case of a Belgian lady, Mrs. Godelieva de Troyer, who made that request and obtained the desired outcome. The aim of the study: to consider a specific case of a patient with major depressive disorder and the role of doctors in informing the decision about medically assisted death. Material and Methods: The history of the request made by Mrs. Godelieva is described. The procedure was followed by the reactive initiatives of the son of the lady, who made a formal complaint against the procedure that brought his mother to death and appealed the European Court of Justice. Results: A description of what happened is briefly reported, including considerations on the clinical treatments received by Mrs. Godelieva, the roles interpreted by the doctors she consulted and, finally, the appropriateness of the decision taken. Conclusions: In revisiting this case, the decision-making process during major depression episodes and the authenticity and robustness of end-of-life choices in similar cases are critically examined. Comments are made on the frequency of cognitive impairments during major depressive episodes and the need to provide depressed people the necessary support during their important choices.