Film can start “The Conversation” about end-of-life

I wrote this column which was published in my local newspaper, The Nugget on 12/10/2014, after viewing the beautiful, award-winning documentary “Final Pose,” about a local yoga teacher who developed cancer and in the end decided to use Oregon’s Death with Dignity Act.

I attended the screening of “Final Pose,” an award-winning BendFilm 2014 documentary directed by Karen Mellberg of Bend at The Belfry last week. The film concerns the end-of-life journey of Sisters yogi Myra Lani Fisher through her own voice and was filmed during the last few weeks of her life as she was preparing to use Oregon’s Death with Dignity (DWD) Act.

I didn’t know Myra and only learned about her a few weeks before she transitioned. I wish I could have had a conversation with this very strong woman to learn how she processed her decision to choose this end of life option. Because this is what I do– help people have these conversations about death and dying so they can make informed choices, have discussions among their family members, and fill out the necessary paperwork so their last wishes will be carried out. It probably wouldn’t surprise you that most people find it difficult to even contemplate their own death, much less plan for it.

I spoke with a number of people that night who had no idea this information was available or even that Oregon has had a DWD law since 1997. Very few have talked to their doctor about anything to do with their own death and not many knew about the process one has to go through to request the option. This can be a daunting task for anyone, especially for those who wait until the last possible minute to even try to find information. Just having to make the request twice 15 days apart, much less trying to find a physician who will write a prescription and a pharmacist who will fill it, can take time and perseverance– this where CompassionandChoices.org can help.

It’s certainly not a fit for everybody as one’s dying process isn’t always a terrible ordeal, but for some people, it is… with some diseases, especially certain cancers such as Lani suffered with, it can be excruciatingly painful in spite of the availability of morphine through hospice services. Certainly palliative pain management is helpful for a lot of people, but it’s not universally available, not everybody benefits equally and an individual’s suffering is intangible.

For those who die slowly over a long period of time, especially in their 80s and 90s, continuing to be kept alive only to continue suffering even without pain can be unbearable to some and these patients often beg to die, beg their loved ones to kill them; some take matters into their own hands.

Voluntary Stop Eating and Drinking (VSED) is often the only sanctioned option a person has if they are not terminal (diagnosed with 6 months or less to live), have a degenerative disease or mental problem or are frail elderly. I’ve seen VSED go well for some people and others not so much. We don’t have a perfect system for helping people to die well yet. Medical students are finally starting to receive some training in end of life care and things are slowly beginning to change. Insurance coverage is a whole other issue.

Those who end up in hospitals trying one more resuscitation, one more invasive procedure, one more experimental treatment, often end up on life support beyond what they would have wanted– just because they were too afraid to have the conversation and make some informed decisions about what treatments they would want and not want at the end of their lives. This agony extends to the family and leaves them traumatized for years over whether they did the right thing because they always thought there would be more time and suddenly there is none.

Yes, there are religious objections, and fears of wantonly offing the disabled, the elderly, the vulnerable who are unable to speak for themselves, which is why we need solid laws to prevent coercion and forced extermination. Seventeen years of experience has shown the Oregon DWD Act to be effective and only used by a small percentage of people. And only a small percentage of the people who request their prescription actually fill it, and an even smaller percentage actually end up taking it.

The recent case of Brittany Maynard, a 29-year old woman with incurable brain cancer, a prognosis of a only a few months to live, and the likelihood of an agonizing dying process, has kickstarted the conversation around the country about our right to choose to die on our own terms. She moved to Oregon from California where there is no legal option for aid-in-dying and ended her life last month with the help of Compassion & Choices by self-administering the medication on the day she chose at home in her own bed with her husband and her mother by her side. Isn’t this the way we all want to go?

So now we have this beautiful documentary, a gift from Myra Lani Fisher and Karen Mellberg, about the beauty of life in our own death to give each of us the courage to have those hard conversations we don’t want to have with ourselves or with our families, but which we must… because suddenly there may be no more time.

The boundaries that divide Life and Death are at best shadowy and vague.

Who shall say where the one ends and where the other begins?

~Edgar Allen Poe

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Death with Dignity laws

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The recent death of a 29-year old woman who chose to use the Death with Dignity law in Oregon has invigorated the debate about our right to make choices about our healthcare at the end of our life. Brittany Maynard had a brain tumor that doctors said would end her life in a most undignified manner and she chose not to experience that part of her illness. She completed her Bucket List and enjoyed the last quality time she could with her husband and parents, and died peacefully at the time of her choosing at home in her own bed surrounded by those who loved her.

If you are facing such a decision, whether you are thinking about the Death with Dignity option or not, this book by a Near-Death Experiencer, will help you find acceptance and peace of mind as you navigate medical decisions, care options including palliative and hospice services, conversations with family and providers, filling out Advance Healthcare Directives and making decisions about how your want to die.

Beyond the Veil is for caregivers who will be transition guides for their loved ones, for families to help them have the necessary conversations, and for the dying person who wants desperately to know what is happening to them along their journey home.

Excerpt from Beyond the Veil: our journey home by Diane Goble about Death with Dignity laws:

Reasonable laws can prevent abuse while honoring self-respect, human dignity and compassion. Just as an obstetrician might administer a drug to hasten a birth, a doctor may prescribe a drug that will hasten not death but the rebirth of our spiritual nature. Prepared ahead of time and guided by a transition guide’s voice reading one’s Personal Transition Guidebook, it is a peaceful journey home beyond the veil.

Some people believe it is a slippery slope to allow this at all. They are afraid mentally or physically disabled or senile elderly people will be murdered for convenience. Perhaps in some societies where human life isn’t valued that could be true. It is up to those who believe in death with dignity to make sure laws are in place to prevent forced euthanasia by designating medical professionals and safe procedures to provide humane, compassionate assistance to those who decide of their own free will to exercise this option.

A May 2005 Galllup Poll indicated that 75% of Americans support “euthanasia” for certain patients but only 58% support “doctor-assisted suicide” for the same patients. Use of the term “suicide” was the only difference in the question asked. The Gallup Poll conclusion was that the use of the word caused the apparent conflict in values.

Opponents count on the negative emotional impact of the term. Calling it “suicide” or “murder” conjures up images that clash with religious beliefs and humanitarian values, but have nothing to do with personal choice at the end of life.

This is what Dr. Jack Kervorkian fought for–a patient’s right to choose and the physician’s role at end of life. It’s nobody’s business except the person who is dying, his physician and his family members (and sometimes not the latter). It’s continuing care through the end of life.

Instead of physicians abandoning their patients at the end of their invasive medical treatment options, they could stay with them to provide the medication that will quickly end their suffering if that is their patient’s final request.

Their Hippocratic oath says, firstly, do no harm, but if forcing a person to stay alive while their body  progressively deteriorates for years, whether physically or mentally, isn’t doing harm, I don’t know what is. Seems to me physicians need a better understanding of compassion. Continuing to swear an oath to Greek gods is out of touch with contemporary reality–the earth is not flat and doctors are not gods.

Having “The Conversation” about End of Life Healthcare Planning

The Nugget, Sisters, Oregon – October 15, 2014

Having “The Conversation”

By Diane Goble

Ever since Ben Franklin warned us, “If you fail to plan, you are planning to fail,” we’ve been diligently planning for everything — college, career path, marriage, children, home buying, vacations, retirement — everything, that is except our inevitable end of life. We don’t want to think about that so we tend to ignore it or postpone dealing with it, often until it’s too late. We live in the state of denial that keeps us oblivious to the unthinkable fact that this day could be our last on earth.

Hopefully that’s not true for you this day, but statistically, in this country, 1 person dies every 3 seconds, approximately 6800 of us every day, 2,468,435 every year. Most people die from health-related conditions, including (in order) heart disease, cancer, chronic respiratory diseases (COPD) and stroke. Accidents are next down the list. All of these are, to some degree, preventable, treatable, manageable, mitigated by medical care and healthy lifestyle changes, and most of us will survive to live the life we planned to a ripe old age.

And that’s part of the problem. Health care has improved, we’re making progress with many cancers, we’ve recognized the problem of obesity and we’re eating healthier and exercising more so we’re living longer but we’re getting diseases now that people didn’t use to get because they died at earlier ages — Alzheimer’s Disease, in particular, but also emphysema, COPD, Parkinson’s Disease, and diabetes. And with the aging Boomer population, we wonder will there be rationing of medical services.

The health care system has us focused on treatments that almost kill us in order to make us better so we can live longer and get more diseases for them to treat. At the same time there are more people in need of care, there are also fewer doctors and medical services are stretched thin.

And within this maelstrom of activity is the elephant in the room. At some point, we are all going to die — but no one wants to admit it or talk about it and certainly know one wants to plan for it. We always think there will be more time.

This is a quote from this correspondent’s soon to be released book on amazon.com, Beyond the Veil: Our Journey Home, from a woman named Kathy who shared her experience of not planning ahead:

While we had gradually acknowledged to each other that he might not make it, we’d never really accepted it or talked about what it meant. I always thought we’d have a period of time when he was in hospice care when we would talk more and say our goodbyes. While I, and my kids, said lots of goodbyes and I love yous while he was in a coma, he was never able to communicate with us again. I still replay those last few days over and over and wonder how we didn’t know he was so close to the end and wonder if he knew.

There is a lesson in this: to say the things we want to say while we can – and it illustrates why it is so important to plan for the end of our lives, not just for our selves, but for our loved ones as well. We won’t know how we are going to die, where we will be when it happens, who will be with us or if we will be alone, but we can make our choices known about how we want to be treated at that crucial time, which will guide our loved ones to follow our wishes.

We do have some options and they are more likely to be honored if we have discussed them with our family members and doctors, appointed a healthcare representative who supports our wishes through our Advance Healthcare Directive so physicians will know what we want and don’t want if it comes down to that. The biggest hurdle is sitting down to have the conversation.

Realize that this is not a one-time conversation. It may occur in bits and pieces — a question at the dinner table, a comment during a TV program or news story, a shared article from a magazine, a book, a website, a post on Facebook. Over time and with new information or health concerns, you may change your mind several times.

You may have a conversation with your doctor or a clergy member that provides some new insight or clarifies your values. After seeing what another family went through, you may decide you do or don’t want that to happen to you. Visiting a friend in hospice care may change you mind about how soon you would want to bring hospice services into your life or the life of a family member. Advance Healthcare Directives are changeable and should be reviewed every 5 years or as you health changes.

No matter how old you are — and perhaps this is something everyone should do when they first get their driver’s license because those are extremely vulnerable years for accidents — no matter what your health status is, the time to have these important conversations is when you are healthy and mentally competent to make decisions. By the time you are in an ambulance, in the ER, or on your deathbed, it is too late. Leaving it to your distraught family members to decide what you would want during dire circumstances is setting them up for unending grief and trauma over whether they did they right thing — no matter what they did or didn’t do.

Fortunately, right here in Sisters, there are several people, including Kelsey Collins, Sue Stafford, myself and others, who are available to help people sort through the information about Medicare, home health care, palliative care, hospice services, Advance Healthcare Directives, POLST and Oregon’s Death with Dignity Act. Talk to your doctor, talk to your spiritual adviser and by all means, talk with your family about your last wishes — then you don’t have to think about it anymore!

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Wrapping up the Massachusetts Death With Dignity Defeat

 sunsetcloudsDeath – the last sleep? No, it is the final awakening.

–Sir Walter Scott

Now that the dust has settled around the Massachusetts ballot initiative for Death with Dignity, and the opposition and the proponents are preparing for the next battles in New Jersey, Connecticut, New Hampshire and Vermont, I’m going to provide excerpts from articles released in November leading up to the vote and its defeat to see what happened.

An interesting thing about this emotional argument is all the different players involved so I’m going to present their perspectives according to the articles leading up to the Massachusetts vote… with the caveat that I’m in favor of a Death with Dignity law but not particularly of the one that was proposed in Massachusetts or the ones that currently exist in Washington and Oregon. I will reserve my opinion for a subsequent blog post. So in alphabetical order–

THE DISABLED COMMUNITY

According to Second Thoughts (People with disabilities opposing the legalization of Assisted Suicide) director John Kelly, the only way for the law to be acceptable to them would be to make the safeguards so exacting that no one could get past them.

• They fear heirs might pressure their relatives to end their life early and with dementia they might relent.

• They stress people with mental illnesses,  including depression, are unable to make these decisions.

• They fear someone putting something into a feeding tube without the person’s knowledge.

• They fear wanton killing of  sick elderly and handicapped, disabled, challenged people as was done in Nazi Germany because they were considered unworthy, too expensive and too much trouble to take care of.

Second Thoughts contends that:

• Assisted suicide is a deadly mix with a profit-driven healthcare system. Pressure to cut costs, delays in treatment and limited coverage for home care can lead patients, families and doctors to choose the cheapest alternative, even if that is assisted suicide.

• Assisted suicide is unnecessary because current law gives every person the right to refuse lifesaving treatment, and to have adequate pain relief, including palliative sedation to die in your sleep. Assisted suicide decreases self-determination by giving doctors and insurers the power not just to cure, but to kill.

• The proposed law is a recipe for elder abuse. An heir can be a witness and help sign someone up, and once a lethal drug is in the home, no one will know how the drug is administered. If the person struggled, who would know?

•A lack of safeguards and oversight in the proposed law puts people at risk of misdiagnosis, deprivation of treatment and economic pressure to choose suicide, while protecting doctors from liability.

  • No mental health evaluation is required for depression or other treatable cause of suicidal feelings.
  • If a doctor refuses lethal drugs, the patient or family simply can—and do—find another doctor (“doctor shopping”).
  • “Terminal condition” and “death within six months” are often misdiagnosed, opening the dangers of assisted suicide to many who are not terminally ill.
  • Nothing in the law can offer protection when family pressures, whether financial or emotional, distort patient choice.
  • The law does not include enforcement provisions, investigation authority, oversight or data verification. The only foolproof safeguard is for the prescribing doctors. The law holds doctors only to a “good faith” standard, which makes any safeguards unenforceable.

• Discrimination: A law that singles out some people (such as old, ill and disabled people) for assisted suicide instead of suicide prevention is not in step with Massachusetts’ progressive tradition as a leader against discrimination.

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A writer commented– “Now is the worst time to perpetuate that death is better than disability.”

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Not Dead Yet Director Diane Coleman praised Second Thoughts Director John Kelly and the Steering committee for inserting the disability rights perspective into the Massachusetts debate. Coleman said Second Thoughts made the difference in preventing assisted suicide from gaining a foothold in the Northeast.

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A woman now confined to a wheelchair because of her MS, which she described as “the slow road to death,” was opposed to voluntary euthanasia until recently. ”As little as five years ago, I really did believe that without safeguards, voluntary euthanasia could be open to the terrible abuse of the elderly and the vulnerable in our society. I felt that quite strongly.” But she had no idea her illness would go into such a steep slide, prompting a ”drastic change in my feelings” about voluntary euthanasia. Now with her new consciousness, she wonders why it is illegal. ”If I’ve got a suffering animal, I won’t hesitate to have them euthanised,” said the keen horsewoman.

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Tony Nicklinson (58), a former soccor player in England, who developed locked-in syndrome following a stroke in 2005 and could only move his eyes, fought for the right to die by doctor-assisted lethal injection.  When his last request was turned down by the High Court in August, he felt his only alternative was to stop eating and drinking thus starving himself to death. Tony developed pneumonia and died a week after the verdict. His wife, Jane, and other people with locked-in syndrome, are continuing to pursue a change in the law to allow euthanasia for people like Tony who are incapable of doing it for themselves and need professional assistance.

THE DYING ONES

These are excerpts from various articles, letters, blogs by people who are or were in the process of dying:

“To end this suffering is not euthanasia. It is a display of pure love and decency for a fellow human through assisted suicide, and an acknowledgment of his own written wishes.”

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“It is not a choice between living and dying, but between different ways of dying.”

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“I don’t know if I’ll use the prescription but I know it’s there, just in case I decide I do. It gives me peace of mind.”

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“It’s not that I’m depressed, I’m just fed up and frustrated,” Ms Harrison (New Zealand) said. “I’ve had such a wonderful life, travelled widely, with glorious memories and now I have no control over my life whatsoever with much worry and anxiety. I am living in such despair. I want to go. I’m quite happy to go. I have no fear of death whatsoever. My one fear is, because I have spent the last 3 years in bed, that I’ll suffer a stroke or other medical disability and my wishes will evaporate with my physical or mental agility. If euthanasia was legal, I could spend more time alive without worrying that I must terminate my life as soon as possible before anything drastic happens.”

Ms Harrison has lived with MS for more than three decades but says the deterioration of her condition in recent years has made life unbearable. Confined to the living room that was once the bustling centre of her family home, she relies on her 26-year-old son, a member of the Army Reserve who is studying for his masters degree, as her primary carer. “All my loves . . . I loved nature, I love books, horseriding. Everything is now lost to me,” she said. “I have to cope daily with double incontinence, gripping spasms and physical and nerve pain, to say the least.”

As a member of Philip Nitschke’s right-to-die group Exit International, Ms Harrison had planned to travel to Dignitas. However, difficulty in obtaining paperwork led to delays and this year she fractured her femur, making the trip impossible .”I wanted to do it properly, to die in the company of friends and with dignity, I didn’t want it to be ‘suicide’,” she said.

EHTICISTS

“While I’m certainly someone who believes in increasing and furthering and advancing patient autonomy, I think that there are a lot of problems with the current ballot initiative. Primarily, the potential problems in having this initiative without any mandate for psychiatric evaluation.”

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“Euthanasia, also known as mercy killing, is the act or practice of deliberately killing a dying individual, who no longer wants to tolerate pain and suffering, in a relatively painless way. Physician assisted suicide, on the other hand, takes direct control out of a doctor’s hands. The doctor presents the patient with the means to end his life. Both issues are extremely controversial in the world of bioethics.” (Bioethicist)

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“The only really difficult ethical question surrounding assisted suicide is how we can ensure that an individual’s desire to end their life is the genuine, settled, free choice of a mentally competent individual. Of course, therefore, there must be safeguards in any future regulation of assisted dying. But as long as stringent safeguards are put in place, it is difficult to see the ethical case against it being provided at all.”

FAMILIES

“Those who have witnessed the agonies of a loved one in the final stages of ALS, MS, cancer, dementia, etc., will tell you that when there is no dignity nor purpose left, then the choice should be the patient’s.”

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I had a million questions about how he expected Ed’s decline to progress and I needed advice regarding the multitude of issues involved in end-of-life care. I wanted to know about ventilators, antibiotics, DNR (do not resuscitate) orders, living wills and so many other things. I also wanted to know how much longer he thought Ed might live, what specifically he might die of, and what signs I should look for that would indicate the end was imminent. And I had a lot of questions about hospice care, including whether I could stop it if I changed my mind later. (He told me I could stop it at any time, for any reason, and that if I changed my mind again, I could resume the services.) The conversation was incredibly stressful. At one point I realized I was holding my breath.

After answering all my questions, Doug looked at me kindly and said, “You know, Marie, the real question for the caregiver is how to help the patient have the highest possible quality of life in the time that is remaining.”That completely changed my thinking about the situation. It gave me a new and positive goal – to bring Ed as much happiness as possible. It led me to think about all the special things I could do for Ed — visiting him more often, taking my little Shih Tzu to see him, having that violinist come back and play another concert, reading to him from the New York Times, and buying him even more of the stuffed animals he loved so much. After that talk, I spent many hours pleasantly thinking up special things to do for and with Ed. Once I got my mind off his looming death, we were able to have a beautiful, pleasurable months-long conclusion of our life together.

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But in focus groups support took a nosedive when participants were told the measure did not require mental health specialists to sign off and did not mandate that family members be notified. When told that one of the common lethal prescriptions required patients to break up 80 to 100 capsules and stir their contents into a drink, support waned. People didn’t find that very dignified.

They also recoiled at the idea that the prescription would be obtained from a local pharmacy and ingested without supervision. As one guy said, ‘So, I’m waiting in line for my Sudafed and some guy waiting in front of me is trying to kill himself?” The research informed a series of powerful ads, including one featuring a pharmacist warning of the dangers and pouring out a bottle of red pills that skittered into a glass dish.“No doctors, no hospitals, just a hundred of these,” the pharmacist in the ad says. And they call that death with dignity?

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Although I asked point blank what to expect, I was told not to worry, mum would simply spend more time asleep and quietly pass away. If only. The weeks over which my mother passed away were a drawn out and traumatic experience that I would not wish on anyone. Several times I tried to get information about what would happen, from all the places you might expect, but none of it cut the mustard. It may be difficult to predict exactly what will happen in individual cases, but we weren’t even told about what might happen and how to prepare for it. Even when it was staring everyone in the face, there was little mention of the elephant in the room. Instead, the stark reality of what was happening was glossed over by those whose honest advice we might have benefited from. I’m sure our family is not alone, and although we may not all want such detail about what happens during death, most of us would admit we need to know it, however hard that might be. Informative conversations about the end of life give patients a better quality of life and help families cope with their bereavement.

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Thomas sat across from me on his sofa, holding his wife’s living will and health care proxy in his hands, still wondering if he chose the right time. Could his wife have changed her mind? Sure, she could have lived weeks or months more, perhaps, but would she have wanted that if she were able to choose?

His wife’s living will did seem to cover such a scenario, though typically such a document applies to a patient who is in a vegetative state rather than one who is conscious and talking (but not making any sense). Hers read: “If I have an incurable, irreversible condition that will cause my death within a relatively short time…I direct the withholding or withdrawal of all treatment, including nutrition and hydration, that only prolongs the process of dying.”

“I was very fortunate to have met Judy,” Thomas said of Schwarz, explaining that she had “held my hand through this process and provided advice that wasn’t coming from anyone else.” Still, Thomas is angry that the American medical system isn’t set up to deal with the complexities of the situation he faced.

“There aren’t a lot of guides for this process,” he said. “You would hope your own physician is [a guide], but they are there to treat you.”

“What am I doing?” she asked my father several times. “Life is not worth anything like this.”

Her hospice nurse was part of a team sent by Hospice and Palliative Care, which also included a doctor, a social worker and a rabbi. I was told when we met last spring that my mom’s quality of life had been deteriorating as April dragged on. She said my mom had told her, “I’m ready.” But my mom knew better than to ask a hospice nurse for help with that task. The goal of hospice is to keep the dying patient as comfortable as possible until death naturally occurs.

The associate chief medical officer told me that if a patient decides on her own to stop nourishment, medicine or machinery, no one will stand in her way.

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For months afterwards, George lay in bed, helpless and wasting away, with 24-hour nurses who washed and fed him and changed his diapers. He was lucid, and asked my mother and her sister to poison him. They told him they couldn’t do that, but my aunt Nina pointed out that his medicine was probably keeping him alive. Ending his life merely by omission hadn’t occurred to him.

“It was humane to put him out of his suffering but done through his choice,” Aunt Nina told me recently. “He certainly acted on that information pretty quickly.”

He died a few days later.

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The week she started hospice care, at the beginning of April 2011, my father contacted them. A few days later, they got a call from the clinical coordinator of Compassion & Choices, who lived nearby on the Upper West Side. She came over and spent a few hours talking with my parents, explaining her organization’s mission and discussing my mother’s illness and the options available. “She was warm and it was personal,” my father said. “She was a professional who is very skilled at dealing with situations like this.”

 The first thing she did was set me straight on the terminology when asked about “assisted suicide.” The term “suicide” has a lot of baggage whether religious, legal or moral, so to call it “assisted suicide” or “euthanasia” is to miss a crucial distinction.

