Death With Dignity – September 2012

Overview of National News – September 2012

(NOTE: List of articles are under the category “Assisted Dying & Euthanasia”)

Media coverage in the U.S. during August and September was primarily about the Massachusetts ballot Question 2 which would allow physicians to prescribe a lethal dosage of medication under certain conditions to terminally ill people who request it. Pro and con articles in the state were almost evenly split, 13 pro and 16 con, although I noticed a tendency for con writers to have the same article published in several publications so there may be duplicates.

There is strong opposition to it coming from the Catholic Church and Right-to-Life groups. They are well-funded and are providing speakers around the state to educate people about their perspective. A bully attitude comes through in their media releases. In the headlines they use words like “battle,” “war,” “murder,” and terms like “Nazi death camps,” and “eugenics.” Many bloggers are quite opinionated and come up with the darnedest conclusions. They discuss “aid-in-dying” as if it foreshadowed the apocalypse. They insist on using the dysphemism “assisted-suicide” and calling “aid-in-dying a euphemism. I don’t feel any compassion from that side about the plight of individuals trapped in a body that no longer works for them, but I do detect a lot of do what we say or God will smite thee! attitude.

I just don’t think all that drama is necessary when what we’re all really trying to get to is a set of laws regarding end of life parameters that protect and empower people to die on their own terms and in their own time however they choose to do that. The important thing is that it be the person’s choice, not anyone else’s, and to do that everyone needs to discuss and fill out an Advance Healthcare Directive or POLST (Physician Orders for Life-Sustaining Treatments).

We all get that we don’t want wanton killing of elderly and disabled people, but unless you walk in someone else’s shoes… you can’t say what they can/should/ought to do. We all get the difference between ending the life of a relatively healthy person who can’t bear to live in whatever situation they are in and hastening the death of someone who is dying or almost completely incapacitated or in a coma. It doesn’t take a psychiatrist to figure out who is eligible for Death With Dignity if they’ve expressed a desire to use that option.

Of course people are sad when they realize their life as they knew it is over, but clinically depressed to the point someone else needs to decide what’s best for them? No… they are dying and want to get on with it. Just shoot me now! And they will if the law isn’t on their side. And that’s so sad because people will use violent means if they aren’t able to obtain a gentle means without having to jump through all kinds of legal hoops. If someone is determined and they have the ability, they will do it one way or another regardless of the law.

Speaking of funding, the biggest contributor to the anti-assisted-suicide group in Massachusetts turned out to be a conservative Mississippi-based organization with anti-gay views, but which describes itself as pro-family. From Mississippi? The Massachusetts group supposedly gave the money back. Bet that put a dent in their advertising budget, but they have their cadre prolific bloggers putting out negative, and sometimes stretching the limits of truth, stories about the horrors of Nazi death camps alongside the Christian value of suffering to scare people away from allowing dying people to hasten their deaths a bit if that is their choice. Let’s put the fear of God in them!

Published polls indicate the majority of people in Massachusetts are in favor of legalizing physician-assisted suicide (64%), including a lot of Catholics. It doesn’t sound like Senate candidates Elizabeth Warren or Scott Brown are in touch with the issue at this point though Ms. Warren said she was leaning toward supporting assisted suicide legalization. Brown says he needs more  information. I don’t know what rock he’s been hiding under. Plymouth, maybe?

Things will be heating up in Massachusetts during October in anticipation of the election. I expect some groups will be out on street corners shouting to drivers-bye to Honk for not murdering granny or people with disabilities and the Church will be threatening the wrath of their God upon human civilization if folks don’t vote ‘no.’ But I think others will see the rational perspective that we each have the right to request assistance from a medical person if we want it… and those are the people who will quietly vote ‘yes!’

I’ve noticed that more and more states are testing the waters as articles appear here and there in local press about what’s being talked about in other states and other countries. The number of articles is small (1 to 3) compared to 45 articles from Massachusetts.

Montanians are still insisting assisted dying isn’t legal there, it’s only that doctors won’t be prosecuted, but apparently nobody is paying any attention to them and I keep seeing articles that say it is legal there. Hawaii has been quiet lately, not talking much about a panel of doctors who have agreed to offer assisted-dying even though the law hasn’t caught up to them yet. New Jersey popped up toward the end of the month saying it could become the 3rd state to legalize aid-in-dying per Oregon/Washington laws with an Assemblyman proposing the New Jersey Death With Dignity Act. Another citizen proposed looking into the effects of grief on families who witness various dying circumstances to see whether assisted dying is less traumatic that witnessing death in a prolonged, perhaps agonizing, dying process at home.

There are studies that show a big difference in grieving between people who witnessed death in an ICU compared to a peaceful process at home surrounded by family… which is what assisted dying would allow, including the day and time so everyone could be there to see them off on their journey. Not to say that palliative care isn’t extremely important, that hospice care isn’t the best way to go… it’s just that sometimes it isn’t enough.