We use the term ‘aid in dying because it more accurately reflects the information and support we provide to terminally ill and suffering clients”—information about how patients might control the circumstances or timing of their death. She went on to say that the motivation for suicide, which often results from mental illness and depression, is another thing entirely. We do not support suicide,” she said, noting the difference between suicide and the “thoughtful and considered decisions” made by some terminally ill patients as a means to avoid further suffering.

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Although Thomas’ wife was concerned about how this decision might affect her family members, it’s what she wanted to do. They got the lethal dose of medicine ready for when she might decide she needed it. But not long after preparing the dose, the cancer spread to her brain and she became unable to make the decision on her own. “So that plan went out the window,” Thomas said.

Even if his wife had been capable of deciding, Thomas wonders whether she would have made the decision to take the lethal dose, after all. “What point have you crossed where you truly don’t want to live in the situation any longer?” he asked. “It sounds more clear-cut when you are talking about it in the abstract than when you’re actually faced with it.”

Nevertheless, in a state of dementia, with hallucinations of snakes, Thomas’ wife was certainly not getting much in the way of dignity or quality of life. So after nearly 44 years of marriage, he decided to stop offering liquid when she stopped asking for it.

“She wasn’t able to consciously express the desire to die,” he said. “I acted on what I believed her wishes would have been.”

It took over a week before she fell into a coma and died.

HOSPICE/PALLIATIVE CARE

Patients would not be required to consult with a palliative care or a hospice expert. Hospice addresses the multifaceted distress that dying patients and their friends and families are experiencing by providing extensive palliative care, expert pain management, and extraordinary social and spiritual supports.  Hospice works with the patient to design a program that is individualized for the patient and provides choice, control and dignity when most needed.  Unlike even a few years ago, appropriate medical care is now able to keep patients comfortable and pain free. When the Oregon law was first passed, hospice care was only a glimmer of what it is today. Even though hospice services are now widely available, they are infrequently accessed.

PROCESS: Before care is provided, hospice staff meets with the patient’s personal physician and a hospice physician to discuss patient history, current physical symptoms, and life expectancy. They then meet with the patient and their family to discuss the services provided, pain and comfort levels, support systems, financial and insurance resources, medications and equipment needs. The patient must have a doctor’s referral to enter into hospice. Medicare covers all services, medications, and equipment related to the illness for patients with a prognosis of 6 months or less. (Source: http://www.hospicefoundation.org)

BENEFITS OF HOSPICE CARE: The use of hospice care can offer benefits to not only patients but their family members and loved ones as well.
1.    For terminally ill patients, the decision to receive hospice or palliative care instead of continued curative treatment can help them avoid the dangers of over-treatment.
2.    Hospice can reduce anxiety in the terminally ill patients as well as their family by helping them achieve some level of acceptance.
3.    Other than the focus on the physical health and comfort of the patients, hospice also focuses on the emotional needs and spiritual well-being of patients and their families.
4.    In-home care from a hospice IDT often means the patient receives greater monitoring than he or she would in a hospital. (Source: http://www.helpguide.org)

HELP FOR FAMILY MEMBERS:  The death of a loved one can be a difficult time and another benefit of hospice care is the support offered to family members after a patient has died. The bereavement support is when the hospice care team works with surviving family members to help them through the grieving process. This can include counselor visits to the family during the first year, support groups, and phone calls or letter contact with the family.

LAWS, COURTS

Sadly, many still believe that those living wills filled out years ago offer us some protection. They do not. We have progressed with the development of representation agreements and advanced directives, but the legal system still hovers threateningly. The author of such a directive – now in no fit state to demand execution of his wishes – must still face each day as a living hell.

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Death With Dignity Act – the state secretary, “This proposed law would allow a physician licensed in Massachusetts to prescribe medication, at a terminally ill patient’s request, to end that patient’s life. To qualify, a patient would have to be an adult resident who (1) is medically determined to be mentally capable of making and communicating health care decisions; (2) has been diagnosed by attending and consulting physicians as having an incurable, irreversible disease that will, within reasonable medical judgment, cause death within six months; and (3) voluntarily expresses a wish to die and has made an informed decision.”

There are, of course, a number of other safeguards built in, such as the need to make the request twice, separated by 15 days, in the presence of witnesses.  However, there could probably be stronger safeguards to protect individuals who are experiencing depression and anxiety, and might have preferable alternatives to physician-assisted death.

If passed on Election Day, physician assisted suicide would become legal under Massachusetts law, effective January 1, 2013. No additional legislative or other approvals would be necessary.  As written, the legislation is poorly written and lacks the basic safeguards against unintended consequences.

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Law is to make sure the assister isn’t prosecuted for helping a terminally ill person who wants to die carry out their wishes– not to determinate rightness or wrongness of the act of helping someone hasten their death. -dg

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In Montana, physician assisted suicide is not explicitly legal, but a state Supreme Court ruling gives legal protection to it.

The Montana Board of Medical Examiners has rejected a request to strike its policy on physician-assisted suicide that opponents criticize as too permissive. The board this year tried to provide some guidance to doctors on the issue that remains unclear in law. The board says it will review complaints on their merits if any are filed against a doctor for providing “aid-in-dying.”

Montanans Against Assisted Suicide says it wants the board to revoke that policy, saying it appears to condone a procedure that they argue is illegal. The board rejected the request on Friday, potentially paving the way for opponents to sue. The Montana Supreme Court in 2009 declared nothing in state law or precedent makes the procedure illegal. The Legislature has been unable to provide any further clarity.

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“Assemblyman John Burzichelli (NJ) introducted a bill modeled on the Death with Dignity Act legislation of Oregon and Washington. It is doctor-assisted suicide, NOT euthanasia. As a humane society we do not force animals to suffer an agonizing death. Why should we not be given the option of having that same right if that is our personal choice?”

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Gov. Peter Shumlin (VT) says he is confident that the Vermont Legislature will pass marijuana decriminalization and Death with Dignity or what opponents call physician-assisted suicide legislation this session.

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In recent years, Compassion & Choices has tried to do something about the shortcomings—or failure, in many opinions—of physicians to guide their patients through the dying process. David C. Leven, a lawyer and the executive director of the organization’s New York affiliate, has led the effort on the legal front.

“Why do you feel the need to urge doctors to diagnose dying?” I asked.

“Nobody tells them to,” he said. “Nobody reimburses you for that diagnosis.”

1997 Supreme Court ruling that individuals have no constitutional right to aid in dying. This ruling left it to states to decide the issue for themselves.

“We are over-treating people at the end of their lives,” Leven said. “People who are dying often suffer unnecessarily because they’re receiving aggressive interventions they may not want and don’t benefit from.”

The solution, in his opinion, is to provide patients with more information so that they can make informed end-of-life decisions that suit their needs. To this end, Leven helped enact New York’s Palliative Care Information Act, which took effect in February 2011. The act requires that doctors provide information and counseling to terminally ill patients who want it—which turns out to be most of them. But it seems that the vast majority of doctors don’t even know about the law. (In the group he spoke to at the hospital on Roosevelt Island, less than a quarter had heard of it.) Another problem is that some doctors may reject a legal mandate that tells them what to do with their patients, which is why the New York State Medical Society opposed the legislation. In Leven’s view, this shouldn’t be an issue because it is supposed to be part of a doctor’s job description.

“Doctors already have an ethical obligation to provide their patients with a diagnosis, prognosis, treatment options, and the risks and benefits of those options so that patients can make informed decisions,” he said.

Leven cited studies showing that a large percentage of doctors don’t have this conversation with their patients or don’t do it well. If they did, patients would be much better off, he said. For instance, when the big picture is explained to them and the options are reviewed, patients typically choose less aggressive treatment and opt more often for  palliative care and quality of life than for extending it. (Gawande made the same point in his New Yorker piece.)

Patients may get referred to hospice care, set up a do-not-resuscitate order, and put other measures in place to make sure that doctors don’t provide treatment against the patient’s wishes. (New York ranks 49th in the country in hospice enrollment.) The result, Leven said, is reduced medical costs, better quality care, and ultimately, a death that is peaceful and dignified; all from a simple conversation between the patient and his doctor.

Dr. Alan B. Astrow, Chief of Hematology and Medical Oncology at Maimonides Medical Center in Brooklyn, said he agrees that it is a doctor’s responsibility to have this talk with patients. But he told me he understands why they often don’t.

“Many doctors avoid having to tell the patient that things are not going well and that the patient is at risk of dying in the near future,” Astrow said. “It’s hard to tell people, and also patients don’t really want to hear that news.”

However, he does not believe that the solution is a statute ordering doctors to do this—a point he made in an article in the New England Journal of Medicine last year. Astrow instead favors “more training in how to discuss end-of-life care issues with patients.” (David Leven agrees that doctors need more training, and is currently working on a bill that would require all healthcare practitioners in New York to get training in pain management and end-of-life care every four years.) Astrow acknowledged, however, that even with training, such care will still be very difficult for doctors. He stressed that he does agree with the goals of the Palliative Care Information Act, which provides a path toward “good medical care,” but he doesn’t think a legal remedy is enough to bring about a change in the overarching medical culture.

Considering that most doctors still don’t know about the Palliative Care Information Act, which isn’t enforced unless specific complaints are made to the New York State Department of Health, Astrow does have a point.

This is why Compassion & Choices, with a national staff of forty, has been trying to pick up the slack, making information available to anyone who needs it. After all, roughly a million and a half Americans die of terminal illness every year.

“Too many people are having bad deaths,” Leven said, “and it’s in some measure because they don’t have all the information they should have.”

NURSES

If ratified, the ANA would join the American Medical Association in saying that the “clinician’s participation in assisted suicide is incompatible with professional role integrity” and that assisted suicide and euthanasia “violate the social contract the professions have with society.”  Both organizations have “vowed to honor the sanctity of life and their duty not to inflict harm.” The document acknowledges the “distress” nurses suffer when asked to participate in active euthanasia and assisted suicide, and asserts that limits to their commitment to the patient’s right to self-determination “do exist.”The nurse is not allowed to “administer the medication that will lead to the end of the patient’s life,” says the draft document.Even in states in which assisted suicide is legal – Oregon, Washington and Montana – the ANA directs nurses to refrain from participation, as doing so would violate The Code of Ethics for Nurses with Interpretive Statements. For anti-euthanasia advocates, there is cause for concern, however, in the section of the document on the “withholding or withdrawal of life-sustaining treatments (WWLST).

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Opponents of the proposal say doctors should never, as a matter of professional ethics, intentionally hasten the death of one of their patients, even one who is terminally ill. The codes of medicine and nursing ethics reject helping patients die.

PHYSICIANS

The AMA “strongly opposes any bill to legalize physician-assisted suicide” because the practice is “fundamentally inconsistent with the physician’s role as healer.”

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A difference between this proposal (called Question 2, which allows for physician-assisted death if a terminal illness is diagnosed with a prognosis of less than six months of survival) and some others is that there is no requirement for evaluation by a psychiatrist for depression before the lethal medication dose is administered. This itself is a fatal flaw.  (written by a psychiatrist)

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On being too aggressive trying to save patient, a doctor said: if you can’t save his life; sometimes, being a good doctor means learning to help people die.

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For Dr. Marcia Angell, a senior lecturer on social medicine at the Medical School and one of the initiative’s major public proponents, this question of autonomy and choice has a clear answer.“It seems to me that this most personal and faithful of decisions belongs with the patients and no one else: not the church, not the Mass. Medical Society, not the state, no one but the patient. And it hurts no one if the patient makes this choice,” she said.

Angell said that the experiences of those who have taken advantage of the law in Oregon shows that the availability of this choice is valuable, even if not used by many.“Good palliative care and assisted suicide—those two things are not mutually exclusive any more than the medical treatment of heart failure and heart transplantation. You use one when the other fails,” Angell said. “Allowing the most desperate of patients to have assisted dying to bring about a slightly faster, more peaceful death, does nothing to the other 99.8 percent of patients.”

“First of all, the totality of suffering at the end of life often involves pain, but it often reflects other reasons as well. For instance, air hunger in someone who has pulmonary disease, or sleeplessness in someone with so-called Lou Gehrig’s disease. So pain control is a major part of palliative care, but palliative care is broader than just pain control. The concept of “total pain” has been in the literature for years. “Total pain” includes physical pain but also involves spiritual or existential pain and psychological burdens. So there’s more to palliative care than pain control, and there’s more to pain than just its intensity.

In the clear majority — in most cases of, say, cancer-related pain — the figure that people quote is from studies applying a very simple three-step ladder that was developed by the World Health Organization: You can control about 90% of the pain in people with cancer. Now, I’m blending together different cancers, different stages and resting pain versus movement pain. But if you were to say: ‘Can you control most people’s pain with simple, non-invasive measures,’ the answer is yes. That’s been studied.

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As for people who have more difficult pain problems despite moving up the medication ladder, by providing a suitable nerve block or infusion, you can probably control the majority of the remainder. So the instances in which you have to choose between the patient’s being awake but in intolerable pain or being deliberately sedated to the point of unresponsiveness are very few.

If you talk to people who work in hospice or palliative care, terminal sedation is uncommon. – It’s wrong to oversimplify this. That’s why, as a program, although we have superb faculty who teach classes about end-of-life and palliative care issues, we’re not saying yes or no on Question 2.

I would say hypothetically, there may be an instance, exceedingly rare, where physician-assisted suicide is warranted. But in practice, in those infrequent instances where pain is hard to control, we now already can offer terminal sedation, where someone can be brought to a restful, sleep-like state by using medications. But even that is uncommon.

Preparing a living will and designating a health proxy before illness strikes or becomes advanced, promotes each person’s working through these issues in a thoughtful, unrushed way.

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Critics say the Death With Dignity Act as written does not provide enough safeguards against mentally ill people securing the drug or prevent patients from being coerced into killing themselves. There are also no rules regarding storage of the lethal pills once they’re brought home.

Furthermore, the Massachusetts Medical Society says that asking doctors to provide lethal drugs is antithetical to what healers stand for and goes against the Hippocratic Oath, a sort of medical code of conduct.

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As a retired clinical psychologist, I must note that there is a vast difference between the depression of a terminally ill patient, who realistically perceives his situation to be hopeless, and a physically healthy patient suffering from clinical depression.

In the case of a physically healthy patient who is clinically depressed, feelings of worthlessness and hopelessness are the product of inaccurate perceptions of self and circumstances — mental distortions produced by the illness itself. For such patients, treatment can produce marked improvement.The same cannot be said for terminally ill patients, whose feelings of hopelessness are, sadly, all too realistic and whose depression is often a normal response to a disheartening reality.

While the “counseling and caring” the doctor recommends can provide comfort to the terminally ill patient, they cannot change the reality of a patient whose quality of life has diminished to the point where each day is another round of frustration and pain, be it physical or emotional.

If I should become terminally ill, I would not want to cede to a third party the right to determine when my life is no longer worth living

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“With proper safeguards, this option is valuable for a very small subset of patients with terminal illnesses that would progress with unbearable physical or psychological suffering. The key is to have the right type of safeguards so only appropriate patients are given this option.”

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The Massachusetts Medical Society officially came out against the measure, arguing that, “the proposed safeguards against abuse are insufficient.” It’s difficult to determine exactly when someone’s six months would begin. More loftily, they reasserted the idea that “physician assisted suicide is fundamentally incompatible with the physician’s role as healer.”

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Assisted dying is best dealt with by preventing it from ever developing in the first place by giving patients the opportunity to talk with their physicians and families about how much care they want and offering them palliative or hospice care before being subjected to needless treatments in the first place. Most physicians and patients and their families would agree with this.

It is not surprising, however, that needless treatment can bring on the serious depression and hopelessness that in some patients can drive the desire for assisted suicide. It is hard, as it should be, and becoming harder all the time because of the rapid advances in medical science to decide when and what kind of treatment is “needless.”

Physicians usually make the judgment after considering all the possibilities that modern medicine can offer and then try to make the best medical and humane judgments, taking into consideration the patient’s prognosis and wishes. But sometimes physicians can be moved by the fear of malpractice suits for not having “done everything” and resort to over-treatment as a solution. This is called defensive medicine. It will continue, however, until the defects in the malpractice system are corrected and physicians are not penalized for using good judgment that is later seized upon as a reason for a malpractice suit.

But insurance plays a significant role in over-treatment as well because it isolates patients and families from the astronomical costs of over-treatment, making it easy for them to demand that “everything be done,” even when it is against the collective judgment of the physicians taking care of the patient. But once the decision to do everything is made, it sets in motion a steady stream of reports from CAT scans and laboratory tests and consultants that often create confusion that worsens patients’ feelings of hopelessness and loss of control.

There is a real danger that the insurance companies’ pressure on doctors to practice “economically” will subtly influence the decisions that patients, their families, and physicians make. Already physicians are under great pressure to practice medicine with severe “cost-saving” restrictions.

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WebMD’s physician web site, recently surveyed 24,000 doctors – When asked if physician-assisted suicide should be allowed in some situations, 47% of doctors said “yes,” 40% said “no,” and 13% said, “It depends.”

RELIGION

Vote NO on Question 2,” reads a sign outside St. Stephen’s Parish in downtown Framingham. The message on a second sign is printed in Spanish. The Roman Catholic Church in recent weeks has spoken out fiercely against the ballot measure to legalize physician-assisted suicide and Catholic groups nationwide have donated most of the $2 million the opposition has raised this election cycle. Cardinal Sean O’Malley of the Archdiocese of Boston last weekend broadcast a special sermon to parishes across the state urging churchgoers to vote no on Question 2. Local parishioners last week said they agree. “It’s taking something that’s out of our control.”

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Rabbi Andrew Vogel said Judaism unlike some other religions doesn’t take a black and white stance. The religion opposes suicide but encourages compassion, he said. He opposes the measure but encouraged Jews to make their own decision.

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The flaws Meade cites include no mandatory family notification – and no mandatory counseling. Her allies include Boston Cardinal Sean O’Malley. In a video homily, posted on the cardinal’s blog, he makes it clear that he wants Catholics to vote no.  O’Malley says “We cannot ignore the impending legalization of physician assisted suicide as if it did not affect us. It would bring spiritual death, a cheapening of human life, the corrupting of the medical profession. PAS means making doctors nurses, pharmacists, friends, and society itself accomplishes in suicide.”

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Rabbi Ronne Friedman of Temple Israel of Boston spoke in favor of the question during his Oct. 5 sermon, and he and four other reform rabbis have released a statement backing the measure.“There are a lot of people who want to know that it would be possible,” Friedman said Sunday in a phone interview. “It’s hard to imagine that level suffering if you’re not in that condition. They want to feel that if it’s intolerable, they have the right and permission to exit on their own terms. Just the knowledge provides a sense of relief.”

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Imam William Suhaib Webb, of the Islamic Society of Boston Cultural Center, said that while the question has not been formally addressed during services, “religiously we’re pretty much in agreement as Muslims” against it.“We believe that every breath is a gift,” Webb said. “Every difficulty through that suffering is a means of purifying into the life thereafter.”

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“It’s the wrong direction to go in,” said Bob Denning, 57, of Boston. Denning said that society was “looking for a quick fix” to suffering and that physician-assisted suicide was “immoral and a crime. The way the law is, it’s actually insulting to humans.”

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The Rev. Walter Kim of Park Street Church, a Protestant church in Boston, said his church recently held a panel discussion on the question, which he opposes.“It’s a moral as well as a political issue,” Kim said. “If we created a culture that really took care of the elderly and gave them vibrant communities, we’d be greatly alleviated. ”The wording of the question “is so problematic it doesn’t enable us to speak with moral clarity,” he said. He added that the lack of safeguards makes it such “that you don’t even have to get to all the moral issues. This ballot is problematic.”

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The Rev. Kazimierz Bem, pastor of the First Church in Marlborough, which is affiliated with the United Church of Christ, preached a sermon against the physician-assisted suicide question on Oct. 21. He said that educating the public was important and that he was moderator of a panel discussion held that same day at the church. Supporters and opponents sat on the panel, he said, but the choice is a clear one.“A person ravaged by disease has no less dignity than Michael Phelps in the swimming pool,” said Bem. “It is not up to us to decide when we go.”

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The widow of Senator Edward Kennedy has joined a line-up of high-profile liberal Catholics opposing a referendum that would permit physician-assisted suicide in the predominantly Democrat state of Massachusetts.Victoria Reggie Kennedy voiced her opposition to physician-assisted suicide in an op-ed article in the Cape Cod Times, saying that Tuesday’s referendum would turn her late husband’s lifelong commitment to health care “on its head by asking us to endorse patient suicide – not patient care – as our public policy for dealing with pain and the financial burdens of care at the end of life.” Mrs Kennedy noted that when her husband was diagnosed with cancer he was given two to four months to live and survived for another 15 months.

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According to financial reports filed with the state, the Archdiocese of Boston and some of its affiliated organizations, such as the Boston Catholic Television Center and St. John’s Seminary, spent at least $2.5 million to defeat the proposed law. He added that the American Principles Project, a national conservative organization, along with one of its founders, added another $500,000 to oppose the initiative.

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In remarks to the assembly earlier in the day, O’Malley thanked his fellow bishops and Catholic organizations for their help in defeating physician-assisted suicide in Massachusetts, which he called a “terrible assault on human life.

”The Catholic church teaches that all life is sacred, from conception to natural death, and that suicide is always objectively wrong, though whether a person bears responsibility for committing suicide depends on his or her psychological and physiological state.

In his remarks, O’Malley pointed to the Netherlands, where doctor-assisted suicide is legal and where a group is now creating mobile teams that will offer euthanasia to patients at home, making lethal drugs more widely available to patients. The United States, O’Malley said, is a long way from that scenario, but only because voters in all but two states have held the line.

“What has put the brakes on the growth of physician-assisted suicide in the US is that more than 20 states have rejected proposed legislation and ballot initiatives,” he said.

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The Archdiocese of Boston led the fight against Question 2, the ballot measure that would have allowed people with less than six months to live to obtain lethal prescriptions. The church helped build a diverse coalition of doctors, hospice workers, and interfaith leaders and helped raise more than $4 million, much of it from Catholic organizations and wealthy donors across the country.

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On Tuesday the Roman Catholic Archdiocese of Boston did something it had not done for a while: It won a major political battle.The archdiocese and other Catholic donors supplied a significant share of the $5 million spent to defeat Ballot Question 2, which would have let terminally ill people obtain a prescription drug to end their lives. But the church did not win the fight alone. By Election Day a large, diverse coalition of opponents had united against the measure, including many Jewish, Christian, and Muslim clergy; palliative care doctors; hospice workers; and pharmacists.

Polls in early October suggested two-thirds of voters supported the ballot question. But on Election Day it failed by 2 points. Opponents outspent proponents by a factor of six.

“Physician-assisted suicide,” Cardinal O’Malley told the assembly, ”presents a moral and ethical threat to society, the medical profession, the disabilities community and the common good. It brings spiritual death, a cheapening of human life, and a corrupting of the medical profession. During the course of preaching and speaking about this issue, I often cited the Hippocratic Oath of ‘do no harm.'”Although the measure to legalize assisted suicide was defeated, the Church is nonetheless called to “become more focused on the fact that we must do more to promote good palliative and hospice care at the end of life.”

“The Church has always been committed to compassionate and dignified end of life care,” he said. “We must work with our hospice care and palliative care communities to continue to provide quality of care for the terminally ill. Fear of tremendous pain is advanced as a reason to support physician-assisted suicide. In almost every instance palliative care can suppress pain.”

The cardinal also reminded the assembly that “people already have the right to refuse burdensome, life-extending treatments. They also have the option of leaving advance directives to determine their care when they are no longer able to express their wishes. The death that results from withholding or withdrawing of life-sustaining treatment has always been separated by a bright line from active measures to cause death.”

“Assisted suicide proponents seek to blur this line,” he said. In preventing this measure from being passed, however, the Massachusetts prelate emphasized the importance of providing pastoral and medical care for terminally patients.

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Some religious groups, of course, have starkly different ideas. The Catholic Church has been vocal in its criticism of assistance in dying and, particularly, of Compassion & Choices. Last year, the United States Conference of Catholic Bishops laid out its official position in a statement. The bishops make a range of well-worn arguments, including the sanctity of the Hippocratic Oath and how “suicidal” people need counseling, confusing the distinction between those who are truly suicidal—who do not want to live—and someone who is terminally ill, who wants to live but chooses to hasten their death because they can’t prevent it. The bishops also argue that allowing people to have a say in how and when they die will inevitably lead to abuse of the practice.

“Taking life in the name of compassion also invites a slippery slope toward ending the lives of people with non-terminal conditions,” the statement said.

RIGHT TO DIE

Death with Dignity 2012, the political action group supporting the measure, staunchly disagrees, saying people deserve to choose how they die.

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Compassion & Choices provides information about end-of-life choices to help patients make informed decisions that reflect their personal values and wishes for care. They don’t provide the means. They don’t administer. They don’t encourage or coerce. They have no agenda other than to provide complete and accurate information about end-of-life options.

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Final Exit instructs terminally ill people how to end their lives with helium and an “exit mask”—self-acquired and self-administered—and does not pursue legislative reform. The group has run into legal trouble in recent years, notably in Phoenix, Atlanta, and most recently Minnesota, for breaking state laws that prohibit assisting in suicide. Compassion & Choices has so far avoided such problems.

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“For the past year, the people of Massachusetts participated in an open and honest conversation about allowing terminally-ill patients the choice to end their suffering,” said Compassion & Choices. “The Death with Dignity Act offered the terminally-ill the right to make that decision for themselves, but regrettably, we fell short. Our grassroots campaign was fueled by thousands of people from across this state, but outspent five to one by groups opposed to individual choice.”

The “Death With Dignity Act,” which aimed at allowing a physician licensed in Massachusetts to prescribe medication to a terminally ill patient to end their own life, lost 49% to 51%, according to election results.

In Massachusetts, 1,439,785 voters were against the proposal, while 1,382,651 supported the measure. In Boston, however, voters didn’t share the same sentiment as the rest of the Commonwealth. Hub voters favored the act, with 111,852 of those registered casting a “Yes” vote, compared to 107,377 who voted “No.”

“Even in defeat, the voters of Massachusetts have delivered a call to action that will continue and grow until the terminally-ill have the right to end their suffering,” backers of Question 2 said on Wednesday.

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Compassion & Choices also debunks misinformation, like the idea that ceasing to eat and drink could be painful. It’s not. Terminally ill people typically don’t have healthy appetites to begin with, so hunger pangs are unlikely. Headaches are common at the beginning, but those pass quickly; thirst or dry mouth is the biggest challenge, but it’s more discomfort than pain, and there are ways to ease it.

“I never tell patients I’m going to help them have a good death,” she said. “What I say is, ‘Let’s work together to have the least bad death possible.’”

RIGHT TO LIFE

Some disability groups and religious organizations believe that the terminally ill who are disabled deserve better palliative care and emotional support rather than a prescription of deadly medicine. They also worry that people may feel compelled or coerced into choosing death because their care is expensive, they see themselves as a burden to others or because relatives are thinking that they do not want to spend the grandchildren’s college tuition to keep grandpop going in a nursing home or ICU. Given the current push to contain medical costs, the biggest fear is that the vulnerable will get the bum’s rush to the hereafter.

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Few people know that there is not a provision in this ballot language requiring family members to be notified if their loved one decides to take his or her life, that doctors are not present at the end, and that a terminally ill patient can get this prescription filled at the local pharmacy. There is a misguided perception that somehow this all takes place in a medically supervised setting. In reality, there is no tracking of these pills once they are picked up and brought to the person’s home.

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Patients would not be required to seek psychiatric care before obtaining the lethal drug.  Multiple studies show a connection between a terminal diagnosis and patients developing depression.  As it stands, no mental health professional would be required to be part of the consultative process. I don’t think that the fact that the cardinal is sending out a homily to people is changing poll numbers,” said Mark Horan, spokesman for the Committee Against Physician Assisted Suicide.
Horan said many voters agree the measure has flaws, such as no requirement to notify family members or for psychological counseling.

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Harvard Right to Life stands for the right to life from conception to natural death,” HLR president Matthew R. Menendez ’14 said. “So it is our view that it is never right to voluntarily end a life, and so in that sense we are opposed to [the Death with Dignity initiative].”

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Wesley J. Smith of Secondhand Smoke blog says opposition consists of:
•    Disability rights activists who see themselves and the elderly–rightly–as the targets of the movement;
•    Medical professional organizations are overwhelmingly opposed to legalizing assisted suicide.
•    Egalitarian liberals, such as Robert P. Jones, believe that assisted suicide threatens equality.
•    Pro-lifers offer a solid foundation of opposition from which to build a winning coalition.
•    Advocates for the poor who understand that assisted suicide could easily become a form of medical cost containment

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The landmark 2009 report by MetLife Mature Market Institute describes elder financial abuse as a crime “growing in intensity.” The perpetrators are often family members, some of whom feel themselves “entitled” to the elder’s assets. The report states that they start out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or coercing elders to sign over the deeds to their homes, change their wills or liquidate their assets. The report states that victims “may even be murdered” by perpetrators.

With legal assisted suicide in Oregon and Washington state, perpetrators are instead able to take a “legal” route by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over administration. The elder could be cajoled or coerced into taking the lethal dose, for example, while under the influence of alcohol. The lethal dose could be administered while the elder slept. If he awoke and struggled, who would know?

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A Boston Globe poll in September showed 68 percent of voters in support and 20 percent opposed. In the end, the margin of defeat was 62,000 votes out of nearly 3 million cast. Some commentators attributed the defeat to prominent opposition by disability activists there who feared pressure to use the law, especially for older people with disabilities. Opposition also included the Massachusetts Medical Society and Senator Ted Kennedy’s widow.

INTERNATIONAL ACTIVITY

AUSTRIA

The Gallup Inc. poll for the Swiss Medical Lawyers Association (SMLA) found that Catholic Austria had the third highest support for the idea of allowing people to decide to take their own lives with 83 per cent in favour. An additional 4 per cent had no opinion and 13 per cent did not agree.

The country which showed the least enthusiasm still also had a majority in favour in Greece where just over half – 52 per cent – agreed assisted suicide should be allowed in some cases such as terminal illness. Support was only stronger in Germany and Spain.

In addition 72 per cent of people in Austria agreed that they could consider using assisted suicide themselves with 18 per cent against the idea, and of these 85 per cent said it should always be carried out with professional assistance in the form of a medically qualified person.

Most Austrians also felt it was wrong that doctors could face prosecution for helping with assisted suicide with 77 per cent calling for it to be lifted against 14 per cent that felt it was right to keep the law in place and 9 per cent that did not know.

Some 27 per cent of Austrians however also admitted that they were worried that they might be put under pressure to choose suicide if it was legalised, saying they saw it as an occasional risk and 7 per cent said they imagined it would be a frequent risk.

AUSTRALIA

Every week about five elderly Australians commit suicide, and euthanasia advocates say most of them hang themselves for lack of a better way to end their pain.

At the same time, keeping people alive with “futile” but expensive treatments in hospitals is both cruel and blowing out health budgets, an intensive care doctor says. “The vast majority is by hanging themselves. The explanation for that is that rope is very easy to get and access to information about how to hang yourself is easy to get … but information about a safe peaceful mediated death is not.

CANADA

Exposing Vulnerable People to Euthanasia and Assisted Suicide by Alex Schadenberg uncovers data from peer reviewed journal articles and studies related to the euthanasia deaths without request, the unreported euthanasia deaths, and the experience of nurses with euthanasia in Belgium. The book also examines the most recent statistics from the Netherlands.

This book exposes how vulnerable patient groups are dying by euthanasia and it also exposes how Justice Smith in the Carter case, the Royal Society of Canada end of life decision making report and the Quebec Commission on Dying with Dignity avoided the truth in order to establish false and dangerous recommendations for the legalization of euthanasia and assisted suicide. “Using already existing studies, Schadenberg has uncovered the shocking truth about euthanasia in Belgium, the lives lost and the deep threat to others. His work demonstrates unequivocally that we must never follow this Belgian pathway to the easy killing of people whose lives are not valued by those who do the killing.”

SOUTH AFRICA

Davison, author of Before We Say Goodbye: Helping my mother die and After We Said Goodbye, was sentenced to five months of house arrest in New Zealand for assisting in the suicide of his terminally ill mother. He returned to South Africa at the end of April. Davison is on the executive committee of DignitySA and they have drafted a policy document that could be used as the basis for a draft bill. The organisation is considering bringing a class action to the Constitutional Court if the bill is not adopted by parliament. They are aiming to legalise euthanasia by the end of next year.

UNITED KINGDOM

An independent review of the controversial palliative care practice known as the Liverpool Care Pathway (LCP) has been announced, many newspapers report.

The LCP is intended to allow people with a terminal illness to die with dignity. But there have been a number of high-profile allegations that people have been placed on the LCP without consent or their friend’s or family’s knowledge.

Concerns have also been raised about hospitals receiving payments for increasing the number of patients who are placed on the LCP.

Care minister Norman Lamb is quoted as saying ‘It is clear that everyone wants their loved ones’ final hours of life to be as pain free and dignified as possible, and the Liverpool Care Pathway is an important part of achieving this aim.’

‘However, as we have seen, there have been too many cases where patients were put on the pathway without a proper explanation or their families being involved. This is simply unacceptable.’

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Does the cost of applying heroic measures at the end of life exceed the cost of palliative care for 6 months? Can’t be about saving money. In America, nothing happens without a cost-benefit analysis. But the case for a less excruciating death can stand on a more neutral, less disturbing foundation, namely that it is simply a kinder way of death.

*

A Church of England body is opposing changes to a British law on assisted dying, saying it would permit people to actively participate in someone’s death, a move unprecedented since the country’s abolition of capital punishment.

 

NATIONAL/INTERNATIONAL ORGANIZATIONS

Care Not Killing (UK)

Committee Against Physician-Assisted Suicide (US)

Compassion & Choices (US)

Compassion in Dying (UK)

Death with Dignity (US)

Dignitas (Switzerland)

Dignity in Dying (UK)

Dying with Dignity (Canada)

Euthanasia Prevention Coalition (Canada)

Final Exit Network (US)

Healthcare Professionals for Assisted Dying (UK)

Not Dead Yet (US)

Patient Rights Council (US)

Second Thoughts (US)

World Federation of Right to Die Societies (UK) – The World Federation, founded in 1980, consists of 45 right to die organizations from 25 countries. The Federation provides an international link for organizations working to secure or protect the rights of individuals to self-determination at the end of their lives.

BOOKS

How to Die Consciously by Diane Goble – Practical suggestions about how to prepare yourself and your family for your transition whenever/however it happens (because we are all going to die)

Death with Dignity – October 2012

Overview of National News – October 2012

(NOTE: For list of articles quoted, go to Categories: Assisted Dying & Euthanasia: Assisted-Death Debate – October 2012)

The major news throughout October has been about the vote in a few days in Massachusetts for a Death With Dignity law, similar to the proven-effective laws in Oregon and Washington. The laws provide similar guidelines and safeguards for those dying patients who want to request a prescription from a physician to hasten their deaths if they decide to and for those physicians who may write the prescriptions.

Is it a perfect law, no. Do some of the opponents have legitimate concerns, certainly. Do they have a right to impose their beliefs on others, no. Is it a work in progress, yes. We need rational debate not fear tactics and threats of being banished to hell to consider all sides of the issue.

I found it interesting that I only came across relevant articles from 12 states and Washington, DC in October. Most articles mentioned the growing debate about the Massachusetts ballot issue to be voted on November 6… however, the one Illinois article discussed the controversy over a proposed  assisted-death bill being introduced in Quebec and the one article from North Carolina had the anti-euthanasia advocate from Canada claiming fraud and abuse at Dignitas in Switzerland. They may be testing the waters.

In Oregon, where the Death with Dignity law has already passed, some of its financially-strapped hospitals are now facing take-over by the Catholic healthcare systems whose execs tell the town folks nothing will change… well, except that abortions (unless to save the life of the mother) and writing prescriptions for a life-ending drug won’t be allowed “on their dime.”

The people of Ashland kicked them out but they continue to target other towns in Oregon and Washington. According to a Catholic Bishop in Wisconsin, supporting a woman’s right to reproductive freedom (abortion); death with dignity (euthanasia); important scientific research (stem cell research); and marriage equality for gay and lesbian citizens are all “intrinsically evil” and, of course, we are all going to hell in a handbasket.

BTW, a gay bashing group from Mississippi sent the opponents of the Death with Dignity law in Massachusetts $250,000 to help them with their campaign. It became a hot news item and they were guilted into sending at least some of it back, although they continue to accept contributions from the Catholic Church (whatever happened to separation between Church and State?) and other dubious supporters for the media blitz this week leading up to voting day.

Unfortunately, it seems their media blitz is working because the gap that according to polls was a slam dunk for passage has been shrinking the past week. Don’t take anything for granted if you want this to pass. Get out and vote, and tell your friends to vote their choice.

It seems that in some states people are beginning to look at this issue and talk amongst themselves about how they want to die when their time comes. If it passes in Massachusetts, some claim it will open the floodgates for other states to get it on the ballot. One writer prophesized: “Coming soon to your state!”

The next states getting close to having a Death with Dignity law on the ballot are New Jersey, Hawaii, Vermont and Texas… and, who knows, maybe even Montana will make it official soon!

People in those other 38 states need to wake up and pay attention not just to what’s happening in Massachusetts, but all over the world on this issue because this is an idea whose time has come. And it’s not going to go quietly away.

Overview of International News – October 2012

In Australia, euthanasia advocate Dr. Philip Nitschke is urging Tasmania’s Upper House MPs to open their minds to what he calls progressive legislation. A discussion paper on legalising voluntary euthanasia is due out in the next few months. A euthanasia bill will have to pass the Upper House before it can go to parliament next year. The issue of gay marriage has only just been dismissed from the Tasmanian Parliament but already Christian groups are preparing for the next moral battle while MLC Paul Harriss has dismissed the debate as a Green-led agenda.

Actor and Bell Shakespeare theatre director John Bell who supports the rights of patients to choose to end their life says it is not a morose or negative cause. ”We’re not about embracing death … we are about celebrating life. Once the quality of life is gone, life is not worth very much,” he said. ”I don’t want to reach that stage of being incontinent, helpless, totally dependent. It’s a dreadful way to end a life that’s been a very happy and blessed one.” John said that often children of parents are particularly torn by how to care for their dying loved one. “They often feel guilty about wanting the parent to go, and therefore not being able to let them go and not knowing how to do it.”

Sarah Edelman, clinical psychologist and vice-president of Dying with Dignity, NSW, says that under current law it is legal to starve oneself to death over several weeks in a hospital bed and to commit suicide using violent means. (In fact, it is difficult to end one’s own life peacefully without appropriate medication or ”insider knowledge”). However, it is illegal to access medical help to die peacefully when faced with intolerable suffering and no prospect of recovery, or when dying is slow, painful and undignified. Politicians should be asked why this is an acceptable state of affairs.

From a woman in Sydney– “Right now there are two people in my life wanting to die. My 19-year-old university student friend Josh made his intentions really, really clear last week. He stood in front of a train. It didn’t kill him and he is vigorously being kept alive in intensive care. My 86-year-old dad, Bob, who lives in an aged care facility, regularly quotes the Ol’ Man River song ‘I’m tired of living, but scared of dying.’ So with all this talk about the possibility of legalising euthanasia, what’s the difference between Josh’s suicide attempt and assisted suicide should my dad Bob want it?

David Leaf, a Dying with Dignity NSW board member, said mounting evidence that supported legalising euthanasia was being ignored. He said assisted dying programs worked, with no evidence of heightened risk for groups considered vulnerable to euthanasia, including the elderly, uninsured, poor, physically disabled and mentally ill.

Dr Leaf criticised Father Brennan and “other Catholic lobbyists” for using emotive terms like “legal killing,” “suicide,” “death by doctor,” and “lethal injection” in their input into the debate. “I’m not anti-Catholic, but I’m anti-bullshit,” Dr Leaf said.

More than 200 Australian doctors have banded together to call for law reform on voluntary euthanasia, but few of them would want to administer a fatal drug dose. “But doctors wouldn’t be administering the drug, because that responsibility could instead lie with the patient who would self-administer the dose, which is what happens in countries where it is legalised,” Dr Marr said.”This is not about the suffering of doctors, it’s about the suffering of the patients and that’s what the doctors signed up to our organisation recognise.”

When the swimming champion Murray Rose died on a quiet Sunday last April, he was at peace. His wife, Jodi, believes palliative care and a supported death at home helped create that peace. “There’s no greater transition than death – and you want it with dignity,” she said. “He loved being at home so I knew in general that if there was any way he could pass away at home that was our ideal scenario. I did not do it alone. I could not have done it alone,” she said. The provision of palliative care in NSW is at a critical juncture: historically underfunded services are struggling to meet increasing demand while federal funding appears to be drying up. The Roses’ experience is unusual in NSW, according to the Palliative Care Plan. One third of people who die of cancer and 90 per cent of those who die predictable deaths from other conditions do not receive palliative care.

And this is one of the problems everywhere it’s being debated. People say palliative care can help relieve the pain and suffering that often comes with the dying process. First, palliative care isn’t available everywhere, in fact hardly anywhere– it’s a new field. Second, there aren’t enough trained medical people to administer and implement palliative care programs to handle the growing need (think Baby Boomers). And third, what is available is expensive and mostly not covered by insurance– including Medicare, which will pay the MD but not the nurses, the social workers, the caregiver assistants, or the chaplains necessary to make it truly a palliative care program.

***

In Belgium, deaths from “voluntary euthanasia” are approximated at 2 percent, – 2,000 annually. At a recent conference in Brussels, a Belgian doctor reported that organ transplants are being done on euthanized patients and that Belgium leads in this practice. Dr. Van Raemdonck reported that nine successful lung transplants from “voluntary euthanized” patients have been performed since 2007.

If a person who is an organ donor is brought into the emergency room and declared brain dead, his body can be kept alive by machines until his organs can be harvested. What’s the difference if a person who is dying wants to be euthanized at some point so that his still viable organs can be harvested for transplant? I’m sure there will be outcries from the right that people will want to euthanize granny and sell her lungs when this gets around.

A filmmaker researching a film about dying interviewed two doctors who told him, “Unusually, the Belgian palliative-care movement and right-to-die movement developed alongside each other. Today, following legalisation in 2002, both palliative care and euthanasia are available alongside each other in the mostly Catholic-run public hospitals as part of an integrated system of end-of-life care. Under Belgian law there two key preconditions: incurable illness and unbearable suffering. The euthanasia usually takes place in the presence of friends and family, often accompanied by prayers, music and even champagne.

In the city of Hasselt, Fr Marc Desmet, a kindly palliative-care consultant and Jesuit priest, brought us to meet an older woman, Delphine Van Hoebrock, the evening before she was euthanised. He held her hand gently as he checked whether she had any last doubts. She seemed remarkably certain and sanguine about her choice, although I couldn’t help sensing some loneliness too. It was both emotionally charged and strange to spend time with Delphine on the eve of her chosen death. Heartbreakingly sad also, even though we knew her only fleetingly. Even an assisted death is a sad and lonely affair, it seems, no matter how much it is desired.

***

It looks looks Canada is set to become the next country to allow assisted dying. The Quebec legislature passed a report early in October, after two years of work from the Dying With Dignity Committee. The action was part of the Parti Quebecois’ election agenda (Parti Quebecois is the minority government in Quebec at present) and likewise had the backing of the all-party National Assembly committee.  The Liberals have remained silent on the issue.

Nonetheless, the Criminal Code still prohibits medically assisted-suicide. Social services junior minister Véronique Hivon asserts that Quebec can pass the law without the support of Ottawa as “Quebec has jurisdiction over health and also over professional qualifications” which “gives us the confidence to introduce this medical aid in dying in our bill.” The passing of the law will place Canada under the umbrella of other countries who exercise physician assisted-suicide such as Switzerland, Belgium and the Netherlands along with a few American states.

Wanda Morris, Executive Director of Dying With Dignity-Canada, believes Canada has a clean slate where” we can introduce any criteria for eligibility we choose, and we can adopt whatever safeguards we feel are necessary.” Canadians can look to the decision of B.C. Supreme Court Justice Lynn Smith who had access to detailed testimony from both sides, experts from around the world and the results of cross-examinations from both teams of lawyers.

Among her conclusions: there is no slippery slope; the safeguards work. “In my opinion, opponent’s presentation of data from Oregon and Netherlands is generally incomplete, frequently filled with factual inaccuracies and distortions, and often meant to construct a false empirical foundation for what is essentially a moral opposition to the practice of physician-assisted death.”

Ottawa, on the other hand, has filed its arguments in an appeal of a B.C. decision that struck down the prohibition on doctor-assisted suicide, arguing the trial judge was wrong to conclude the law is unconstitutional. In documents filed with the B.C. Court of Appeal, the government says the law reflects a reasonable belief that allowing assisted suicide would put vulnerable people at risk of being coerced or even forced to end their lives. The government says the law reflects Parliament’s desire to discourage and prevent suicide in all cases, and it should be up to lawmakers, not the courts, to decide if that needs to change.

Quebec grassroots group Living with Dignity director Linda Couture expressed alarm at how fast the government is moving, noting the new government hopes to have a bill passed by June next year.

Consistent with Canadian law, most of the country’s medical governing bodies are opposed to assisted death. So taking a principled stand, even within the quiet confidence of colleagues, can trigger career-ending attacks from within.They have to worry as a physician how the public, their patients, and their colleagues are going to view them. Whenever you depart from the traditional viewpoint in medicine, it’s going to be uncomfortable.

Some doctors fear the hot-button issue is drawing focus away from a different, and widely used form of end-of-life care. Dr. Romayne Gallagher works with the palliative care program at Providence Health Care, which aims to alleviate suffering for the dying. However, even though Canada has offered palliative care since 1975, it is still largely unavailable to most Canadians.

So medically assisted death is still not an option in Canada, but it’s  only a matter of time before it is. And we’re talking a few more years, not decades. But Canadians are already finding ways to spare themselves unbearable suffering, because there are organizations out there willing to educate them about the alternatives. And those organizations are watching with interest as several court cases wind their way through the justice system — cases which could turn the tide.

Meg Westley witnessed two people die. One died painfully and slowly of the cancer ravaging her body. Another was relatively well, but decided to hasten his death before Huntington’s disease took its terrible toll. Both, she believes, were abandoned by Canada’s ban on assisted suicide.

“I think it’s barbaric that even though people want to go, we let them suffer on,” said Westley, a University of Waterloo communications professor and president of the right-to-die advocacy group Dying with Dignity. “It is about compassion,” she said. “Give them the assistance so they don’t have to suffer if that’s their choice.”

The wrenching experience was made worse knowing Nagui Morcos died when he still had months, even a couple years of relatively decent health to enjoy with his wife, family and friends. But Morcos knew he could not get the help needed later when he was no longer physically able to end his life on his own. Watching life slip away from this cheerful and passionate man who talked repeatedly of the great moments he would miss reaffirmed the unfairness of Canada’s law against doctor-assisted suicide.