Baby boomers in Washington DC are more open to discussing this subject and want to be in control of their end-of-life care. They have a more patient-centered approach to health care issues than their parents’ generation. Compassion & Choices had its annual conference there in June. Its president Barbara Coombs Lee discussed the strategies for success in affirming and protecting end-of-life liberty, including aid in dying in the states. Compassion & Choices (after which the right to lifers always add, formerly the Hemlock Society, which if you look at the history is only partially true as it continues on as the Final Exit Network) provides Advance Healthcare Directives for all states and counseling about end-of-life choices within the law.

Illinois has a heated congressional race going on with one candidate a doctor who was fired from his hospital job because of his views on assisted-suicide. He claims a lot of doctors are upset and disgruntled that they aren’t allowed to assist their patients. Really? You can get fired for having an opinion? The Wisconsin Death With Dignity Bill is also getting some attention with the Wisconsin Medical Society onboard and we’ll likely hear more next month.

I’d say the worst thing I came across this month came from Ohio where Pro Life Ohio is sponsoring an essay and poster contest for students in 7-12 grades with two winners in each contest receiving a $50 bill. The essay should be on a Pro Life topic defending the sanctity of life from conception to natural death against affronts to life ranging from contraception and abortion to euthanasia.

Really? 12 to 18 year olds defending the sanctity of life from conception to natural death against affronts to life? It’s that kind of early programming that scares me about the younger generation. They won’t be able to think for themselves. Apparently PLO’s advertising budget is only $100 because they are then going to use the children’s entries for their promotional purposes.

Oregon is currently grappling with the issue of hospitals that need funding merging with organizations like Dignity Health, which is an arm of Catholic Hospitals. Ashland is currently debating about allowing the take-over of its community hospital because doctors won’t be allowed to perform abortions except to save a mother’s life and won’t even be allowed to talk to patients about Oregon’s Death With Dignity Act.

The good news is that Oregon’s POLST (Physicians Orders for Life Sustaining Treatment) program, created two decades ago and put into state law by the Legislature in 2009, has been adopted by 15 states and is under consideration in 28 others. This allows patients to make decisions about their end-of-life care, and is kept in their doctor’s file, posted on one’s refrigerator, and registered with the State. If 9-1-1 is called, EMT’s and ERs can check the database to find out whether the patient wants life-saving measures to be taken (resuscitation, intubation, artificial feeding. etc.) or just comfort care.

Overview of International News – September 2012

The majority of the articles for the past 4 months have appeared in Australia, New Zealand, Canada and the United Kingdom, with the UK reaching 40 and 45 the last 2 months and other countries an article or two. Activity in Scotland has picked up since independent MSP Margo MacDonald, who has Parkinson’s Disease, said she was in favor of changes to the law.

This isn’t an exact count by any means as some articles are duplicated in various countries and some articles are just not worth repeating, but it does give a picture of what parts of the world are having the conversation. The National Right to Life group from Canada has been the most vocal opponent in a number of countries around the world, along with the Catholic Church.

In Canada, the ball has been tossed back to the Supreme Court but Gloria Taylor, who has MS and requested euthanasia, was exempted as long as she does it before Court is back in session in 2013. Right to Life groups protested but it’s become a moot point as Ms. Taylor died from an infection on October 4th.

In New Zealand, Paula Westoby, an 83-year old woman who had “Do Not Resuscitate” tattooed on chest has died and Rosie Mott made a video explaining that she was doing herself in so her husband wouldn’t be prosecuted. Family Life International claimed that set a dangerous precedent for future cases of assisted suicide in New Zealand. However so-called “right to die” advocates are very excited about the outcome of this case hoping this decision will  influence politician’s thoughts on MP Maryann Street’s “End of Life Choices” Bill which is awaiting its first reading. A recent poll found 62.9% were in support, 15.8% neutral, 12.3% opposed and 9% were not sure.

Dr. Phillip Nitschke from Australia who helped his mother die, after serving his sentence in New Zealand, returned home to crusade for assisted-dying. He tried to get Fiji to change its laws to allow clinics (similar to Dignitas clinic in Switzerland) where dying people could come from around the world to die on a beautiful tropical island. Welcome to Paradise! The Fijians didn’t go for it.

Dying With Dignity in Australia is lobbying to change the law to allow euthanasia claiming it contradicts the Territory’s Human Rights Act to prevent people from assisting others to die. The Labor Party doesn’t support “elective death” for people who are not terminal.

The Green Party plans to introduce the Rights of the Terminally Ill Bill to legalize voluntary assisted suicide for sound-minded people with an intolerable terminal illness who request a prescription for a lethal sedative.