Gloria Taylor, the 64 year-old Okanagan woman who had amyotrophic lateral sclerosis, or Lou Gehrig’s disease and fought to change Canada’s law on assisted dying, died in early October. She was gradually losing control of her muscles and feared dying of the disease. Together with two others, she launched a lawsuit claiming that the Canadian Charter of Rights implied a right to choose the time of her death. Judge Lynn Smith agreed and struck down the law, but suspended her judgement until after the inevitable appeal. However, she did give Ms Taylor a personal exemption from the law, making her the only person in Canada allowed to have recourse to doctor-assisted suicide.The Association says Taylor’s death was sudden: she developed a severe infection resulting from a perforated colon. Given the acute nature of the illness, she did not need to seek the assistance of a physician to end her life.

An Ontario man also with ALS ended his life this month. Part of his final statement reads as a kind of social treatise on the role of government in the final choices of Canadians. “Any liberal, democratic system respectful of human rights should provide for a legal and humane way to exit this life at a time chosen by a rational person and with appropriate safeguards and assistance. Unfortunately, the Government of Canada and Canada’s Supreme Court do no do so. While Canada’s law criminalizing assisted death may have been conceived to protect life, it can have the effect of doing just the opposite. I am now looking for ways to die that I must implement myself, that is while I am still sufficiently strong to take all the necessary steps myself. Having in mind the nature of ALS, this will force me to terminate my life earlier than would otherwise be the case.”

“People are dying too early because of laws against assisted dying. People are killing themselves while they still have the ability to do it.” Wanda Morris, Executive Director of the national organization, Dying With Dignity, advocates with great passion and compassion the urgent need to legalize assisted dying for individuals who have been diagnosed with a terminal illness or a progressive incurable physical illness.

What choices are they left with? With the blasé patter of an airline attendant explaining the protocols of oxygen mask use, the 71-year-old retired librarian removes a microwave bag and pulls it over her head, her face shrouded beneath clear plastic, her features blurring, her graying bun compressed into a soft helmet. Slowly, her fingers begin to pinch a seal around her neck using Velcro strips she attached at the open end of the bag. Her voice muffled and faint, she points to the spot where a tube is to be inserted. “I would probably use helium,” she declares, deadpan. “A few deep breaths and you fade off.”  She is Ruth von Fuchs of the Right to Die Society of Canada who says, “No one wants to die alone. Most just want someone there to hold their hand.” Von Fuchs is a death midwife.

The Social Science Research Laboratory at the University of Saskatchewan – the only facility of its kind in Canada – created the Taking the Pulse survey in its group analysis lab, which includes multiple departments from across the Faculty of Arts and Sciences. Their research found that 59 per cent of Saskatchewanians surveyed believe they should have the option of doctor-assisted suicide when the end is nigh.

***

A senate committee in Colombia voted 10-4 to send a proposed measure to regulate euthanasia to the full Senate for consideration. If approved the measure would be sent to the Colombian House of Representatives for a vote.

A representative of the Colombian bishops, Father Pedro Mercado Cepeda, pronounced that “No circumstance can make it legally acceptable to intentionally cause the death of a human being.  The right to life is constitutionally inviolable.”

Now here’s a country where people are lying dead in the streets due to the drug cartels and Father Pedro here is making a moral issue of people who probably have no healthcare to begin with and just want out of the misery of their lives. Take care of the people and stay out of politics Father!

***

The Law Commission in India has made a recommendation to the government to initiate measures to enact a comprehensive law on passive euthanasia, subject to certain safeguards. “It’s not objectionable from a legal and constitutional point of view,” the commission, which advises the government on legal issues, said.

Dr. Pallavi A. Roshi says  “This decade has brought a significant change in a doctor’s point of view. Many of us have changed the focus from ‘only care’ to ‘cure and comfort’ to ‘only comfort,’ when cure is impossible. Although doctors should strive to extend life and decrease suffering, they must also accept death as a defining characteristic of life. Sometimes, so-called heroic methods may lead to needless suffering instead of preventing death. So, when the incurability of a disease is confirmed, there begins the journey of palliative care to make the end of life easy, and assuring the patient of a dignified death.”

***

From Ireland… Sadly, cases like Jenny Grainger’s, who had to stand by and watch her mother stop eating and drinking to have a better death than she might otherwise have had, are not uncommon. Barbara Grainger (75), who had a motor neuron disease and was a lifelong supporter of euthanasia, told her daughter that she wanted to die and asked for her help. Barbara also wanted the tragic story of her death made public in the hope of helping bring about a change in the law which governs people’s right to choose when and how they die. She wanted to go to Switzerland to Dignitas, but unfortunately she wouldn’t be able to swallow the barbiturate pill given there. So she decided that she would die through a voluntary refusal of food and fluids.

Too often, we see accounts of people travelling abroad to die, or attempting to end their lives at home, sometimes alone to avoid implicating loved ones. For this reason, as well as the many people who suffer unbearably against their wishes, many people in Ireland are campaigning for a change in the law.

One writer says, “if we agree that people like Barbara Grainger  should not have to suffer against her wishes at the end of her life, which the vast majority of us do, then we must continue to fight for a law in the UK which allows dying, competent adults the choice of a peaceful and dignified assisted death. No one should have to contemplate travelling thousands of miles for assistance, or weeks refusing food or water to have what they consider a good death.”

Another writer goes on about all the reasons it’s a bad idea, slippery slope and all, and proclaims– “The vulnerable and sick need support and reassurance they won’t suffer alone. It is sometimes difficult for families to give this support, so there is a duty on society to provide it. The compassionate response to suffering is not to encourage suicide, but to offer the palliative care and psychological support the sick need to help them live.

Perhaps in a perfect world. Once again, I’d ask where is that support? In most cases, it’s either not available or too expensive for the people who need it most. We need to meet people where they are, not in some hoped for future.

“Regardless of their religious or political background, this is an issue which affects everyone and politicians need to take a stand and help bring about the change in the law, which currently robs people of their right to choose,” says Jenny Grainger. She has been inundated with messages of support since she shared the heartbreaking story of how her family stood by her mum when she chose to end her own life through the voluntary refusal of food and fluids. Because she did not have the option of a quick and pain-free death through euthanasia, Barbara lingered for 24 days before her heart finally stopped.

An Irish assisted-suicide campaigner will not face prosecution over his visit to an elderly multiple sclerosis sufferer (MS) who took a fatal overdose to end her life because there is “insufficient evidence.” Tom Curran, who says he will risk up to 14 years in an Irish prison to assist his partner Marie Fleming — also a MS sufferer — to die at a time of her choosing, was interviewed by British police following the death of a wheelchair-bound grandmother of five. Ann Veasey (71) died in August 2011 at her nursing home in Harrogate, North Yorkshire, after she overdosed on pills she had bought online from China.

On the face of it, there is an overwhelming case to permit assisted suicide. For the greater, if not far greater, part, it would apply to people who have lived a life, made it into the upper reaches of the average span, and, were it not for a debilitating condition, would want to cling to life. Why should somebody in that position be held prisoner by nothing more than a societal taboo? Why should that person not be afforded the comfort of knowing that they were ultimately existing on their own terms? On the other hand, there is an argument that any introduction would lead down the slippery slope to elderly people being pressured to consent to their own death.

We live in a society that values choice. We choose our careers, our partners and almost every aspect of our lives. It is then a strange situation that we are ultimately unable to choose the nature of our deaths beyond a small number of options. As the Tony Nicklinson and Marie Fleming cases reach their conclusions in the media and the courts, we may have to reassess this strange paradox and address how we ourselves want to die, on our own terms or on the terms of our final illness?

***

From Italy, an online newspaper aimed at providing the last breaking news on welfare policies, an article about the advance of euthanasia in The Netherlands.

Pioneer in Europe, with a law issued in 2002, the Netherlands explicitly guarantee to its citizens the right to interrupt treatment if they want to or can no longer stand their disease. The same right has been then recognized in Belgium, Luxembourg and Switzerland. This latter rejected a few days ago a proposal to ban assisted suicide to foreigners in its territory, thus confirming the outcome of a popular referendum held last year. After all, there is no risk that the country can be invaded by ‘mild death’ tourists: in the last few years, the number of sick persons – mainly from France, Germany and the UK –  emigrating to Switzerland to appeal to the assisted suicide law for a decent and aware end of life (even in the most serious cases of depression) was cut by half.

If in 2006 there were 199 cases of euthanasia among extra-EU citizens, in 2010 this number dropped to 97. Perhaps because, over the years, other European countries have authorized treatment interruption in different ways, while in others euthanasia is still a topic in political and social debate. This is the case of France, where President Hollande announced a palliative care reform last summer. Not the case of Italy, though. “Euthanasia” still remains an unrepeatable word here. Meanwhile, Vatican’s spokespersons in Parliament, probably alarmed by the refusal of any form of therapeutic obstinacy opposed by cardinal Carlo Maria Martini, push for the approval of a law on the living will with dubious constitutional outlines.

***

Retired film director Michael Winner has considered ending his life at a euthanasia clinic after doctors told him he has just 18 months to live. The moviemaker from New Zealand, who has battled ill health in recent years, revealed this summer that liver specialists have given him between 18 months and two years and he now admits the prognosis led him to look into the controversial Dignitas institution in Switzerland. The 76-year-old opened up about his research  insisting he was put off by the amount of paperwork required to go through with assisted suicide.

He says, “I checked Dignitas on the computer and you need to go through so much. It’s not a walk-in death. You don’t just go in and say ‘Here I am, do your worst.’ You have to go through a whole series of papers and re-examinations just to die. You have to fill in forms and things and you have to fly there, go back twice…

“I think the idea that people should be able to have an assisted suicide is absolutely highly proper. Why should people elongate life when it’s no good for them? People should have the right to terminate their own life. If you’re dead, you’re dead, so who cares? I’m very happy to snuff it. I’ve had enough time on earth. I’d be happy if someone gave me the plug to pull.”

“If you have the right to die, it’s a completely different feeling than if you do something that is not legal,” Anne Mohrdieck said. “It’s different for me and it’s different for the people around me. It is to die with dignity. “Everyone has different abilities to cope with the suffering. If my ability does not allow me to have a quality of life in any way, and I choose a better option would be to go out … then I’d be enraged if that possibility would be taken from me or wouldn’t be given to me.”
Mary Stewart says euthanasia is just a euphemism for hetero-homicide – getting someone to kill you. After 30 years as a nurse, Mrs Stewart says it will confuse the role of health professionals, who swear an oath to heal and provide comfort.New Zealand medical practitioners anecdotally report having been asked by their patients for assistance in dying gracefully, and many of them have complied. However, rather than following a protocol with built-in safeguards and safety standards, the process is unregulated. For patients and family members who decide to take things into their own hands, the outcome could be devastating.
Advanced care-planning initiatives and advance directives in New Zealand already address patients’ objectives and desires for refusing medical treatment in emergent situations. If those conversations expand to include aid-in-dying options for the terminally ill, then patients have a true grasp of the entire spectrum available to them. Further, it allows family members to discuss options and support each other, rather than have secret conversations and fear of legal prosecution if they follow a loved one’s requests. Medical practitioners have clearly defined processes in place, and medical protocols they must follow to comply with legislation. This protects medical practitioners from having to guess at an appropriate dosage or surmise which drugs to use. The process is defined and has paperwork that shows protocols are followed. There is no legal ramification for following their patient’s wishes. Further, medical practitioners may opt out of the process, which protects their rights to their own personal beliefs about death and dying.
And under the headline of Euthanasia Opens Floodgates of Nastiness— Once assisted suicide becomes legal, anyone old and frail and rich will be expected to do the decent thing by whoever stands to profit from their death. Athinly-disguised legal murder will become routine, especially as lack of respect for the old, and the belief that they don’t have any quality of life anyway, is underscored by the ease with which you can ”help” them die.***From Russia, On the death ofbard Ada Yakusheva– I had heard that Yakusheva was battling cancer, but what I hadn’t realized is that her doctors had denied her pain medication, on the basis of some bureaucratic error. When her relatives confronted them about her suffering, they were curtly told, “everyone suffers.” Only on her final day alive was Yakusheva allowed some dignity and peace. A hospice doctor had her transferred to a palliative care facility. She was given a shot of morphine, curled up, and slept for what was probably the first time in a month. The following morning, Yakusheva passed away peacefully.

The other issue here is, of course, the attitude of the actual doctors. Most are simply not trained to make their patients comfortable. Once it is clear that the patient is dying – a lot of them simply stop caring. And even though palliative care is certainly a major aspect of healthcare in modern Russia, many doctors still resist any urge to call a colleague who works in that field, if only because they don’t want anyone taking over their case. Yakusheva’s doctors went as far as to accuse her relatives of trying to use the dying woman’s condition to score drugs for themselves. The fact that this happened to a well-known personality speaks to the enormity of the problem.

***

In Scotland, there is concern that the Swiss assisted-suicide clinic Dignitas helped 217 Britons to die in 10 years. It is understood that the Dignitas Clinic in Switzerland has more than 900 Britons on its books and has ended more than 20 lives a year on average since it was set up ten years ago. The new figures from Dignitas and progress of Ms MacDonald’s latest bill has led anti-assisted suicide campaigners to warn against a change in the law.

***

South Africans are discussing how voluntary euthanasia is legal for citizens of Holland and Belgium, and doctor-assisted dying is legal in a few states in the US, and in Switzerland. Lord Joffe is confident it will be legal in the UK in the not too distant future. When asked which he thought was easier — voluntary euthanasia or doctor-assisted dying? He felt it was easier to get someone else to kill you, than to kill yourself. On reflection, the reporter  could only agree. Yet no matter whether it’s voluntary euthanasia or doctor-assisted dying you’re after, the driving force behind legalising it is simply dignity in death.

***

According to a new study by the University of Zurich, Switzerland, one in four people who accompany someone to commit assisted suicide suffer massive psychological distress. Researchers at the university spoke to 85 people who went with a family member or close friend to an EXIT euthanasia clinic one to two years after the assisted death of loved ones. A quarter suffered from post traumatic stress disorder while 16 percent had depression. Five percent were found to have long-term grief. The results state that problems can surface 14 to 24 months later and that a death not from natural causes was a heavy burden for those who supported the deceased. Although the research didn’t include a direct comparison with the effects of a natural death on a loved one, the study was compared to others. This showed the researchers that post traumatic stress disorder was more common for people close to an assisted suicide case rather than a natural death.

They don’t mention the other 54% who apparently weren’t heavily burdened or traumatized– and I wouldn’t be surprised to find out that the whole ordeal of having to take one’s dying loved one somewhere to die, as opposed to being in one’s own bed in one’s own home surrounded by loved ones, has a lot to do with the agony of it all.

***

Dr. Peter Saunders, a former general surgeon and CEO of Christian Medical Fellowship, a UK-based organization with 4,500 UK doctors and 1,000 medical students as members, says the current British Suicide Act is thereby shown to remain fit for purpose. Through its blanket prohibition on all assistance with suicide, it continues to provide a strong deterrent to the exploitation and abuse of vulnerable people whilst giving both prosecutors and judges discretion in hard cases. It strikes the right balance, is clear and fair and does not need changing. The Swiss vote means that the small number of British people travelling to Switzerland to end their lives will probably continue but we should continue to resist any calls from pressure groups to weaken the law here in the UK.

A poll conducted by Christian Concern surveyed more than 150 MPs across all parties and found that only 29 per cent supported proposals to introduce assisted suicide, whilst 59 per cent were opposed to the move and 12 per cent were undecided. The poll also found that the majority of MPs believe that a change in the law would result in an increase in the number of suicides, and 72 per cent felt that it would place vulnerable people under pressure to end their lives prematurely. Almost 60 per cent were of the opinion that the current economic climate would result in more patients opting for an assisted death to avoid placing a financial burden on family members and carers.

Regarding the case of Tony Nicklinson, who chose to starve himself to death after losing his last appeal for euthanasia in September, a reporter from the Christian Institute wrote: The case of a man who campaigned for doctors to be allowed to kill him will not go to the Court of Appeal, High Court Judges have ruled. Lord Justice Toulson said the case was “plainly a matter for Parliament.” Tony Nicklinson, who suffered from a condition known as ‘locked-in syndrome’, wanted doctors to be able to end his life.

Now judges at the High Court have turned down an application by Jane Nicklinson to be made party to the proceedings. Lord Justice Toulson said: “We do not consider that the proposed appeal has any real prospect of success. Mrs Nicklinson has vowed to appeal the decision. However a second locked-in sufferer, whose case was heard alongside that of Mr Nicklinson, has been given leave to appeal.

Meanwhile, Jane Nicklinson says, “It is not easy to admit feeling relieved that the love of your life, your soul mate, has died.” But that is exactly how Jane Nicklinson feels about husband Tony Nicklinson, the assisted suicide campaigner who died of natural causes six weeks ago. Mrs Nicklinson understands that she might come across as callous or uncaring, especially by those who opposed her family’s very public battle to change the law so that locked-in syndrome sufferer Tony could be legally helped to end his life. But for anyone who has cared for a loved one with an intolerable terminal or degenerative condition, Mrs Nicklinson may just be articulating what many find too difficult to admit.

The widow is expected to call this week for Scotland to become the first part of the UK to change the law on assisted suicide. She will appear at a conference in Edinburgh with the MSP Margo MacDonald, who has already tried and failed to make assisted suicide legal north of the border. The conference will also hear from Ludwig Minelli, founder of Dignitas, the assisted dying organisation in Switzerland. Among Ms MacDonald’s new proposals is a suggestion that a “licensed facilitator”, a so-called “friend at the end”, would have to be present when someone was at the point of ending their own life. The facilitator could be a doctor, social worker, or close friend but not a relative or anyone who stood to gain from the death.

Exactly what I’ve been proposing– Transition Guides, death midwives, doulas. It doesn’t have to be a physician since they are so attached to Hippocrates and don’t understand how important healing of the soul is at the end of life. We need a new specialty and a new perspective about the end of life.

Now doctors have a new worry– Doctors are required to provide access to a patient’s records under the Data Protection Act 1998 if a ‘subject access request’ has been made. However, new GMC draft guidance for fitness-to-practise decision-makers, due to be published later this year, advises it is a criminal offence for doctors to encourage or assist a person to commit or attempt suicide. GPs should explain this to patients when faced with demands for medical records for this purpose, the guidance says. The GMC says that GPs are required to provide medical records under the Data Protection Act. However, if a GP suspects this will be used for the purposes of assisted dying, the GP will be contravening the 1961 Suicide Act by providing the medical records.

Which means if you plan to go to Dignitas, don’t tell your doctor when you ask for your medical records.

Dignitas has seen an average of 18 British citizens coming through its door each year since 2002 and many have chosen to be very open about what compelled them to travel abroad to die. Having control over the timing of their death and avoiding a painful, lingering end have been the over-riding wishes of people like Dr Anne Turner, Peter Smedley and Jackie Meacock as they made their final journey to Zurich. For those who travelled with them, there was always the fear of prosecution but, to date, no-one who accompanied any of the 182 Britons has been prosecuted.

The European Court of Human Rights in Strasbourg last year, ruled that while there is a “Human Right” to suicide, the state has no obligation to provide citizens with the means to commit suicide. Grégor Puppinck, the director of the European Centre for Law and Justice explained, “The Court notes that the vast majority of member States place more weight on the protection of an individual’s life than on the right to end one’s life and concludes that the States have a broad margin of appreciation in that respect.”

During a panel discussion with Human Rights solicitors, Richard Stein observed that the argument that there can never be adequate safeguards to protect the vulnerable  is being used as a “smokescreen”, and, equally, the notion that disabled people cannot exercise their free will to die because it reduces the value of disabled lives is a “hugely patronising” one.

All this reflects a big shift towards secular thinking and individual autonomy as well as growing worries about the medicalised, miserable and costly way of death that awaits many people in rich countries. Assisted suicide typically gains overwhelming public support; legislators, pro-family lobbies, churches and doctors’ groups tend to be more squeamish. They fear that legal, easy-to-get assisted suicide will have dire social and moral effects.

More from Dr. Peter Saunders– Now that the Tony Nicklinson case is over and the next assisted suicide bills (from Falconer in the House of Lords and Macdonald in Scotland) are not to be debated until next year one could be forgiven for thinking that the relentless media pressure for the legalisation of euthanasia might relent for a few weeks. But no – first we have the pronouncements of junior health ministers Norman Lamb and Anna Soubry giving their support for the legalisation of assisted suicide and now the BBC, in its role as cheerleader for assisted suicide, is making an international news story about the fact that it is ten years since the first Briton went to the Dignitas suicide facility in Zurich to kill himself.

As fall-outs between pro-life campaigners go, this one has yet to surface, but it could turn for the worse. The tension is over whether or not the Liverpool Care Pathway (LCP) is being used as a form of euthanasia. In June Dr Patrick Pullicino, a neurologist, claimed that the Pathway was an “assisted death pathway”. According to the doctor, patients are being placed on the LCP without clear evidence that they are close to death, while the sensationalised Daily Mail headline ran: “Top doctor’s chilling claim: The NHS kills off 130,000 elderly patients every year” – where 130,000 is the total number of patients who are put on the LCP out of the 450,000 that are terminally ill. In other words, the majority of people who are close to death are not put on the Pathway.

Since it was rolled out across the country in 2004, it has received three glowing audits, the endorsement of this Government and, just this month, the public support of 20 respected organisations representing millions of patients, carers, doctors and nurses. Yet last week the Association of Palliative Medicine bowed to pressure from a lobby of Roman Catholic doctors, pro-life groups, some media and a small number of distressed and grieving relatives to order a review into the Pathway. Was this a victory for patients’ rights or capitulation to media hysteria and public misunderstanding?

** ** **

This will be the last month I’ll be listing all the articles that come to my email box because it just takes way too much of my time. I will, however, continue to read new articles and contribute to the debate about aid-in-dying from my perspective.

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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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Assisted-Death Debate – blogs and news from around the world – August 2012

End-of-Life discussions about Assisted Dying/Suicide/Euthanasia in news articles, blogs, videos from the left, right and center during the month of August 2012. This is a place to find out what’s being talked about around the world as we sort out this highly emotional and controversial issue.

Become informed, open your mind,  join in the discussions. Don’t be swayed by emotional euphenisms or dysphemisms, or religious dogma. Our leaders need to know what people are thinking and we need to know what our leaders are considering in terms of laws. These are conversations we all need to have! The end result should be reasonable laws that protect the vulnerable yet allow self-determination at the end of life for those who want the option of assistance.

NATIONAL/INTERNATIONAL ORGANIZATIONS

Care Not Killing
Committee Against Physician-Assisted Suicide

Compassion & Choices
Death with Dignity
Dignitas
Dying with Dignity
Euthanasia Prevention Coalition
Final Exit Network
Not Dead Yet
Patient Rights Council

BLOGS

Death with Dignity National Center – Living with Dying – This Week in the Movement
August 3
August 10
August 17
August 24
August 31

Laws Should Reflect Diversity of Opinions by Melissa Barber, Death With Dignity National Center (6/28/12)

Allow doctors to support patient wishes by Melissa Barber, Death With Dignity National Center (8/10/12)

Terminal Cancer and Euthanasia – a conversation

Huge crackdown on fake drug production in China – Assisted-Dying Blog of Derek Humphry (8/6/12) -If you buy drugs from China, please check out this article and exercise caution.

Bad News for anti-euthanasia campaigners – Udo Schuklenk’s Ethx Blog (8/12/12)

New laws allowing physician-assisted suicide opposed by doctors and Catholic Church – Why Evolution Is True (8/12/12)

Unitarian Debate – Issue of the Moment: Assisted Dying – Does the law need to change?

A Theological Look at Suicide – Pastor Zach’s Blog

Death With Dignity: Positive data on why it works… – Jan’s Stinkin Blog

Assisted Suicide, The Courts and the ECHR by Tobias Thienel – Invisible College Blog – School of Human Right, The Netherlands

Euthanasia is a Cultural Addiction – Secondhand Smoke by Wesley J. Smith (8/16/12)

UK Paralyzed Man Loses Euthanasia Court Request – Secondhand Smoke by Wesley J. Smith, (8/16/12)

The case for assisted dying – New Humanist Blog

The Browser: The Case for Assisted Dying by Raymond Tallis (8/17/12)

Crisp: Dr. Kervorkian had it right about assisted suicide (8/20/12)

Crisp: Assisted suicide as an option (8/21/12)

LeisureGuy: Later On – The case for assisted dying (8/21/12)

LeisureGuy: Later On – Assisted Dying (Tony Prachett Video) (8/22/12)

Compassion & Choices – The Psychology of Aging and End-of-Life Planning by Jason E. Schillerstrom,MD – ABC News (8/22/12)

On assisted suicide Free Thought Blogs by Christina (8/22/12)

US, UK medical journals increasingly tout euthanasia – Catholic World News (8/23/12)

Man who fought for his own assisted suicide dies – SNS Post (8/23/12)

Worrying about “Our Neurotic Fear of Suffering” Secondhand Smoke by Wesley J. Smith (8/24/12)

Tony Nicklinson: Can law change on assisted dying and protect vulnerable – One News Page (8/24/12)

Truth and Charity Forum – Do No Harm?: Medical Journals Show increasing Support for Euthanasia by Denise J. Hunnell, MD (8/24/12)

Choice in Dying: Why can’t opponents (or very tentative supporters?) of assisted dying get it right? by Eric MacDonald (8/25/12)

Jack Kervorkian comes to town, Opinion of Tom Keane in boston.com (8/26/12)

Why assisted suicide is the right answer, for some by John M. Grohol, PSYD – PsychCentral.com: World of Psychology (8/27/12)

Shortage of helium worldwide – Assisted-Dying Blog (8/27/12)

Compassion & Choices – The Conversation Project: It’s time to start talking about end of life by Joseph Nowinski (8/29/12)

HuffPost 50 – The Conversation Project: It’s time to start talking about end of life by Joseph Nowinski, PhD (8/29/12)

Physicians’ emotional, institutional barriers propping medical futility at end of life by Sarah Guy, medwireNews Reporter (8/29/12)

Dreaming of Call Bells – Is there such a thing as a “good” death? (8/29/12)

BOOKS

The Amateur’s Guide to Death & Dying by Richard Wagner

In Search of Gentle Death: the Fight for Your Right to Die With Dignity by Richard N. Cote

How to Die Consciously: Secrets from Beyond the Veil by Diane Goble

BROADCASTS

ACLU Podcast: Death with Dignity (8/15/12)

JOURNAL ARTICLES

Reason why physicians do not have discussions about poor prognosis, why it matters, and what can be improved by Jennifer W. Mack and Thomas J. Smith in Journal of Clinical Oncology

MAGAZINES

Assisted Suicide: Court Rules That Locked-in Syndrome Sufferer Does Not Have Right to Die – RELEVANTMagazine.com (8/21/12)

VIDEOS

Physician-Assisted Suicide – behavenet.com

Los Angeles Times chat: Columnist Steve Lopez on death with dignity in California

Dying with Dignity: Respecting choices with end of life care – WKBT LaCrosse, Wisconsin

The Last Chapter – End of Life Decisions – West Virginia PBS

Fixing to Die – 60 Minutes

Mark Solock Blog – New laws allowing physician-assisted suicide opposed by doctors and Catholic Church

Edward Tarte, former Catholic priest, now an atheist talks about death with dignity

Choosing Death

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UNITED STATES

(News this month from California, Colorado, Connecticut, DC, Florida, Hawaii, Louisiana, Kansas,  Maine,  Massachusetts, Montana, New York, Ohio, Oregon, Pennsylvania, South Carolina Texas, Virginia, Washington, Wisconsin)

CALIFORNIA

Steve Lopez: After a ‘barbaric death,’ a call for change – LA Times (8/6/12 ) – My Sunday column on the “barbaric death” of a terminally ill man near Sacramento, and his wife’s plea for an Oregon-like Death With Dignity law in California, brought responses from those wanting to know how to join such a cause.

As I’ve reported before, there is no current campaign for such a change. The best place to get involved in the greater movement, though, and to check on legal developments around the country that could one day have an impact in California, is to visit www.compassionandchoices.org. The no-profit advocates for more end-of-life options and alternatives to often-futile, budget-busting medical procedures that can end up doing little more than prolonging the dying process.

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Steve Lopez: End of life case in New Mexico may affect California – LA Times (8/14/12) – There’s no way to predict when or if California will offer what’s known in Oregon and Washington as Death with Dignity, or physician-assisted aid in dying, but I’ll keep you posted on a case in New Mexico that could have implications here.

In the New Mexico case, said Kathryn Tucker, legal affairs director for a nonprofit advocacy group called Compassion & Choices, “We hope to clarify … that a vague statute that makes a crime of ‘assisting suicide’ does not reach the conduct of a physician providing aid in dying, because of course the choice of a dying patient for a peaceful death is not, and ought not be conflated with, ‘suicide.'”

Tucker said the case in question involves a woman with advanced uterine cancer who has said she would like to have, as one option, the right to avoid prolonged suffering by obtaining doctor-prescribed medication she could ingest to bring about a peaceful death if she finds her dying process unbearable.

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Husband won’t be charged in wife’s suicide by Tony Perry– LA Times (8/23/12) – Criminal charges will not be filed against an 88-year-old San Marcos man who sat beside his ailing wife as she committed suicide, the San Diego County district attorney’s office announced Wednesday.

After a thorough review, the office decided that it could not meet “the ethical and legal burden” of proving a charge of “assisted suicide” against Alan Purdy, according to a spokesman for Dist. Atty. Bonnie Dumanis.

Purdy, a semiretired engineer, did not try to stop his wife as she swallowed apple sauce mixed with sleeping pills and put a plastic bag over her head.

“Yes, I sat beside her as she died,” Purdy told The Times weeks after the death. “I didn’t want her to feel abandoned. I wanted her to know that I loved her.”

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Assisted suicide: The last frontier of civil rights? by Logan Jenkins UT San Diego (8/28/12) – There’s no courtroom in the country, for example, that would have found Alan Purdy, 88, guilty of a felony for tearfully witnessing the suicide of Jo, his 84-year-old wife who suffered crippling pain from a variety of ailments.

In a sense, it would have been a crime against nature not to stand by her as she ate the sedative-laced apple sauce and placed a plastic bag over her head.

She had informed her husband and children of her decision, a course they opposed. She received counseling from health professionals. After listening to the pro-life argument, “Jo simply told them, after a bit, to buzz off,” Alan told a U-T San Diego reporter.

“Yes, I sat beside her as she died,” Purdy told The Times weeks after the death. “I didn’t want her to feel abandoned. I wanted her to know that I loved her.”

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COLORADO

Physician-Assisted Suicide (PAS) – Sisters of Charity Health System – Physician-Assisted Suicide refers to the unethical practice of physicians providing the means of death at a patient’s request. Usually, this will be by supplying or writing a lethal prescription for medications. The patient, however, and not the physician, ultimately administers these drugs. This differs from Euthanasia, because the physician does not act directly by, for example, actually administering a lethal injection in order to end the patient’s life. Both euthanasia and physician-assisted suicide are unethical, and neither can be permitted in a Catholic health care facility. It is never ethical to take the life of an innocent person, even at his or her request, or to help a person take his or her own life.
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CONNECTICUT

UK man who failed to overturn euthanasia law diesby Maria Cheng – The Hour Online (8/23/12) – Tony Nicklinson, paralyzed and unable to speak, found life so unbearable he wanted to die. On Wednesday, the 58-year-old Briton got his wish.

His family said he died of pneumonia at home.

In January, Nicklinson asked the High Court to declare that any doctor who killed him with his consent would not be charged with murder. Last week, the court rejected his request, a decision that Nicklinson said had left him “devastated and heartbroken.”

Experts weren’t sure what impact, if any, his death might have on the ongoing euthanasia debate in Britain.

Penney Lewis, a law professor at King’s College London, said previous deaths of euthanasia advocates didn’t have any effect on changing laws to allow the practice.

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D.C.

Medical journals show increasing support for euthanasia – by Denise Hunnell, MD – LifeNews.com (8/24/12) – The British Medical Journal (BMJ), a publication distributed to the members of the British Medical Association, devoted much of its June 14, 2012, issue to endorsing voluntary euthanasia and physician assisted suicide. Raymond Tallis, emeritus professor of geriatric medicine at the University of Manchester, argues in this issue that respect for patient desires and autonomy renders irrelevant any opinion on the matter by the Royal College of Physicians or the British Medical Association. Therefore, all opposition to euthanasia is merely inappropriate paternalism and should be dropped.

In this same issue, Tess McPherson relates the difficult last days of her mother, Ann McPherson, and uses this painful experience as a call for legalized physician assisted suicide and euthanasia. Rather than seeking better pain control, she argues that death is the best option for those suffering at the end of their lives.

Finally, Fiona Goodlee, editor in chief of the BMJ, rounds out the arguments by declaring that legalization of assisted dying is not a medical decision, but rather a societal question. She argues that the role of the physician is compatible with providing euthanasia or assisted suicide and if society wants it, they should get it.

Amid these scholarly endorsements of euthanasia come the claims of British physician Patrick Pullicino that the National Health Service (NHS) is effectively killing 130,000 patients every year when doctors place these patients on the Liverpool Care Protocol (LCP) and deny them nutrition and hydration.

The medical literature from the United States also shows an increasing acceptance of physician assisted suicide and euthanasia. The July 12, 2012, issue of the New England Journal of Medicine (NEJM) included an article by Dr. Lisa Soleymani Lehmann and Julian Prokopetz that suggested physician opposition to assisted dying was an unreasonable barrier to patients seeking lethal medications. They recommended that all patients who met the legal criteria for assisted suicide as outlined in the state laws of Oregon, Washington, and Montana should be able to obtain the drugs necessary for suicide without a physician’s prescription or approval.

Perhaps the most chilling example is the enthusiastic endorsement in the Journal of the American Medical Association (JAMA) for the book Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life, by Drs. Franklin Miller and Robert Truog. This book seeks to do away with two core principles of medical care. The first is that a physician cannot intentionally cause the death of his patient. The second is that donors of vital organs for transplantation must be dead before the organs are harvested.

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FLORIDA

Pro: When he is near death, this man wants the choice to kill himself by Tom O’Hara  – jacksonville.com (8/21/12) – I would much prefer to spend a few weeks getting things organized and saying my goodbyes. Then I want to take control.

It’s my life.

It’s my body.

If I want to spare myself and those I love months of useless pain and sadness, then I should be allowed to kill myself without a lot of legal debate and secrecy.

And I’ll get the satisfaction of knowing that I’ve saved the taxpayers a nice piece of change.

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HAWAII

Join Juggie – My Life. My Death. My Choice. Compassion & Choices – Former State Representative Ernest “Juggie” Heen, cancer patient and aid-in-dying advocate. He believes every Hawai’i citizen with terminal illness should have the legal right to choose a dignified death

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Compassion & Choices – Spotlight: Hawaii -8/13/12) –  We have identified a core group of physicians willing to practice aid in dying and speak out for patient choice. Courageous, skilled and respected medical practitioners lead our growing Physician Advisory Council.

Our Hawaii Executive Council, composed of highly respected caregivers, community leaders and legal experts, will serve as educators and spokespeople for patient choice.

We will prepare a legislative contingency plan and organize constituent visits to educate lawmakers about current law and how patients suffer when their choices go unrecognized. We will also assess lawmakers’ views on end-of-life choice so we can move quickly to mobilize supporters.

In January, Compassion & Choices released a poll of Hawaii voters’ opinions. The results:

77% favor allowing those who are dying of a terminal disease the choice to request and receive medication from their physician to bring about a peaceful death.

90% agree the decision about aid in dying is a personal one between patient and doctor.

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LOUISIANA

Louisiana: Key Pro-Life Bulls on Abortion, Euthanasia Take Effect by Seven Ertelt, LifeNews.com (8/1/12) – Four key pro-life bills take effect today that protect vulnerable people at both the beginning and end of life. The Pain Capable Unborn Child Protection Act, the Hear the Heartbeat Bill, the Criminal Abortion Dismemberment Act, and the Additional Protections Against Euthanasia and Assisted Suicide Act took effect at midnight.

“Louisiana is ranked as the top pro-life state in the nation, and I commend our Senators and Representatives, our Governor, and the great citizens of Louisiana for their support in enacting these new pro-life laws,” Clapper said.

Finally, the Additional Protections Against Euthanasia and Assisted Suicide Act better protects the disabled and ill from euthanasia and assisted suicide.

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KANSAS

Man dies after losing fight for assisted suicide – KMBZ.com (8/22/12) – “I thought that if the court saw me as I am, utterly miserable with my life, powerless to do anything about it because of my disability, then the judges would accept my reasoning that I do not want to carry on and should be able to have a dignified death,” the former corporate manager from Wiltshire said in a statement issued by his lawyer.

But on Aug. 16, the court upheld the law barring Nicklinson from dying with a doctor’s help.

“It is not for the court to decide whether the law about assisted dying should be changed and, if so, what safeguards should be put in place,” Lord Justice Roger Toulson said in his ruling. “Under our system of government, these are matters for parliament to decide, representing society as a whole, after parliamentary scrutiny, and not for the court on the facts of an individual case or cases.”

A spokesman for British anti-euthanasia group Care Not Killing applauded the ruling, saying, “it confirms the simple truth that the current law exists to protect those without a voice: the disabled, terminally ill and elderly, who might otherwise feel pressured into ending their lives.”

For Nicklinson, the decision was devastating.

“I am saddened that the law wants to condemn me to a life of increasing indignity and misery,” he said in a statement.

Nicklinson planned to appeal the court ruling, but his health quickly deteriorated. He “died peacefully this morning of natural causes,” according to a tweet posted by his wife, Jane, and daughters Lauren and Beth.

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MAINE

Physician-assisted suicide– time to reconsider by Dr. Erik Steele, The Bangor Daily News/Health (8/16/12) – One night several years ago, my terminally ill patient David chose the time of his own death by shooting himself in the chest. I believe he picked that method because he knew I would be angry if he chose to end his life more peacefully by simply taking an overdose of the pills I prescribed him. I have been angry at myself ever since for having given him good reason to think so.

The upshot of that gunshot was that it’s echo has been banging around my head since it rang out, often when I am trying to fall asleep at night. It has led me to rethink what I had always thought about physician-assisted suicide: that the price to be paid for the liberty of some to choose it carefully and appropriately would be others who chose it prematurely and unnecessarily, a price too steep to be paid. Several years later, I think what I thought was wrong, and I figured I owed it to David to say so.

New data — evidence from actual experience delineated in careful medical studies — can be such an element leading to change. In the case of physician-assisted suicide it comes from the growing experience of states such as Oregon and Washington, where it is legal. Evidence from both states suggest that physician-assisted suicide is used less often than was feared, with fewer than 600 in Oregon over 15 years, and only 156 in Washington since it became legal there in 2009.

Both states have found that the liberty can be carefully overseen by the medical profession so patients are not using it for the wrong reasons (depression, lack of support, etc.), and that one in three patients who have their physician’s support for dying that way choose not to use it.

The data suggests much of what I and others feared would result from the legalizing of physician-assisted suicide does not happen when the medical profession works with the political profession to craft, implement and oversee a good law that makes a reasonable liberty available to an intelligent public. Go figure.

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MASSACHUSETTS

Why Assisted Suicide is the Right Choice, for Some by John M. Grohol, PsyD, Founder & Editor in Chief,  World of Psychology – Assisted suicide is a simple, reasonable and dignified choice that individuals at the end of their lives should be allowed greater access to. The only reason to withhold such access is the belief that government knows better than you what’s best for you at the end of your life.

I believe that few of us would agree that government knows what’s best for us in our personal health decisions. With all things being equal at the end of your life, would you rather gain a few weeks of life living in a hospital bed, heavily medicated, with tubes running from you, with machines helping you “live,” or would you rather die in a place and at a time of your own choosing?

Even if you choose, “hospital bed,” shouldn’t that choice be yours, and yours alone?

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“Death With Dignity Act” Ballot Initiative by Rabbi Liberman in Rabbi’s Thoughts (8/16/12)

Priest-physician brings unique perspective to suicide debate by Christopher S. Pineo, PilotCatholicNews.com (8/17/12) – “I think it is very clear, in that, indeed we have a profound responsibility to provide excellent care for those who are facing the end of life, and that to move on to assisted suicide represents a failure for individuals and for our larger society,” he said.

Father Sheehan said fear contributes strongly to attitudes that push people to choose to end their own lives.

“The major thing is that people are very frightened, and they are frightened about facing the end of life, their fear of being in pain or being a burden on others, or being alone when they die. So, as a consequence these fears and worries, maybe driven by the media or perhaps by the experience of someone in their family or a friend, lead them to think that assisted suicide would be a good option,” he said.

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Northampton woman, plagued with terminal illness, supports ‘Death with Dignity’ option on the Massachusetts ballot by Dan Ring, The Repubican (8/20/12) – Myra P. Berzoff said she doesn’t know if she would take life-ending medications, but said she would like the choice.

At 91, she needs oxygen virtually 100 percent of the time, or else she would suffocate. She said she was diagnosed with emphysema three years ago and lives with the fear she could die from breathlessness.

Berzoff said she is a strong supporter of a ballot question on Nov. 6 that if approved by voters would allow adults to self-administer lethal drugs after requesting a prescription.

“I think I should have the right if tomorrow I decide I want to do myself in,” she says bluntly. “I’m using up resources. I feel very strongly about that.”

James F. Driscoll, executive director of the Massachusetts Catholic Conference, the public policy arm for the Roman Catholic bishops in Massachusetts, said the church values life from conception to death. He said the church is a big supporter of hospice and palliative care. McDonnell also emphasizes hospice and palliative care in his upcoming column.

Driscoll said the ballot question would set a dangerous precedent. “The church is against this initiative and thinks it is a dangerous path to take a human life before natural death,” Driscoll said.

Taught by nuns at Catholic school, Myra Berzoff scoffs at the argument that the ballot question is dangerous because it advocates taking a human life before natural death. She said she should have the option offered by the ballot question.

“That’s absurd,” she said. “If you’re suffering, it’s your life. It isn’t the life of the Catholic church. It’s mine.”

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Beware Death with Dignity Bill – LowellSun – Opinion (8/21/12)

Opposing Euthanasia in pro-life (A call to Massachusetts activists!) by Thomas Peters – Live Action News – Opinion (8/21/12)

Majority of Massachusetts Voters Support Death with Dignity by Melissa Barber – Living with Dying: Death with Dignity National Center (8/22/12) – The poll question had the same wording as what will appear on the November ballot:

Question 2 would allow a physician licensed in Massachusetts to prescribe medication, at the request of a terminally ill patient meeting certain conditions, to end that person’s life. If the election was today, would you vote yes or no on Question 2?

Yes…………………………… 58%
No ………………………………….. 24%
Undecided……………………….. 18%

See also:  The major myths about Death With Dignity laws

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UK man who failed to overturn euthanasia law dies by Maria Cheng, boston.com (8/22/12) – Tony Nicklinson, paralyzed and unable to speak, found life so unbearable he wanted to die. On Wednesday, the 58-year-old Briton got his wish.

His family said he died of pneumonia at home.

In January, Nicklinson asked the High Court to declare that any doctor who killed him with his consent would not be charged with murder. Last week, the court rejected his request, a decision that Nicklinson said had left him ‘‘devastated and heartbroken.’’

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Briton who fought for assisted suicide is dead by John F. Burns, The New York Times-Europe (8/22/12) – A 58-year-old British man suffering from so-called locked-in syndrome died Wednesday, six days after a panel of High Court judges rejected his request for help in ending his life. His death is certain to galvanize the already contentious debate about assisted suicide in Britain
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Massachusetts Assisted Suicide Proposal Preys on Seniors by Steven Ertelt – LifeNews.com (8/22/12) – A diverse group of people is fighting the proposal on the November ballot in Massachusetts to legalize assisted suicide. Among them is Margaret Dore, an attorney who is a recognized expert on the subject.Dore points out in a brief column, that appears below, how assisted suicide preys on seniors and how assisted suicide, a practiced in other states, includes significant abuses.
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Tony Nicklinson, Man at Center of UK Euthanasia Case, Diesby Steven Ertelt – LifeNews.com (8/22/12) – Tony Nicklinson, 59 and paralyzed from the neck down after a stroke in 2005 and the man at the center of a controversial euthanasia case in England, has passed away. Nicklinson was arguing for permission that a doctor who performed voluntary euthanasia on him would have an effective defense when prosecuted for murder. However, lost his court quest to be legally euthanized and now he has died of pneumonia.“Everyone could understand and empathize with his anguish and pain.  But the request to be killed didn’t just involve him,” he said. “And as I mentioned in my last post on this very sad case, if death remained his goal, he was not “powerless” toward that end as he feared, having every right to refuse life-sustaining treatment if he became ill. That appears to be what happened.”
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Tony Nicklinson Dies After Losing Fight for Assisted Suicide by Katie Moisse – ABC Good Morning America (8/22/12) – A paralyzed man who fought to overturn Britain’s ban on assisted suicidedied today from pneumonia less than a week after losing his controversial court case.Tony Nicklinson had locked-in syndrome after suffering a stroke in 2005. Trapped inside a paralyzed body and forced to communicate by blinking his eyes, the 58-year-old man asked three of Britain’s High Court judges to grant him the right to end his “dull, miserable, demeaning, undignified and intolerable” life with a doctor-administered lethal injection.”I thought that if the court saw me as I am, utterly miserable with my life, powerless to do anything about it because of my disability, then the judges would accept my reasoning that I do not want to carry on and should be able to have a dignified death,” the former corporate manager from Wiltshire said in a statement issued by his lawyer.
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Jack Kervorkian comes to town by Tom Keane – boston.com (8/26/12) – The late Jack Kevorkian, a saint to some and a demon to others, was the controversial proponent of physician-assisted suicide for the dying and ill. This November, Kevorkian comes to the Commonwealth, or the spirit of the man at least, in the form of Question 2. The ballot measure, neutrally titled “Prescribing Medication to End Life,” would allow doctors to help the terminally ill kill themselves.

Massachusetts is thus somewhat of a test case: Is legalized suicide a trend?

Should we have state-sanctioned suicide? Libertarians argue that your body is your own, to do with as you wish. Some major religions disagree, but nothing in the proposed law requires the faithful to commit suicide. It simply permits it.

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Parishes oppose proposal on doctor-aided death by Tom Dalton – The Salem News (8/27/12) – The Catholic parishes of Salem are campaigning to defeat a question on the November ballot that would allow doctors to assist terminally ill patients who want to end their lives.
“The church is very much opposed to it,” said the Rev. Timothy Murphy, pastor of Immaculate Conception Church.
The so-called “death with dignity” ballot question began with an initiative petition filed with the state attorney general’s office by a group of citizens that included Dr. Paul Spiers of Danvers.
State Rep. John Keenan, whose mother died of lung cancer, said he supports the measure as a way to lessen suffering. Keenan, of Salem, said he believes anyone who has watched a parent or child die from a terminal illness would also support it.
Members of the local pro-life committee, however, are taking a strong stand against a question they say is misunderstood and open to abuse.
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Campaign Aims to Spur End-of-Life Conversations Within Familiesby Kay Lazar – The Boston Globe (8/29/12 ) – Compassion & Choices – “I knew what he wanted,” said his wife, Nancy. “I had had this discussion many times with him, but the kids hadn’t and they weren’t ready to let go.”

With death and dying, most Americans engage in a conspiracy of silence, surveys show, failing to discuss their final wishes until it is too late. A new Massachusetts-based coalition aims to change that.