Joanne Duune, whose son Mark Liegep was unresponsive and in a persistent vegetative state since suffering head injuries in a car crash 6 years ago, had to watch him waste away for nearly 4 weeks before he died last month. She said “if it happened in one day, with an injection, the whole family could have been there.” Ms. Dunn wants new laws which would allow families in similar circumstances to choose swift euthanasia by drugs.

Hospice and Palliative Care are making inroads in Africa and opening up the conversation in some areas. Even in Nigeria, the views of the Catholic Church on Euthanasia are discussed, i.e. euthanasia means “good death” but the Church prohibits it. In Russia, it’s completely unacceptable and India just rejected the pleas of an 72-year old who has been bed-ridden for 10-11 years for mercy killing. A German assisted suicide group moved their office to Switzerland because many in Germany object to the practice because of its association with Nazi euthanasia programs. A French film about a man’s difficult relationship with his dying mother has put the euthanasia debate back in the public eye. Hong Kong is seeking legal clarity on assisting another person to die. In Ireland, the case of a woman with MS is testing the law by claiming people with disabilities are discriminated against when it comes to assisted suicide. When doctors removed a respirator from a 76-year-old woman known only as Kim , it sparked a national debate in South Korea about choosing to die, or not, and who can make that choice. Belgium seems to be the place to be for creative applications of legalised euthanasia by allowing gravely ill prisoners to die. Even the Arab Emirates are discussing cases of requested euthanasia in European countries.

There is ongoing conversation in Switzerland because of what’s being called “suicide tourism.” People who want to be assisted or euthanized are traveling there because it’s illegal in their home countries. Dying and disabled people have to schlep themselves through airport security and fly far from home (usually hooked up to life support)  just so they can die in peace with their dignity in tact.  I agree with UK Health Minister Anna Soubry that that’s simply ridiculous and appalling! People should be able to die in their own country in their own home without fear of the law pursuing those who would assist them. Switzerland’s parliament voted against a bid to toughen controls on assisted suicide, rejecting concerns about foreigners traveling to the country to die.

In Ireland, a 59-year old woman in the terminal stages of MS is challenging the courts to allow her husband to help her die without prosecuting him. She was going to go to Dignitas in Switzerland but wants to be able to die at home and her husband has vowed to help her even if he has to go to prison.

In The Netherlands, where euthanasia is legal, they now have  specially equipped vans that will come to your door with a doctor and a nurse who will assist you, which is certainly controversial, but people are lining up for the service. Of course, some people are going to find this abhorrent but that is an emotional response. I can see this as the wave of the future, not just because hospitals and physicians don’t want anything to do with the dying, but with the growing population of elderly, sick and dying patients in the coming decades, they won’t be able to keep up with the demand for aid-in-dying.

They also have an interesting case with Queen Beatrix’ son Friso who was smothered in an avalanche while skiing in Austria and has been in a coma in a London hospital for 6 months. He lived and worked in London. Doctors say there is little chance he will recover. Now a well-known Dutch ethicist has claimed that if he had been hospitalised in the Netherlands, doctors would have stopped treating him. Another controversy has arisen since it came out that psychiatrists have euthanized dementia patients plus an upward trend in euthanasia deaths.

In Scotland, It was revealed that 27 people died from bed sores… DIED FROM BED SORES, and it’s going to take them until 2015 to ensure there are no more avoidable hospital-acquired pressure ulcers… but they won’t allow aid in dying! Labor MP Margo MacDonald accused Care Not Killing of ignoring her End of Life Assistance Bill’s purpose and linking it with the programme of state-sponsored murder of disabled Germans. She says interest in the Bill has increased since the death of Tony Nicklinson in England.

Tony Nicklinson’s case has dominated the news in England for months. A former Rugby player suffered with locked-in syndrome, the result of a stroke, for 7 years has been begging the courts to allow him assisted dying. He died this month a week after losing his legal bid to end his life when he chose with the help of a doctor. He was 58 at the time of his death. His widow Jane has vowed to carry on his fight and now welcomes the willingness of newly appointed health minister Anna Soubry to “stick her neck out” on the issue of an assisted suicide law, but said reforms that restricted the measure to the terminally ill would not be enough.

Tory MP Anne Soubry says the current laws on assisted suicide are ridiculous and appalling and that legislation needs to evolve. Her Liberal Democrat colleague Norman Lamb, who was moved to the health department at the same time, said he believed there was “a strong case” for the present law to be reconsidered. Another MP Richard Ottaway called for reform of the law on assisted suicide to allow Britons to die at home. MP Lorely Burt backed a call at the Liberal Democrat conference allowing doctors to help patients end their lives. A policy motion was passed reaffirming the Party’s support for a debate and free vote in Parliament on legislation allowing medically assisted dying in limited circumstances and with extensive safeguards

Martin Horwood, MP for Cheltenham (LD), said he was “strongly in favour” of legally assisted suicide, but stressed the need for “strong safeguards.” He stated his position is strongly influenced by his father’s experience when he was terminally ill and thinks the decision should be left in the hands of the patient and not the doctor.