Called The Conversation Project, the national campaign encourages open and honest discussions among families and friends about how they want to live life at the end, so that their wishes will be followed.

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Death with Dignity: Doctor-prescribed suicide for terminally ill may soon be a way to die in Massachusetts – AllVoices.com (8/31/12) – Living — and dying — according to one’s own desires and personal beliefs is possibly the greatest freedom a human being can have. But what happens when the autonomy and, potentially, the peace of mind of choosing one’s time and place of death conflicts with qualms about a physician’s role as a healer and, ultimately, the value of human life?

Massachusetts residents will contemplate those questions in November, when the Bay State will become the third in the nation to consider a ballot initiative that would allow terminally ill people to end their lives through the self-administration of medications prescribed for that purpose.

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MONTANA

Assisted Suicide: “Whose Choice?” – Montanans Against Assisted Suicide and for Living With Dignity (8/12/12) – Have you been solicited to engage in “aid-in-dying?”  Were you told that “aid-in-dying” is legal?  Did something about what you were told seem not quite right?

“Aid-in-dying” is a euphemism for assisted suicide and euthanasia.

“Aid-in-dying” is, regardless, not legal in Montana.  Baxter did not legalize the practice.  Moreover, a bill that would have legalized the practice was defeated in the last legislative session.

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Assisted suicide is not legal in Montana – Mass Against Assisted Suicide (8/31/12) – I am a Montana State Senator.  I disagree with your article, “Redefining Physicians’ Role in Assisted Dying,” claiming that assisted suicide is legal in Montana.  At the very least, Montana law is unclear.

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NEW YORK

At the end of life, talk helps bridge a racial divide by Joseph Sacco, MD (8/6/12) – The New York Times – Our findings, published on July 9 in The American Journal of Hospice and Palliative Medicine, upend the conventional view of preferences for care among blacks. Sixty-five percent of black patients who were given palliative care consultation elected DNR, and 32 percent chose hospice — rates significantly higher than those previously demonstrated.

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Richard Wesley: Ill doctor sheds light on who chooses physician-assisted suicide– The Inquisitor (8/12/12) – When Dr. Richard Wesley voted to approve Washington State’s Death With Dignity Act in 2009, he had no idea that just one month later he would be diagnosed with amyotrophic lateral sclerosis — or Lou Gehrig’s Disease — just one month later.

Despite the prospect of living, and dying, with an incurable disease that eats muscles, yet leaves the mind intact, Dr. Wesley is at peace knowing there is a prescription of barbiturates waiting at the pharmacy should he choose to end his life on his own terms. (video)

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Dr. Kervorkian had it right about assisted suicide by John M. Crisp – Newsday.com (8/20/12) – My uncle got a lucky break last week — literally. He got up in the middle of the night and, enfeebled at 81 years of age, he fell, hitting his head on a desk and breaking his skull. Later the next night he died, having never regained consciousness.

Why am I calling this gruesome mishap lucky? Because a few months earlier he had been diagnosed with lung cancer, and a couple of days before he died he had gone into hospice care. He was facing several months of increasing discomfort, disability and undignified decline, and then real pain and finally a smothering death. With a misstep in the middle of the night, he managed to avoid all of that.

Barbara Wise wasn’t quite so “lucky.” She suffered a stroke recently and was bedridden in a Cleveland hospital, unable to move or speak. John Wise, her husband of 45 years, smuggled a pistol into her hospital room and fired a single round into her head. She died the next day. Even though Wise and his wife had agreed long ago that neither of them wished to live in a bedridden, disabled state, prosecutors have charged the 66-year-old Wise with aggravated murder.

(m0re)

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Tony Nicklinson, who lost “assisted-suicide” case, dies by Victoria Cavaliere – NY Daily News (8/22/12) – A paralyzed man who lost a landmark assisted suicide case in England died Wednesday from natural causes.

Tony Nicklinson died at his home in Melksham after suffering complications from pneumonia, his family said on Twitter. He was 58.

Nicklinson had described his life as “a living nightmare” since suffering a stroke in 2005 that left him with locked-in syndrome, a total paralysis of all the muscles.

The former corporate manager and rugby player was unable to speak or move, but his mind remained intact and he was not terminally ill.

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Overtreatment is taking a harmful toll by Tara Parker-Pope – NYTimes.com (8/27/12) – When it comes to medical care, many patients and doctors believe more is better.

But an epidemic of overtreatment — too many scans, too many blood tests, too many procedures — is costing the nation’s health care system at least $210 billion a year, according to the Institute of Medicine, and taking a human toll in pain, emotional suffering, severe complications and even death.

“Sometimes the test leads you down a path, a therapeutic cascade, where you start to tumble downstream to more and more testing, and more and more invasive testing, and possibly even treatment for things that should be left well enough alone.”

Some complained that when they switch doctors they are required to undergo duplicate blood work, scans or other tests that their previous doctor had only recently ordered. Others told of being caught in a unending maze of testing and specialists who seem to forget the patient’s original complaint. I heard from doctors and nurses, too — health professionals frustrated by a system that encourages these excesses.

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OHIO

Hospital shooting fuels euthanasia debate – news24.com (8/13/12) – The shooting leaves authorities in a dilemma some experts say will happen with greater frequency in coming years as the baby boom generation ages — what is the appropriate punishment when a relative kills a loved one to end their suffering?
More often than not, a husband who kills an ailing wife never goes to trial and lands a plea deal with a sentence that carries no more than a few years in prison, research has shown. In some instances, there are no charges.

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OREGON

Assisted suicide most often chosen by affluent white by Katie Hafner – bendbulletin.com (8/12/12) – Washington followed Oregon in allowing terminally ill patients to get a prescription for drugs that will hasten death. Critics of such laws feared that poor people would be pressured to kill themselves because they or their families could not afford end-of-life care. But the demographics of patients who have gotten the prescriptions are surprisingly different than expected, according to data collected by Oregon and Washington through 2011.

They are overwhelmingly white, well-educated and financially comfortable. And they are making the choice not because they are in pain but because they want to have the same control over their deaths that they have had over their lives.

While preparing advance medical directives and choosing hospice and palliative care over aggressive treatment have become mainstream options, physician-assisted dying remains taboo for many people. Voters in Massachusetts will consider a ballot initiative in November on a law nearly identical to those in the Pacific Northwest, but high-profile legalization efforts have failed in California, Hawaii and Maine.

Oregon put its Death With Dignity Act in place in 1997, and Washington’s law went into effect in 2009. Some officials worried that thousands of people would migrate to both states for the drugs.

“There was a lot of fear that the elderly would be lined up in their RVs at the Oregon border,” said Barbara Glidewell, an assistant professor at Oregon Health & Science University.

That has not happened, although the number of people who have taken advantage of the law has risen over time. In the first years, Oregon residents who died using drugs they received under the law accounted for one in 1,000 deaths. The number is now roughly one in 500 deaths. At least 596 Oregonians have died that way since 1997. In Washington, 157 such deaths have been reported, roughly one in 1,000.

In Oregon, the number of men and women who have died that way is roughly equal, and their median age is 71. Eighty-one percent have had cancer, and 7 percent ALS, which is also known as Lou Gehrig’s disease. The rest have had a variety of illnesses, including lung and heart disease. The statistics are similar in Washington.

There were fears of a “slippery slope” — that the law would gradually expand to include those with nonterminal illnesses or that it would permit physicians to take a more active role in the dying process itself. But those worries have not been borne out, experts say.

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BackyardChickens.com – What do you all think about Euthanasia? – opinions

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Oregon Death with Dignity – More Educated About Issues More You Understand About End of Life Care by Anthony Cirillo – about.com Assisted Living (8/20/12) –  The data show Death with Dignity is a rarely used option for a small number of terminally ill Oregonians. The report indicates the process was implemented, in every instance, under the strict guidelines written into Oregon law and the established medical standard of care that has evolved since implementation.

During the 13 months covered by the report, 114 qualified patients received a prescription under the provisions of the law. Approximately 62%, or 71 terminally ill individuals, died as a result of ingesting medication prescribed under the Oregon Death with Dignity Act. Sixty-two different physicians wrote prescriptions under the law. According to the Health Division’s report, in the 14 year history of implementation, 935 prescriptions have been written and 596 individuals have ingested medication and died using the standards spelled out in Oregon law.

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Assisted suicide in Oregon – Questions & Answers

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PENNSYLVANIA

British man’s death adds fuel to fire in assisted suicide debateby John F. Burns – post-gazette.com (8/23/12) – A 58-year-old British man suffering from so-called locked-in syndrome died Wednesday, six days after the nation’s High Court rejected his request for help in ending his life.

His death is certain to galvanize already-contentious debate about assisted suicide in Britain.

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SOUTH CAROLINA

Are our lives our own? The ethics of ‘elective death’ by Bill Thompson 8/5/12 – Given the choice, few would want to end their lives in nursing homes, hospices or in hospitals, however caring the professionals, but rather in their own home in the embrace of family and friends.

Yet many who are terminally ill and/or suffering excruciating pain that palliative care cannot balm spend their last days in clinical settings hooked to life support equipment they do not want. Others are compelled to go on living in ruined bodies or in advanced old age when they have no wish to do so, often beset with emotional or psychological pain that has become unbearable.

When all medical and counseling measures have been taken, and proven unsuccessful, should an individual have the right to end his or her own life? It is a debate with profound ethical, religious and human rights implications.

“Life should not be a sentence. The freedom to die in the manner of our own choosing is the ultimate civil liberty,” argues Mount Pleasant social historian Richard N. Cote, author of “In Search of Gentle Death.” “There is rising criticism that keeping dying people alive against their will is a violation of their civil rights.”

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TEXAS

We should reconsider assisted suicide laws by John Crisp San Angelo Standard Times (8/22/12) – My uncle got a lucky break last week — literally. He got up in the middle of the night and, enfeebled at 81 years of age, he fell, hitting his head on a desk and breaking his skull. Later the next night he died, having never regained consciousness.

Why am I calling this gruesome mishap lucky? Because a few months earlier he had been diagnosed with lung cancer, and a couple of days before he died he had gone into hospice care. He was facing several months of increasing discomfort, disability and undignified decline, and then real pain and finally a smothering death.

With a misstep in the middle of the night, he managed to avoid all of that.

Barbara Wise wasn’t quite so “lucky.” She suffered a stroke recently and was bedridden in a Cleveland hospital, unable to move or speak. John Wise, her husband of 45 years, smuggled a pistol into her hospital room and fired a single round into her head. She died the next day.

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VIRGINIA

Hospice: Celebrating the end of lifeby William C. Boinest and SR. Victoria Segura – Richmond Times-Dispatch (8/30/12) – No one likes to talk about the end of life. It seems more natural to celebrate its beginning. But, death is a part of life, and when it comes, most of us want to be at home, at peace, surrounded by our loved ones.

For some, that’s not possible. For some, a higher level of medical care is needed. Many families think they can handle caregiving duties at home, but most find they are overwhelmed and unable to spend precious, focused time with their loved one.

Most communities the size of Richmond have an answer to this problem, a place where patients can receive a higher level of medical care in a home-like environment, and families can be present for their loved ones, unencumbered by caregiving duties.

Richmond does not. Surprisingly, freestanding palliative and hospice care is not available within a 55-mile radius of our city.

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WASHINGTON

Death with Dignity Act ensures control, not pain – The Seattle Times – Letters (8/18/12)

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Who chooses assisted suicide? Data reveal surprising answersby Katie Harner in The Seattle Times (8/12/12) – Dr. Richard Wesley has amyotrophic lateral sclerosis, the incurable disease that lays waste to muscles while leaving the mind intact. He lives with the knowledge that an untimely death is chasing him down, but takes solace in knowing that he can decide exactly when, where and how he will die.

Under Washington state’s Death With Dignity Act, his physician has given him a prescription for a lethal dose of barbiturates. He would prefer to die naturally, but if dying becomes protracted and difficult, he plans to take the drugs and die peacefully within minutes.

“It’s like the definition of pornography,” Wesley, 67, said at his home here in Seattle, with Mount Rainier in the distance. “I’ll know it’s time to go when I see it.”

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Physician-assisted suicide: A chance for dignity in death by John Culver– The Gonzaga Online Bulletin (8/22/12) – In 1997, Oregon’s Death with Dignity Act came into effect, hearkening in a new era of end of life care in the United States. The bill was created in response to the suffering of individuals experiencing end-stage terminal illnesses in which physical deterioration and pain coupled to bring about an unacceptably low quality of life. The law signaled a growing recognition that palliative care could not always prevent dying individuals from reaching a state of existence that they found degrading and unacceptable. Rather than suffer for days, weeks or months during an inevitable decline toward death, terminally ill patients could request that their physician prescribe them a lethal dose of barbiturates. They would bring about a merciful, dignified death.

Since its inception, the law has allowed more than 600 terminally ill Oregonians to die on their own terms, rather than suffer through the natural progression of their diseases. The law’s utility extends far beyond its potential to directly alleviate physical suffering; it provides tremendous mental comfort to terminally ill Oregonians.

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WISCONSIN

Seeing death in a new light by Bruce Wilson, The Journal Sentinel (8/13/12) – Death has become a taboo subject, but it hasn’t always been so. It seems to be feared mostly because as a society we have become so unfamiliar with death. Medical science has evolved very rapidly, and over the past 50 years we have become so good at treating illnesses that we somehow have come to view death as an option. Before heart surgery and angioplasty and antibiotics and chemotherapy, people often died when they got sick.

In earlier agrarian times, Grandpa dropped over of a heart attack while harvesting the corn or milking the cows. Doctors couldn’t get to the patients and had little to offer when they did. The family called the undertaker, who helped get Grandpa into his dark suit and they laid him out on the dining room table. Friends and family were summoned, everyone drank some whiskey and they buried him. Children and adults alike saw this cycle of life over and over. There was sadness, but it was familiar, and a fact of life.

In more modern times, Grandpa is in the ICU at the hospital. Children are frequently not allowed to visit.

Physicians have spent years learning how to fight off almost any condition, and have become unfamiliar with death themselves, so much so that internally they may have a sense of failure when death finally comes, often after a long siege of warfare against nature.

In addition, there has been almost no training for doctors in how to speak about death or prepare patients and families for this when the picture becomes clear.

This is almost a uniquely American phenomenon. The reason is simple: Most other countries do not have enough money to spend on “health care” at the end of life, when many of the measures that we view as routine are often futile.

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INTERNATIONAL

(News updates from Australia, Canada, Fiji, Germany, India, Japan, The Netherlands, New Zealand, Russia, Scotland, Switzerland, United Kingdom)

AUSTRALIA

Euthanasia: tackling the ‘wicked’ policy problem by Scott Prasser – onlineopinion.com.au (8/7/12) – There are three basic requirements for dealing with ‘wicked’ policy problems like euthanasia.

First, there needs to be time to engage the public in open, depoliticised, iterative discussion of the many dimensions of the problem. This is an absolute necessity for complex social issues with a strong moral dimension like euthanasia, in order to make different perspectives understood and create a shared understanding of the issue to address.

Second, there needs to be reliable evidence and data so as to inform the debate and avoid distortion of the facts, but this alone it is not sufficient when conflicting values and perspectives are at stake. Euthanasia is not an issue where ‘evidence’ based policy development alone can resolve the matter, but we certainly need to clarify the ‘evidence.’

Third, it is essential to have appropriate mechanisms (more than one) for public engagement in informed debate, to explore the range of arguments and to encourage the consideration of wider social implications if an agreed policy solution for the common good is to emerge.

Engaging the public in this kind of policy process would be a welcome new feature in the Australian political process.

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Mother wins six-year fight for right to let brain-dead son die by Jordanna Schriever, The Herald Sun (8/10/12) – Mrs Dunn will meet doctors on August 22 to seek a decision that he no longer be fed.

Mr Leigep, 37, has been unresponsive and in a vegetative state since March 2006 after a car crash in Adelaide’s north.

Ms Dunn would prefer her son die in a more humane way and be euthanased with drugs. She said the laws must be changed to allow families in her position to have access to euthanasia.

“I’m starving my son to death, and I’ve got no other choice but to leave him as he is,” she said.

“If I starved my dog, I would be locked up. But I’m allowed to starve my son.

“I can’t let him suffer any more. I wish there was another choice. I’m so devastated. It’s not just about euthanasia, we want him to die with respect … families have got to have that right.”

(more)

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Philip Nitschke says Exit International has seen a surge in demand for help to die peacefully by Steve Rice, heraldsun.com.au (8/16/12) – Dr Nitschke says the $690 kit allows for a peaceful death.

HIs voluntary euthanasia group, Exit International, has sold 50 of the kits and ordered another 100 – most of which have already been pre-ordered – at a cost of about $345.

He said there had been a surge in demand from people wanting the gas.

“If people really want an anonymous death, that is one that will never be detected, (this) is really your only option,” he said.

“It’s the only undetectable method of death.

(more)

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Euthanasia Campaigner Philip Nitschke Meets His Match in Debate by Paul Russell, a leading campaigner against euthanasia  (8/17/12) – Here’s the text of my talk:

Unless you’re posing a serious and present threat to my life, I can’t kill you. That’s a good thing. We all enjoy this protection in law equally, every one of us.
But, now we’re saying that it’s okay for someone else to kill you.
That is the fundamental issue: we will be making an exception to the Criminal Code that changes the laws on homicide. That is serious stuff.
We’d be creating a right for someone else to kill us or, to put it another way, a right to be killed.
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St Vincent offers peace to dying by Hamish Broome (8/20/12) – The team at St Vincent’s Hospital palliative care unit have been recognised as one of the best in the country, with a recent report ranking their services as second in NSW and fifth in Australia.

As part of a national program to benchmark patient outcomes, St Vincent’s unit was found to provide exceptional care in clinical outcomes and symptoms relief.

“Dying is one of the most critical things that happens to us,” said clinical nurse specialist Alan Hickey, who’s spent more than a decade in palliative care.

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Only person ever convicted in Qld for assisting suicide, Merin Nielsen, released from jail  – Herald Sun (8/20/12) – Merin Nielsen, 50, was freed last week after serving six months of a three-year jail sentence for assisting the suicide of an elderly man in 2009.

Euthanasia campaigner Philip Nitschke on Monday said he’d spoken to Mr Nielsen, who was utterly relieved to be out of jail and hoped the laws around euthanasia would change.

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Euthanasia decision – 4BC.com.au (broadcast) (8/23/12) – South Australian mother, Joanne Dunn, yesterday made the heartbreaking decision to ask doctors to stop feeding her 37-year-old son, Mark, who has been in a vegetative state since 2006 after a car crash.

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Australian euthanasia advocate wants Fiji death clinic– Google News (8/23/12) – Prominent Australian right-to-die campaigner Philip Nitschke said Friday he wants to set up an assisted suicide clinic in Fiji, but the government in Suva downplayed the idea.

Nitschke, a doctor who has campaigned on euthanasia issues for more than a decade, wants it to operate like the Dignitas centre in Switzerland, where 144 people ended their lives in 2011, virtually all of them foreigners.

Nitschke, head of Exit International, told the Sydney Morning Herald it would make it easier for people from the Asia-Pacific who wanted to end their lives to do so, rather than having to travel to Europe.

“Given the logistical problems faced by those in the Asia-Pacific travelling to Europe when seriously ill, Exit would suggest that a mirror clinic is well warranted in this region of the world,” he said.

He said he had written to Fiji’s attorney-general who had asked for more details, and hopes his organisation can go to the Pacific nation to discuss the idea.

(more)

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Fiji eyes proposal for assisted suicide by Julia Medew – The Syndey Morning Herald (8/24/12) – A 58-year-old British man suffering from so-called locked-in syndrome died Wednesday, six days after the nation’s High Court rejected his request for help in ending his life.

His death is certain to galvanize already-contentious debate about assisted suicide in Britain.

(more)
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Nitschke’s death clinic on agenda for Fiji

by Julia Medew The Canberra Times (8/24/12) – THE Fijian government is considering a proposal to open an assisted-suicide clinic where seriously ill Australians and others could go to die.

The Australian euthanasia advocate Dr Philip Nitschke has proposed a ”hastened death service” in Nandi which would operate like the Dignitas clinic in Switzerland, where about 1000 foreigners have died since 1998.

While a handful of European countries and two US states have legalised euthanasia or physician-assisted suicide, the Dignitas clinic is the only one in the world that allows foreigners to use its service.

(more)

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Fiji says No to suicide clinic – BioEdge.org (8/24/12) – Australian euthanasia activist Dr Philip Nitschke seems to have jumped the gun by telling the media that the South Pacific island of Fiji was considering his plans for establishing a suicide clinic in the city of Nadi.

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Tony Nicklinson: Can law change on assisted dying and protect vulnerable? by Isra Black – International Business Times (8/24/12) – In this post, I attempt to clarify what the vulnerability objection is, that is, what concerns it raises against the legalisation of assisted dying, and who the ‘vulnerable’ are. This post also presents an overview of the safeguards designed to ensure that assisted dying is implemented without diluting the protections afforded to certain members of society. It ends by challenging the basis for assisted dying chosen by campaigners for a change in the law.

A detailed study of the safeguards present in the laws and practices of jurisdictions where assisted dying is lawful can be found in the briefing paper Professor Penney Lewis and I wrote for Demos and the Commission on Assisted Dying.

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Australians must have death with dignity – Herald Sun (8/28/12) – A Herald Sun investigation has found thousands of terminally ill people are unable to make their lives easier because of unduly restrictive regulations.

(more)

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CANADA

Suggestions for slipping a mortal coil: The important questions make dying livableby Gordon Sinclair Jr. – winnepegfreepress.com (8/4/12) – “But nobody had actually gone to dying patients and asked them what dignity was about,” Chochinov recalled. “What it meant to them.”

So he began asking palliative care patients in Winnipeg the dignity questions.

What Chochinov discovered was dignity for those who needed it most had more to do with emotional well-being, than physical requirements.

He found people lost their sense of dignity when they felt their life had lost meaning and purpose in its final stages.

Or, as Chochinov told me: “We looked at pain, we looked at physical symptoms, spiritual issues, psychological issues. The single most important predictor of people’s dignity was, in fact, how people perceived they were seen. How people saw themselves to be appreciated or seen by others.”

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DWD newsletter accuses the Euthanasia Prevention Coalition of lying by Alex Schadenberg, LifeSiteNews.com (8/6/12) – In the June 2012 edition of the Dying with Dignity newsletter (p.10), Wanda Morris, the executive director of Dying with Dignity states that EPC bases its arguments on Lies, Damn Lies and fear mongering.

Morris ought to look in the mirror when she accuses EPC of lying or fear mongering.

I knew that I was doing well in the debate when Morris stated that I lacked compassion because I opposed euthanasia and assisted suicide in all circumstances. Low blow Wanda, too bad it proved to the audience that you were getting desperate.

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Ottawa appeals B.C. assisted suicide ruling by Paul Tuns, TheInterim.com (8/7/12) – Waiting until the second-last business day to file, Canada’s federal government appealed the June 15 decision of B.C. Supreme Court Justice Lynn Smith overturning Canada’s ban on euthanasia and assisted suicide. Smith claimed that Canada’s Criminal Code prohibiting euthanasia and assisted suicide violated the Charter rights of those seeking assistance killing themselves and those who help them carry out their lethal wishes. The justice also argued the Criminal Code provisions violated disabled persons Section 7 rights of life, liberty, and security of the person.

On July 13, the Friday before the July 16 deadline to appeal Smith’s decision, federal Justice Minister Rob Nicholson announced the Conservative government sought to stay the ruling which urges Parliament to change the law to allow euthanasia and assisted suicide within the next 12 months and gives an immediate exemption to Gloria Taylor, an ALS sufferer who is challenging the assisted suicide law.

(more)

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‘One-sided and misleading’: Anti-euthanasia leader slams upcoming Canadian ‘expert panel’ event by Peter Baklinski – LifeSiteNews.com (8/7/12) – A pro-euthanasia group has teamed up with an atheist group to present what they call an “expert panel” to inform Canadians about recent legal developments in the country regarding medically assisted suicide.

Meanwhile, the country’s top advocate for the right-to-life of the elderly has slammed the expert panel event, calling it “one-sided and misleading”.

“Canada does not need anybody promoting laws that allow one person to kill another person, whether they are terminally ill or not,” said Alex Schadenberg, director of the Euthanasia Prevention Coalition, to LifeSiteNews.

The UK Care Not Killing Alliance is honoured to host this first European symposium, which builds on several successful meetings in North America organised by the Euthanasia Prevention Coalition.

First European Symposium on Euthanasia and Assisted Suicide

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Canadian attitudes skewed in favor of physician-assisted suicide by Michael Swan, The Catholic Register (8/9/12) – Canadians and Britons are more open to physician-assisted suicide than Americans, a recent poll by Angus Reid Public Opinion has found.

Eighty per cent of Canadians and 77 per cent of the English said that doctors should be allowed to assist terminally ill, fully informed and competent patients to kill themselves. But only 56 per cent of Americans agreed.

The poll found 10 per cent of Canadians and nine per cent of Britons firmly opposed to physician-assisted suicide no matter who asks for it. Nearly one third — 29 per cent — of Americans said it should never be allowed. On the flip side, three-quarters of Canadians and Britons said physician-assisted suicide should always be allowed under specific circumstances, whereas only half of Americans thought so.

“So far as the UK is concerned, in terms of opinion surveys this doesn’t surprise me,” he said. “What we’re seeing here to a degree is an instinctive, compassionate response from a society that prizes individual autonomy very highly.”

The Angus-Reid survey found 86 per cent of Canadians, 84 per cent of Britons and 69 per cent of Americans agree with the statement that “Legalizing doctor-assisted suicide would give people who are suffering an opportunity to ease their pain.”

People who believe laws against assisted suicide protect the vulnerable from social, economic and medical pressure to commit suicide face a major education challenge, said Wookey.

“It means there’s a very, very clear job for the Church to do, particularly in secular society,” he said.

British bishops have teamed up with disability rights organizations and palliative care professionals to form an alliance called Care Not Killing — a purely secular platform to engage the public policy debate.

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Gloria Taylor regains right to die in peace  by Cathryn Wellner (8/13/12) – Unless the federal government intervenes yet again, Gloria Taylor can decide in peace when her life with ALS (Amyotrophic Lateral Sclerosis or Lou Gehrig’s disease) has become unbearable. At that point she can ask a physician to ease her death. British Columbia’s highest court has granted Taylor a personal exemption.

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Canadian Judge upholds decision giving woman “right” to die by euthanasia or assisted suicide by Dave Andrusko, National Right to Life News Today (8/10/12) – The Euthanasia Prevention Coalition (EPC) said today that it is troubled by the decision of  the British Columbia court not to stay the constitutional exemption granted to Gloria Taylor to die by euthanasia or assisted suicide. Alex Schadenberg, executive director, said EPC urges the Government to appeal the court order issued by Justice Jo-Ann Prowse.

“EPC is concerned that this court order may prompt other people with similar conditions to apply for a constitutional exemption to die by euthanasia before the Supreme Court and Parliament have ruled on the matter,” he said.

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New lease on life for assisted suicide debate– Sun News (8/11/12) – An appeals court ruling Friday that would let Gloria Taylor get help from a doctor to commit suicide doesn’t pass muster with the federal justice minister.

The B.C. woman is suffering from Lou Gehrig’s disease, has lost the ability to walk and is confined to a power chair.

“We are disappointed with this decision and are currently reviewing it,” said Julie DiMambro, a spokeswoman for Justice Minister Rob Nicholson.

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Ill Doctor Puts Spotlight on Euthanasia by Marcel Simmer, Akgulian.com (8/13/12) – Dr. Richard Wesley suffers from amyotrophic lateral sclerosis an incurable disease that ruins the body’s muscles while allowing the mind to remain intact. However, he know that he can make the decision when, where and by what form he can die.

He lives in Washington, which has the Death With Dignity Act and his physician has prescribed for him a dose of barbiturates that is lethal. Wesley would prefer if he could die naturally, but because of his condition, it could become both difficult and protracted. His plan is to take the drugs and within minutes, die peacefully.

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Assisted suicide ruling right move by Charlie Hodge, kelownacapnews.com (8/17/12) – Until one has truly faced death in the face, it is hard to judge, or even begin to comprehend, how complex such a decision is.

Until one has truly come to grips with a debilitating, cruel, lingering, fatal illness, it really is impossible to comprehend the emotions and desires of someone in such a situation.

With death, theory is easy. Grasping it by the throat and actually dealing with it is a whole other ball game.

When one truly comprehends that their life form (as we know it) is dwindling due to a cruel terminal illness, all the theory goes out the window.

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Right-to-Die debate rages on – The Oxbow Herald (8/24/12) – This debate is contentious on both sides. People in support of assisted suicide argue the laws must be changed to allow terminally ill patients to die with dignity. When illness makes it impossible to support any quality of life, and the inevitable end is a slow and painful death, people should have the right to choose when to end their lives.

Opponents argue assisted suicide is wrong.

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Fighting for the right to die by Pam Frampton – The Weekend Telegram (8/25/12) – In Canada, assisted suicide is still illegal, but gains are being made in the fight by those who argue we should have that right.

In British Columbia in June, that province’s Supreme Court declared invalid a section of the Criminal Code that prohibits physician-assisted suicide.

That doesn’t mean the service is immediately available in B.C., but as The Globe and Mail’s Sunny Dhillon reported on June 15, according to Queen’s University research fellow and lawyer Ricardo Smalling, “if the government does not do something about (the court ruling), or if the B.C. Court of Appeal or the Supreme Court of Canada does not grant an injunction to stay the implementation of the decision, then assisted suicide will automatically become legal.”

The article also noted that a panel of experts of the Royal Society of Canada that studied end-of-life decision-making said “in a report released last year, that informed Canadians should have the right to choose death within a regulated system, even if they have not been diagnosed with a terminal illness.”

On March 22 in Quebec, a Select Committee on Dying with Dignity released a report which found similarly, recommending, among other things, “that relevant legislation be amended to recognize medical aid in dying as appropriate end-of-life care if the request made by the person meets (certain criteria) as assessed by the physician. …”

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Physician-assisted suicide poisons the mission of medicine by J. Donald Boudreau – The Globe and Mail (8/28/12) – Nothing would prevent society from mandating responsibilities to a new profession; I have called it euthanatrics.

Its practitioners – euthanologists – could ensure that society-sanctioned suicides are carried out expertly, with transparency and accountability. It would provide a mechanism to meet new legislative demands while protecting the medical profession so that it can continue to fulfill its ancient mandate of healing.

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Euthanasia discussion event will be one-sided, opponent says by Jessica Smith– MetroNews.ca (8/29/12) – The head of a group opposed to euthanasia says an upcoming panel discussion on “medically assisted death” in Ottawa won’t reflect the views of people opposed to the idea.

Executive Director of the Euthanasia Prevention Coalition Alex Schadenberg said he was invited to the panel discussion, but will be out of the county and the organizers did not find someone to fill his anti-decriminalization position.

Two Eastern Ontario professors and a Quebec politician will be speaking in Ottawa about legalizing euthanasia in a panel dubbed “Medically Assisted Death Coming to Canada: How, Why, When??”

“It’s a one-sided event,” Schadenberg said. “I would say this is not really a panel of information it’s a pro-euthanasia event promoting the legalization.”

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Dying with Dignity chapter formed on Salt Spring by Elizabeth Nolan -GulfIslandsDriftwood.com (8/29/12) – Salt Springers concerned about having the same ability to make personal choices while dying as they enjoy in everyday life have created the first local chapter of an organization dedicated to the right to die.

The group’s aim is to change Canadian law to allow people in palliative care to end their lives, with a doctor’s assistance, at the time of their own choosing. The issue has been likened to the debate on abortion: although the ethical question can be thorny,  advocates aren’t trying to make a universal case.

One of the participants at the meeting said his interest in dying with dignity began many years ago, when someone he knew of tried to end his own life before his debilitating disease did.

“But he did it with a shotgun and he didn’t do it right. It was terrible for the family,” he said.

Starvation has been suggested as an easy and mostly painless method: a person in care can simply refuse to take in any more food or water. But two other participants at the meeting recalled how their mother had done that very thing, and took 10 days to pass away.

Hoarding medication is also not advised, as overdoses often lead to brain damage and other lost functions, but may not be enough to end a life.

A Forum Research survey conducted in December 2011 found that 67 per cent of Canadian polled favoured legalizing doctor-assisted death for terminally ill patients. Hogan believes it’s now time for Canadians to make their beliefs known to ease the way toward legal changes. Joining groups such as Dying with Dignity and writing letters to political representatives will be key.

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Death without dignity by Barb Ritchie – Calgary Herald (8/29/12) – I thank God that she has reached the point of oblivion now, so she has some measure of peace in her life. Those who oppose the right-to-die legislation should be sitting on this bed next to me.

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FIJI

Legalise enthanasia– The Fiji Times Online (8/15/12) – CALLS have been made to legalise euthanasia in Fiji to be included in the next constitution.

Doctor Etika Vuniyabola highlighted this as part of his submissions to the Constitution Commission.

Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering.

In his submission, Dr Vuniyabola proposed that this subject be earnestly considered and accepted for the sake of the people in need of its role as a solution to their silent sufferings and helplessness when mental and physical incapacitation had no available cure and solution.

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State rejects death clinic by Nasik Swami – The Fiji Times (8/25/12) – A PROPOSAL sent to the government to open an euthanasia clinic in the country by Australian euthanasia advocate Dr Philip Nitschke has been rejected.

Confirming this to The Fiji Times, Ministry for Information permanent secretary Sharon Smith-Johns said the Attorney-General’s Chambers received a submission from Dr Nitschke in August last year.

“As with all submissions received by the chambers, details of the proposals were requested but there is no plan to establish such a facility,” Ms Smith-Johns said.

However, The Sydney Morning Herald reported that Dr Nitschke had proposed a “hastened death service” in Nadi which would operate like the Dignitas clinic in Switzerland, where about 1000 foreigners have died since 1998.

Dr Nitschke is the owner of Exit International, a leading end-of-life choices (voluntary euthanasia/ assisted suicide) information and advocacy organisation.

(more)

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Fiji eyes proposal for assisted suicide by Richard Dawkins, Foundation for Reason and Science (8/26/12) – Australian euthanasia advocate Dr Philip Nitschke has proposed a “hastened death service” in Nadi which would operate like the Dignitas clinic in Switzerland, where about 1000 foreigners have died since 1998.

While a handful of European countries and two US states have legalised euthanasia or physician-assisted suicide, the Dignitas clinic is the only one in the world that allows foreigners to use its service.

In a proposal sent to Fiji’s Attorney-General, Aiyaz Sayed-Khaiyum last year, Dr Nitschke said the developing country could generate “considerable income” from a similar clinic with demand expected to come from people in Australia, New Zealand, Asia and India who do not have access to physician-assisted suicide.

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Church welcomes rejection of euthanasia clinic in FIJI– Radio Australia (8/27/12) – One man that’s welcomed the news is Reverend Tevita Banivanua, the deputy general secretary of Fiji’s Methodist Church, who’s speaking to correspondent Bruce Hill

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GERMANY

Assisted suicide law split government – TheLocal.de (8/1/12) – A row has blown up within the government about possible changes to German assisted suicide laws, after the justice minister said she wanted to enable not just relatives but also doctors and friends to help people to die.

All sides say commercial assisted suicide should be banned, as set out in the government’s coalition agreement – but disagreement has arisen over where the line should be drawn.

Justice Minister Sabine Leutheusser-Schnarrenberger wants to restrict the ban to organisations with commercial interests – leaving those who offer profit-free suicide advice to terminally ill people free to do so without fear of prosecution.

The Neue Osnabrücker Zeitung newspaper reported on Tuesday that Leutheusser-Schnarrenberger had drafted a law which would lift the threat of prosecution friends and long-term housemates, as well as doctors and carers – if during treatment “a close personal relationship”.

Health spokesman for Angela Merkel’s Christian Democratic Union, Jens Spahn told the Frankfurter Allgemeine Zeitung newspaper on Wednesday, it was not acceptable that commercial operations should be threatened with up to three years in jail, while relatives and friends would excepted.

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Central Council of Muslims criticizes draft law on euthanasia – Euro-Islan.info (8/3/12) – The Central Council of Muslims has issued a press release relatively to a new draft law on euthanasia. The draft law, proposed by Minister of Justice Sabine Leutheusser-Schnarrenberger (FDP), would legalize private euthanasia also when disposed by close relatives, allowing them to do so without legal consequences. The Council expressed the message that Muslims in Germany should not be abiding by this law. The medical doctor Dr. Houaida Taraji said that “Life is worth to be protected at any stage and no side doors should be opened for murder”.

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Half of Germans approve of euthanasia businesses – TheLocal.de (8/6/12) – Nearly half of Germans are in favour of legalising euthanasia businesses, a recent survey revealed. The German parliament is still divided over proposed changes to assisted suicide laws.

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Germany seeks to clarify euthanasia laws – DW-World.de  (8/8/12) – Many in Germany are unhappy with current euthanasia legislation, according to a study conducted by pollsters Emnid. The poll found that almost 50 percent of Germans say they want professionals to be able to help people who wish to die.

But that’s not what Berlin wants. The Justice Ministry has warned in a paper of a scenario where professional companies would be permitted to offer assistance in “a quick and efficient form of suicide.” Means in which companies could do this would be offering medication or a room for the suicide to take place. Under a planned bill though, this though would be punished by a fine or a prison sentence.

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INDIA

Court says woman’s life cannot be ended– UPI.com – India’s Supreme Court Monday declined a plea to end the life of a woman in a “vegetative state” for 37 years after a sexual assault.

The plea by activist Pinki Virani sought to stop the feeding of Aruna Shanbaug, a former nurse at Mumbai’s KEM Hospital and a victim of a sexual attack by a hospital janitor.

The petition said the victim can no longer see or speak properly and keeping her alive in this “persistent vegetative state” violates her right to life with dignity, The Times of India reported.

The case of Shanbaug, 60, has become a huge controversy with opinions widely divided.

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JAPAN

Death with Dignity bills heading toward Diet by Natsuko Fukue – The Japan Times Online (8/25/12) – “We’ve been holding discussions for seven years already. We shouldn’t rush, but I think it’s time to get our thoughts into shape,” the group’s chairman, Teruhiko Mashiko of the Democratic Party of Japan, told The Japan Times. “It’ll be great if the public starts discussing the issue as we submit the bills.”

The group drafted two versions and plans to let Diet members vote based on their own judgement. One version stipulates that doctors can’t start life-prolonging treatment on patients in a terminal stage, defined as “a condition in which patients have no possibility of recovery even with appropriate medical care,” and the other states that cancellation of such treatment would also be allowed.

Under both bills, more than two doctors would have to decide whether a patient is in a terminal stage and they would not be “held liable under the criminal, civil and administrative codes.”

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THE NETHERLANDS

Dutch would have stopped treating Prince Friso– Radio Netherlands Worldwide (8/3/12) – An influential Dutch ethicist has said that if Queen Beatrix’s son, Prince Johan Friso, had been hospitalised in the Netherlands after his ski accident, doctors would have already stopped his treatment.

Heleen Dupuis, who is a member of the Dutch Upper House for the ruling Liberal Party (VVD), said, “it’s questionable whether the prince will ever have a normal life again. I understand that the chances are extremely small.” According to the ethicist, “had the prince been sent to a Dutch hospital, doctors would have probably turned off the life support system because there is such a slim possibility that he will ever recover.”

Prince Friso suffered severe brain damage after he was trapped in an avalanche, while skiing in Austria in February. He is in a coma at Wellington Hospital in London. Doctors say the chances he will recover are minimal.

There’s a growing debate in the Netherlands about how far doctors should go in treating patients. Health care is becoming unaffordable for two reasons. On the one hand, people are ageing and need more medical care, and on the other extremely expensive drugs are being developed for very rare diseases that used to be fatal. The Dutch are asking whether society should pay 50,000 euros to extend a cancer patient’s life by six months. The discussion is likely to play a role in the political campaigns for the general elections on September 12.

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Controversy over assisted suicide in The Netherlands by Wim Jansen, Radio Netherlands Worldwide (8/15/12) – A special website has been launched in the Netherlands for people who assist family or friends to commit suicide and want to tell their stories anonymously, or simply ask questions. Assisted suicide carried out by lay people is currently punishable by law.

In the Netherlands, only doctors can carry out assisted suicides, and they can do so only if they follow strict protocols. According to Right-to-Die-Netherlands (NVVE), physicians frequently refuse requests for assisted suicide, leaving patients unable to carry out their wishes in a humane way. One case recently made headlines: a man who helped his 99-year-old mother to die by giving her the lethal medication she requested. The Ministry of Justice is considering bringing charges against the man.

The NVVE says people are often unwilling to help their friends and loved ones because they fear prosecution. So they’re left witnessing their loved ones dying or committing suicide and have to live with those memories. The organisation hopes that the anonymous testimonies will provoke discussion in the Netherlands and ultimately to the scrapping of the law against lay people helping in cases of assisted suicide.

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Doctors and chemists agree joint euthanasia guidelines  – DutchNews.nl (8/28/12) – Doctors and dispensing chemists have agreed a joint guideline on euthanasia, doctors’ federation KNMG and dispensing chemists’ organisation KNMP said on Tuesday.

The new guidelines will replace those drawn up five years ago by dispensing chemists and underline the cooperation between the two sets of medical professionals on the subject.

‘The guidelines not only contain technical information about, for instance, the amount of a drug to be administered, but also explain for the first time why a certain method has been chosen,’ a KNMG spokesman told website nu.nl.

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Euthanasia guides adopted in Netherlands– UPI.com (8/29/12) – An agreement on joint guidelines on euthanasia was reached between the associations representing doctors and pharmacists in the Netherlands, officials said.

The new guidelines, agreed to Tuesday, replace those developed five years ago by the pharmacists, DutchNews.nl reported.

Euthanasia is legal in the Netherlands under strict conditions, such as a patient “suffering unbearably” and the attending doctor must be convinced the patient is making an informed choice. A second opinion also is required.

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NEW ZEALAND

The peace of assisted dying by Sean Davidson – peoplemagazine.co.za (8/3/12) – If your loved one was dying a long, painful death, would you wish there was some other way out? Soon there might be.

Davison founded an organisation called DignitySA which seeks to legalise assisted dying of the terminally ill under precisely defined circumstances. DignitySA proposes a legal procedure in which those wanting to be euthanised will apply to an independent panel that would look at each case individually.

“It will be a kind, compassionate process with a panel that includes doctors, legal advisers and counsellors,” Davison explained.Opponents of assisted dying suggest that should a system be introduced in which death can be legalised, then that system would be open to abuse. The other common reason given for not legalising euthansia would be the appeal to the ‘sanctity of life’, in which opponents claim that life itself is too precious to be ended, under any circumstances.

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Hospice organising public meeting on euthanasia by Lindsay Shelton – Wellington.Scoop.co.nz (8/6/12) – Hospice New Zealand is pleased to announce a public meeting on euthanasia to be held in Wellington on Thursday, August 16, titled “Euthanasia, an ethical and legal crossroad”.

“Dying is a fact of life and should be discussed openly and often,” says Hospice New Zealand CEO, Mary Schumacher. “We have organized this public meeting to enable discussion on euthanasia outside of any individual case. It’s a subject that needs more understanding in many parts of the world and New Zealand is no different. We want to provoke discussion among New Zealanders and we hope the public meeting will generate questions that will allow people to form their own opinions.”

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Australian & NZ Society of Palliative Medicine on Euthanasia– Scoop.co.nz (8/6/12) – “We should focus on excellence of hospice and palliative care not euthanasia”

The Australian and New Zealand Society of Palliative Medicine Inc., (ANZSPM), believes that the practice of euthanasia and assisted suicide are outside the discipline of Palliative Medicine. The Society endorses the New Zealand Medical Association’s Position Statement on Euthanasia, and similarly the World Medial Association’s which state that euthanasia and doctor-assisted suicide are unethical. This position is not dependent on euthanasia and doctor-assisted suicide remaining unlawful. Even if they were to become legal, or decriminalised, the NZMA would continue to regard them as unethical.

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Dangers of euthanasia spelt out by John Gibb, Otago Daily Times (8/15/12) – Many older people could be subjected to subtle pressures to end their lives prematurely if voluntary euthanasia was made lawful in this country, Baroness Prof Ilora Finlay warned in Dunedin yesterday.

Prof Finlay, a Welsh palliative care specialist, said legalising medically assisted euthanasia and assisted suicide was likely to have significant unintended consequences.

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Maggie Barry: Euthanasia not the answer by Issac Davison, nzherald.co.nz (8/16/12) – National Party MP Maggie Barry says the standard of healthcare for New Zealanders with terminal and chronic illnesses is so high euthanasia should not be considered as an alternative.

Ms Barry’s All Party Parliamentary Group on Palliative Care will meet for the first time today and aims to improve MPs’ understanding of the care available.

Palliative care focuses on relieving the suffering of patients with chronic or life-threatening illnesses.

Ms Barry was partly inspired to form the group after witnessing the high-quality care her parents received before their deaths.

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Palliative care vs assisted dying: A false dichotomy – frogblog by Kevin Hague (8/16/12) – When I arrived at the meeting today it was to a room full of perhaps 70 people from outside Parliament and the full range of parliamentary media. We were given several different presentations, compered by Maggie. While there was some content on palliative care, the absolute focus of the meeting was on mounting arguments against voluntary euthanasia and assisted dying.

Now I believe there should be a very active public debate about Maryan Street’s Bill. I will both participate and listen with considerable interest, but I believe this needs to occur independent of debate over palliative care. It is just nonsensical to present palliative care and assisted dying as some sort of dichotomy between which society must choose. I personally believe in really great palliative care services. I also believe in assisted dying services. I resent the conflation of the two issues.

I also resent very considerably being lured to a harangue against assisted dying (not even a discussion) under false pretences. I believe it was deceitful of Maggie to invite MPs to a meeting about palliative care, but then to have different agenda, particularly in an environment where challenging or leaving would appear churlish and destructive.

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Euthanasia debate starts up again by Adrien Taylor, 3news.co.nz (8/16/12) – The debate on whether euthanasia should be legalised in New Zealand is once again heating up as local and international campaigners gather in Wellington for a conference on the issue.

It’s an argument that provokes strong reactions and is bound to create fault lines in Parliament if Labour MP Maryan Street has her Private Member’s Bill to legalise drawn from the ballot.

“I think there are more people who want to be as self-determining at their end point as they have been during their life and I for one, don’t think they can be told they can’t be,” she says.

She says her End-of-Life Choice Bill would make it legal for those who are terminally ill, or have an irreversible medical condition, but are still mentally fit, the right to choose to die, and for assisting clinicians or family members to be protected from liability.

And she’s confident she’ll have the support of other MPs, if the bill gets drawn.

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Barry denies undercover bid to derail suicide bill by Issac Davison, nzherald.co.nz (8/17/12) – National MP Maggie Barry has defended her new cross-party parliamentary group against accusations it was created solely to kill off a Labour MP’s bill to legalise assisted suicide.

Opposition MPs were furious that Ms Barry’s discussion group for palliative care focused only on arguments against euthanasia at its first meeting yesterday.