Ms Soubry immediately came under attack from fellow Tories, with one warning that any attempt to change the law would be ‘fiercely’ opposed and another saying she should resign. Even David Cameron is distancing himself from his outspoken new health minister and says there is no need for a change in the law or in legal guidance on this issue.

Campaigners for a change in the law are courting the Green Party to back a draft Parliamentary Bill, as the Green Party in Australia is doing. Chief executive of Dignity in Dying Sarah Wootton told the party members at a public debate there was a “strong case” for allowing assisted suicide for people who are terminally ill in England and Wales. They are considering in Oregon-like law.

A survey of MPs found that just 29% back moves to introduce assisted suicide, while 59% were opposed and 12% were undecided. Opposition was especially fierce in Scotland, where 86% of MPs opposed new legalisation. Most MPs seem to fear law changes could push vulnerable people into ending their lives if they faced health problems.

Care Not Killing’s Dr Peter Saunders said: “Allowing assisted suicide would put pressure on vulnerable people at a time when many sick, elderly and disabled people are struggling to make ends meet. A majority of MPs recognise this and agree assisted suicide should not be legalised.”

British Humanist Association Chief Executive Andrew Copson commented that previous attempts to legalize assisted dying have revolved around terminally ill people but that is changing to include mentally competent adults who are permanently incapacitated or in unbearable pain.  The large majority of Britons, including Christians, according to polls, appear ready to accept medical assistance to end one’s life with dignity.

The Church of England’s adviser on medical ethics, Rev Dr Brendan McCarthy, says that changing the existing laws would place elderly people at greater risk and cautions against taking an unrealistically optimistic view of human nature. He apparently thinks a lot of people want to knock off granny. The president of the British Medical Association expressed about the same view. The BMA is opposed to assisted suicide, supports the current legal framework, and supports the establishment of a comprehensive, high quality palliative care service available to all, to enable patients to die with dignity.

Care Not Killing’s Dr Peter Saunders said: “Allowing assisted suicide would put pressure on vulnerable people at a time when many sick, elderly and disabled people are struggling to make ends meet.”

From the Independent Catholic News– Anti-euthanasia campaigners are preparing to mount the first nationwide billboard campaign against euthanasia and assisted suicide. Members of ALERT, Distant Voices and Not Dead Yet UK are behind a venture to post billboards in nine cities in England and Scotland showing a silhouette of a person with the caption:  WHAT’S THE COST OF EUTHANASIA? YOU ARE! Distant Voices is also seeking ‘envoys’ to place themselves in town and city centres on Saturday October 27 – a day of action – and to give out accurate information and speak to members of the public about the evils of euthanasia.The purpose of the campaign is to oppose the legalisation of euthanasia in the UK and to inform the public of the dangers involved in its use anywhere.

Meanwhile…

a man named Martin with locked-in syndrome, who says his life is intolerable and wants help to die, is taking his case to the appeal court and is prepared to go to the highest court in the land, the supreme court, if necessary.

Jackie Meacock, who suffered from the neurological disorder dystonia, recorded a video diary calling for assisted suicide to be legalised. She didn’t want to have to leave the country but she did. She went to Switzerland to Dignitas clinic to take her own life with her family at her side.

Thomas Hobkinson, 71, suffered from motor neurone disease and had bought drugs over the internet so that he could kill himself at home. As his disease worsened, he informed family, friends, doctors and caregivers of his intention to end his life. He did, alone in his home after watching the DVD of his son’s wedding.

Patrick Norfolk, 65, had one last wish as the debilitating physical condition (motor neurone disease) that had plagued him for years entered its final, terrible stages. He wanted to die in his garden among the flowers and plants he  had tended for decades, surrounded by his family. He did indeed try to take his own life at his home but failed. Unable to seek help from his wife Anne or anyone else because of Britain’s laws on assisted suicide – he took the agonising decision to end his life at the Dignitas clinic in Switzerland.

Then there is the crisis in end of life care– More hospices, care homes and other end-of-life facilities are going to be needed to help cope with increasing numbers dying ‘gradual’ deaths, say specialists worried that supply is not keeping pace with demand. Better health care, and to some extent a fitter older population, means less are experiencing ‘sudden’ deaths, for example from heart attacks. But while increased longevity is to be welcomed, doctors say not enough resources are being devoted to making the last days of the elderly as comfortable as possible.

The good coming out of this debate is increased awareness about Advance Healthcare Directives and improved end-of-life care in the form of palliative care and hospice.

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