She was accused of using the all-parliamentary group on palliative care to derail Labour Party MP Maryan Street’s End of Life Choice Bill.

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Palliative Care and Euthanasia – Kiwiblog (8/17/12) – So palliative care is not an alternative to euthanasia in all cases. And where it is an alternative – it should be a choice for the dying person. I do not think it is the role of the state to tell people they can not end their lives if they are in agony. The role of the state should be to put in place rigorous safeguards around those decisions.

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Comfort in the option of a dignified death by Kathryn Powley and Susan Edmunds – nzherald.co.nz (8/19/12) – As the country debates the rights and wrongs of assisted suicide, Kathryn Powley remembers the death of her mother – and asks how it might have been different – while Susan Edmunds looks at the proposed euthanasia bill.

I stroked him as he lay there calmly. I held his little paw as the needle went in, and I kept holding it as he closed his eyes for the last time. And that was that.
I felt relief and was surprised that Huckle seemed to feel nothing. He just went to sleep.
There was no dying gasp. No nothing. Just there one minute, gone the next. It was one of the best decisions I’ve ever made, and whenever I think of that moment I wonder why my lovely Mum couldn’t have had the luxury of such a calm, peaceful passing.

Mum died in North Haven Hospice, in Whangarei, 3 months after a sudden, out-of-the-blue diagnosis of terminal bowel cancer. It had spread to her liver and nothing could be done.
She had so much to do, so many plans, so many trips overseas she had yet to take. She’d worked and saved so hard. Now this? “Just knock me on the head,” she’d say. And she meant it. “I could drive the car off a cliff,” she’d say. And she meant that, too.
Although she hated what she’d been reduced to, she never made peace with the fact she was dying. She simply didn’t want to leave us. Her will to stay was battling with her desire to go.
Mum breathed her final, laboured breath on January 11, 2005, in the wee hours in North Haven Hospice with me, Sarah and Andrew beside her.
It was sad, but it was a relief. But I will always wish that her passing, with her blessing, could have been as peaceful and dignified as her beloved Huckle’s.

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Editorial: Euthanasia bill under fire – Waikato Times (8/20/12) – The group would have created no fuss (and might have attracted little attention) except that Ms Barry’s primary motivation was reported to be opposition to assisted suicide as an alternative for seriously ill patients. Euthanasia should not be considered as an alternative, she said, because the standard of healthcare for New Zealanders with terminal and chronic illnesses is so high.
Ms Barry, too, denounced Ms Street’s measure as a terrible bill that failed to protect vulnerable patients.

Perhaps it is. But euthanasia is not being promoted to replace palliative care. The purpose is to allow a dying person to make that choice under strict conditions. That’s consistent with National Party principles. Among them, National aims to build a society based on values that include individual freedom and choice and personal responsibility. Ms Barry should brush up on them.

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Bigmouth Maggie strikes again: An Auckland minute by Richard Boock – AucklandNow (8/21/12) – May I just say I’m pleased Maggie Barry’s parents received top-class palliative care before their deaths. That’s a good outcome. But for the National Party MP to use the experience as the basis for her stand against voluntary euthanasia inflates an already well-established sense of conceit to startling new levels. According to Barry, since her folks escaped a nightmarish end to their lives, there’s no reason why everyone else can’t as well.

Or, in other words, there’s no need for euthanasia.

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Euthanasia already happening in hospitals– PM by Michael Forbes – stuff.co.nz (8/21/12) – Prime Minister John Key says euthanasia already happens in our hospitals – and if he was terminally ill, he would consider it.

Doctors disagreed with him last night, saying his view of the situation was too simplistic.

Mr Key said yesterday that he could understand the argument that legalising euthanasia might put pressure on the elderly to end their lives early, in the face of “rapacious grandkids”, but “I don’t really buy that argument”.

“I think there’s a lot of euthanasia that effectively happens in our hospitals,” he told Newstalk ZB.

“. . . If I had terminal cancer, I had a few weeks to live, I was in tremendous amount of pain – if they just effectively wanted to turn off the switch and legalise that by legalising euthanasia, I’d want that.”

Labour MP Maryan Street is drafting a member’s bill to legalise euthanasia – and the emotive subject is already sparking debate even before it is in the ballot.

Mr Key signalled his broad support for euthanasia, but said he was not sure if he could support Ms Street’s bill, which looked likely to have some “quirks” that he did not agree with.

“So I may or may not vote for that bill, [but] the broader principle I support.”

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Patient’s wishes paramount– Opinion: Otago Daily Times (8/21/12) – As admirable as palliative care practitioners are, I find there is something disturbing in their zealous obsession that a patient whose life philosophy is different from their own, needs re-education on their deathbed.

Such a patient must, according to Prof Ilora Finlay, be a “control freak” or they must have been subtly coerced by family and society to consider themselves “burdensome”.

They now need to learn that they are valued – as proven by disregarding their wishes. If only palliative care practitioners could accept their patients as they are, they could do even more good than the considerable good they already do.

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John Key ‘broadly supports’ voluntary euthanasia by John Key (8/23/12) – …director of the Association of Salaried Medical Specialists, Ian Powell, did not think euthanasia was occurring the way Mr Key made out.

“The situation is much more complex than that,” he told local media.

“Sometimes continuing a treatment can prolong the agony for a patient, and not even keep the patient alive.

“By not prolonging the agony . . . even though the intent is not for the patient to die, it is sometimes a consequence.”

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PM’s ‘misguided’ euthanasia views anger palliative care specialists by Claire Trevett – nzherald.co.nz (8/24/12) -The comments have angered hospice and palliative care specialists. Sinead Donnelly, New Zealand chairwoman of the Australian and New Zealand Society of Palliative Medicine, said Mr Key had misrepresented the care of terminal patients.

“His personal opinion given as Prime Minister has serious negative consequences in the trust people have in hospital care of the seriously ill.”

She said it was not considered euthanasia to abide by a patient’s right to refuse treatment or if treatment to alleviate symptoms had the unintended consequence of hastening death.

She said the society agreed with the Medical Association’s position on euthanasia, which was that doctor-assisted suicide or euthanasia was unethical – and even if it was legalised it would continue to be unethical.

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Euthanasia claim sparks anger by Bronwyn Torrie (8/24/12) – Angry doctors are appalled at Prime Minister John Key’s claims that euthanasia already happens in hospitals.

“We never practise euthanasia; euthanasia is the deliberate ending of life, and is illegal and unethical,” Australian and New Zealand Society of Palliative Medicine chairwoman Sinead Donnelly said.

Mr Key’s comments could seriously damage the trust people had in hospital care of the seriously ill, the Wellington doctor said.

Mr Key signalled his broad support for euthanasia – medical assistance to die – during a stint on Newstalk ZB this week.

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Euthanasia clinic touted for Fiji by Michael Field – stuff.co.nz (8/24/12) – Fiji is considering opening a euthanasia clinic where seriously ill Australians and New Zealanders can fly to for assisted suicides, Australian euthanasia advocate Dr Philip Nitschke says.

He has told the Age in Melbourne that the centre he proposes in the tourist city of Nadi would be like a similar clinic in Switzerland, where about 1000 foreigners have died since 1998.

In a proposal sent to military regime appointed attorney-general, Aiyaz Sayed-Khaiyum, Dr Nitschke said Fiji could generate “considerable income” with demand expected to come from people in Australia, New Zealand, Asia and India, who do not have access to physician-assisted suicide.

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Key euthanasia claim ‘wrong’  by Alexia Johnston – stuff.co.nz (8/24/12) – Ms Ligtenberg, who is also a Green Party spokesperson, said her comments were based on her own views, not those of her nursing colleagues.

She said she understood that, in some palliative care cases, it was possible that patients were given extra pain medication “to make them less aware” of how ill they were in their final days. However, she did not regard that practice to be euthanasia.

“Euthanasia … is not happening because it’s illegal, but what goes on when you look at palliative care is that possibly people are getting [an increase in pain] medication, so they don’t feel the pain.

“You increase the medication – it’s not the medication as such that causes death.”

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Key’s euthanasia view ill-informed: doctor by Eileen Goodwin – Otago Daily times (8/26/12) – Those wishing to shorten their lives with euthanasia are trying to control what should be a natural process, Otago Community Hospice palliative care registrar Dr Louise Bremer says.

She said Prime Minister John Key’s view aired this week was “simplistic” and “ill-informed”.

Dr Bremer, who also works at Dunedin Hospital as a physician in medical oncology, said euthanasia was not performed in either hospices or hospitals in New Zealand.

Doctors never caused or hastened death, she said.

Through working closely with the patient, clinicians did not extend life unduly, which did not constitute any form of hastened death, she said.

Communication with the patient was critical.

While some patients requested an end to their pain and suffering, this generally was a call for some form of relief, rather than death itself.

She believed people had become used to controlling every aspect of their lives, and this was behind calls for legalising euthanasia.

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Key admits euthanasia comments ‘sloppy’ by Danya Levy – TheDominion Post (8/27/12) – Prime Minister John Key has backed away from his comments about euthanasia, saying his language on the sensitive issue was “a bit sloppy”.

Key last week said euthanasia already happened in our hospitals – and if he was terminally ill, he would consider it.

The comment angered doctors who said euthanasia was never practised as it was the deliberate ending of life, and was illegal and unethical.

The suggestion could seriously damage the trust people had in hospital care of the terminally ill, doctors said.

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Rodney on Euthanasia – Kiwiblog (8/27/12) – Up until reading this account some years ago, I had been slightly anti-euthanasia. Coming from a medical family I did not like the idea of doctors ever having a role in ending life rather than preserving it. But I realised how selfish that preference was, when I read the awful choice the current law forced on people like Martin. No one should ever have been forced into having to make the choice he did.

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Skill levels better in palliative care by Teuila Fuatai – Bay of Plenty Times (8/29/12) – Legalising euthanasia could cut short people’s lives who may be unaware of advances in palliative care, a Tauranga doctor warns.

Waipuna Hospice chief executive Dr Richard Thurlow told the Bay of Plenty Times patients sometimes wished they had the option of physician-assisted suicide. But that was before they realised the options available with palliative care.

“The level of palliative care in the last seven years alone has developed hugely.

“The skills of the medics and the understanding and the knowledge of all the associated disciplines … has meant the level of care has improved dramatically.”

Dr Thurlow’s comments follow remarks by prime minister John Key on Newstalk ZB last week.

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Debate clouding hospice role by Imran Ali – The Northern Advocate (8/31/12) – The importance of easing the suffering of dying Northlanders is being lost in the debate on euthanasia, Northland hospice staff say.

Their comments followed remarks by Prime Minister John Key that a lot of euthanasia happened in hospitals and that if he was terminally ill he would want euthanasia legalised so doctors could “turn off the switch”.

Palliative care, for those affected by a life-limiting condition, can be provided by specialists or non-specialist staff such as GPs and community health teams.

Peter Bassett, general manager of Whangarei’s North Haven Hospice, said euthanasia was not happening in New Zealand hospitals but good palliative care was.

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RUSSIA

Euthanasia – luxury for the wealthy– pravada.ru (8/18/12) – The topic of euthanasia does not leave anyone indifferent. Voluntary withdrawal from life due to serious illness for some people is a grievous sin, for others – the only escape from suffering.

It should be noted that many critics of the law referred to its social injustice. Euthanasia is not cheap, which means that patients from poor families will not be able to die quickly and painlessly. However, it became clear that less wealthy Americans are not particularly inclined to interrupt their tortures with drugs. Euthanasia, according to recent studies in the U.S., attracts financially sound white people with good education.

According to The New York Times, the supporters of euthanasia do not choose it because of the pain, but because they want to control their death as well as they can control their lives.

“Likely, the practice of euthanasia in some form will be implemented in the world.  In Russia euthanasia is illegal, and I now fully agree with that, and not on logistical grounds, but because the meaning of medical practice is to provide life and the patient’s health, and the killing as a way to treat the pain may not be acceptable. There is no pain that cannot be managed. This practice may cause psychological pressure on the elderly, for example, because of financial reasons.

But since there is an issue, and the question arises about its implementation, it should not be the issue of the medical community. This may be a special procedure performed by some social workers. Of course, I would caution to call euthanasia of a seriously ill person a murder, because there is no offense if all procedures are followed.”

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SCOTLAND

It is time for politicians to take a more enlightened view of assisted dying– heraldscotland.com (8/25/12) – In June 2012, a significant development took place in Vancouver, when the Supreme Court ruled that the Canadian criminal code, which prohibits physician-assisted death, violated fundamental rights of equality, life and liberty. The wisdom lying behind that judgment is profound. Terminally ill individuals who experience intolerable suffering now have the opportunity to bring that legally and humanely to an end. The court was satisfied that commonly-advanced reasons for denying them relief, including the protection of the vulnerable and damage to the trust patients invest in doctors, could be properly answered, if that was allowed in highly constrained circumstances.

While it is widely recognised that Switzerland permits doctors to practise euthanasia and extends this to foreign nationals with the financial means (about £10,000) to avail themselves of that option, it is less well known that other jurisdictions, including Oregon and Washington in the US and the Netherlands, Belgium and Luxembourg in Europe, also take a more enlightened view of assisted dying than we do.

In 2011 MSPs in Holyrood rejected any change to the law concerning assistance at the end of life. However, in the near future Margo MacDonald will introduce a Bill again seeking to amend the legislation.

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SWITZERLAND

Assisted suicide firm Dignitas to sue Swiss police for reviving terminally ill woman who fell asleep during procedure by Martin Robinson in MailOnline (8/16/12) – The world’s foremost euthanasia clinic, Dignitas, is to sue the Swiss police after their officers tried to revive a terminally ill woman who fell asleep during an assisted suicide.

Police stopped the procedure near Zurich after the patient lost consciousness after only consuming half the drugs meant to kill her, and therefore officers assumed that her suicide attempt had failed.

The unnamed woman was meant to finish the lethal cocktail of barbiturates and police say their rules state that if a patient is still alive two hours after taking the drugs they will call an ambulance.

Following the intervention the woman in her 60s, who was suffering from a genetic disease and weighed only five stone, was rushed to hospital were she later died.

Under Swiss law, a state official – usually a police officer – must be present to monitor proceedings when an assisted suicide is being conducted.

And Dignitas now want the police to be prosecuted for ‘interfering in a legal assisted suicide’ and ‘abducting a patient’ during the incident on August 2.

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UNITED KINGDOM

Euthanasia and the Death Penalty: a dilemma by Andre Langlois – HuffPost Lifestyle UK (8/1/12) – I don’t believe the dilemma is inescapable. A similar argument can be made against other laws, such as motoring laws, and assisted dying is certainly about facilitating individual freedom. But when it comes to the state facilitating death, my opposition to the death penalty strikes an uneasy contrast with my support for assisted dying.

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Assisted dying debate: promoting patient choice – Kennedy-law.com article (8/8/12) – On 3 July 2012 the All Party Parliamentary Group on Choice at the End of Life (the APPG) in partnership with the charity, Dignity in Dying, published a consultation on a draft Bill entitled “Safeguarding Choice: A draft Assisted Dying Bill”. Whilst this draft Bill is not written (or sponsored) by a government department and is, therefore, unlikely to be taken forward as draft legislation in the near future, its publication provides the opportunity to engage in the assisted dying debate.

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There’ll be no happy ending for us… please just let my father die in peace by Sophie Goodchild, London Evening Standard (8/15/12) – The daughter of a man with “locked in” syndrome today made an emotional final plea for him to end his life peacefully.

Lauren Nicklinson, 25, said her severely disabled father Tony will have to starve himself to death unless doctors are allowed to help him die.

The High Court will reveal tomorrow whether the stroke victim, 58, has won his bid to challenge Britain’s euthanasia laws. He wants doctors to be able to end his life without fear of being sent to jail.

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Assisted suicide comment: euthanasia puts vulnerable at risk, argues Rev Dr Brendan McCarthy in The Telegraph (8/16/12) – It is a tragedy that Mr Nicklinson has suffered a stroke, resulting in ‘locked in syndrome’, but it would also be a tragedy if, in a desire to address his needs, others were placed at unjustifiable risk. Sometimes, even with a heavy heart, it is necessary to make a tough decision in order to protect those who most need protection.

That is, in part, the role of the state and the role of the law.

Rev Dr Brendan McCarthy is the National Adviser on medical ethics and health and social care policy to the Church of England’s Archbishops’ Council.

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Assisted suicide comment: the dying should have advice from professionals – The Telegraph (8/16/12) – Two cases of patients with locked-in syndrome, AM and Tony Nicklinson, were heard in the High Court in June, and the court will rule on both today. While these cases may appear similar on the surface; they are actually very different, and in fact challenge different laws.

Should AM succeed, doctors and patients will be clearer about what discussions they can and can’t have about end of life choices, and should Nicklinson win his case the current inflexibility of murder law will have to be addressed.

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UK denies right-to-die legal challenge by Maria Cheng, HuffPost Tech (8/16/12) – Britain’s High Court on Thursday rejected an attempt by a man who has locked-in syndrome to overturn the country’s euthanasia law by refusing to legally allow doctors to end his life.

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“Locked-in” sufferer’s challenge to ban on voluntary euthanasia fails in high court by Rosalind English, UK Human Rights Blog (8/16/12) – Lord Justice Toulson, sitting with Mrs Justice Royce and Mrs Justice Macur, has  handed down judgment in the case of Tony Nicklinson and that of another “locked-in” syndrome sufferer, “Martin”. On all the issues, they have deferred to parliament to take the necessary steps to address the problems created by the current law of murder and assisted suicide.

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U.K. court denies euthanasia requests from two men with locked-in syndrome,CBS News (8/16/12) – Tony Nicklinson, a man with “locked-in syndrome,” has been denied by a British court his wish to die from physician-assisted euthanasia.

Britain’s High Court on Thursday rejected Nicklinson’s and another man’s attempts to overturn the country’s euthanasia law by refusing to legally allow doctors to end his life.

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UK doctors ‘perform euthanasia’– top Dutch medic by Anna Holligan, BBC News Europe (8/16/12) – In the Netherlands euthanasia has been legal for a decade. Some Dutch medical experts say Tony Nicklinson’s case is a “textbook example” of why people should be given the right to decide when they die.

According to Dr Kruseman, “if the only possibility is death by euthanasia it’s the responsibility you have for your patient when they are experiencing unbearable suffering”.

Commenting on the doctor’s claim, a spokesperson for the British Medical Association (BMA) said: “We are opposed to the legalisation of assisted dying and we are not lobbying for any change in the law in the UK.

“Assisted dying is illegal in the UK, so doctors are not permitted to carry out euthanasia.”

The Royal Dutch Medical Association (KNMG) says that in the absence of an open debate the practice will go on, but in a covert and unregulated manner.

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RCP comment on assisted dying case (8/16/12) – Commenting on today’s judgment in the Tony Nicklinson assisted dying case, Professor John Saunders, Chair of the RCP’s Ethics Committee, said:

‘The Royal College of Physicians does not support a change in the law on assisted dying. It remains illegal for doctors to intentionally and deliberately terminate the life of someone who is not terminally ill. A survey of RCP fellows and members in 2006 showed that doctors were not in favour of a change in the law to allow them to do this.

‘A change in the law would also have severe implications for the way society views disabled people.’

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Assisted dying: the harm in helping by Sarah Wollaston, guardian.co.uk (8/17/12) – t isn’t just the religious lobby that is opposed to a change in the law to allow assisted suicide. I have no faith banner to raise, and as a former doctor I know there are conditions for which I might at some point wish to end my life. Despite this, I don’t believe I should have a right to make a doctor complicit in that decision.

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Allow medically assisted dying on the grounds of mercy, and soon it will be driven by convenience or greedby Steve Doughty, Mail Online (8/17/12) – One of the peculiar horrors of learning about the life of Mr Nicklinson is imagining what it would be like yourself to be entirely helpless for six hours every evening until a carer comes to wash you. Or to eat only soft mashed up food, and to drink only through a tube inserted into your stomach.And to know it could happen to any one of us, anytime.That gives Mr Nicklinson’s plea to die a universal relevance.
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Dying with dignity debate: Should doctors be allowed to help Tony Nicklinson end his life? Mirror News (8/17/12) – Below are the arguments for and against allowing doctors to end his life without fear of prosecution:
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I would help a relative on the final journey by Vickie Woods – The Telegraph (8/17/12) – We need to have a conversation about assisted suicide,” one of my oldest friends told me last year. Oh, crikey. It was dark and filthy weather and I was driving her to an appointment with her GP, so I was furious with myself for mounting the pavement in shock at what she’d said. After which she clung silently to the car door and I drove very, very concentratedly.

I wasn’t shocked that thoughts of assisted suicide had floated into her mind. Because it floats into my mind every time there’s another heartbreak landmark legal battle trumpeting through the newspaper. Nor was I shocked that she’d addressed her thoughts to me. We are both of an age where assisted suicide is something you have to take a view on, like early retirement or selling up and trading down.

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Analysis: Britain’s options for legalizing euthanasia by Louise Bazalgette, politics.co.uk (8/20/12) – In their ruling, the judges were clear that: “It is not for the court to decide whether the law about assisted dying should be changed and, if so, what safeguards should be put in place. Under our system of government these are matters for parliament to decide, representing society as a whole, after parliamentary scrutiny, and not for the court on the facts of an individual case or cases.”

This is not surprising as previous legal precedents, such as Diane Pretty’s case at the European court of human rights (ECHR) in 2002, have confirmed that the legal position of assisted dying is a matter for national law and cannot simply be overturned on the basis that it infringes an individual’s human rights.

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Locked-in man devastated at ruling– Cambridge-news.co.uk (8/20/12) – Lord Justice Toulson, Mr Justice Royce and Mrs Justice Macur, while expressing deep sympathy for their plight, unanimously agreed that it would be wrong for the court to depart from the long-established legal position that “voluntary euthanasia is murder, however understandable the motives may be”.

Refusing the stricken men judicial review, they agreed that the current law did not breach human rights and it was for Parliament, not the courts, to decide whether it should be changed. Any changes would need “the most carefully structured safeguards which only Parliament can deliver”.

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Assisted dying: simple, neat – and wrong – spked-online.com (8/20/12) – At first, Tony Nicklinson’s case seems obvious. Having suffered a massive stroke in 2005, Nicklinson – a former civil engineer who once enjoyed an active lifestyle – was left almost completely paralysed, in a state referred to as ‘locked-in syndrome’. He can only communicate by blinking or using limited head movement. He refers to his life now as ‘dull, miserable, demeaning, undignified and intolerable’. Nicklinson would like the courts to offer immunity from prosecution if, in the future, he asked a doctor to kill him. Last week, the High Court in London ruled against his request.

As many observers agreed, it is his life and who are we – or the courts or parliament – to tell him what to do with it? We all have the right to commit suicide but those with locked-in syndrome need assistance. Nicklinson is quite visibly suffering and has been consistent in his wish to die, so why not allow him to do so?

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Sympathy for one man must not change Britain’s law on assisted dying by Sameer Mallick – opendemocracy.net (8/20/12) – Assisted dying is illegal in the UK – a stance supported by the majority of the medical profession. In the face of harrowing cases such as that of Tony Nicklinson, it is important to remember that unwillingness to deviate from this law is not the symptom of a narrow prejudice but the result of a long and informed debate.

Perhaps a good starting point is to clarify the jargon, as the terms assisted dying, euthanasia and assisted suicide seem to be used interchangeably by mainstream media. The term assisted suicide describes the participation of an individual (usually a healthcare professional) helping a patient end their life. However the onus is on the patient to perform the final act of killing, such as self administering a lethal injection. This differs from euthanasia in which the ‘assistant’ performs the final act which ends a patient’s life. Both actions come under the overarching term known as assisted dying. Whilst the focus of lobby groups has been to legalise assisted suicide in the UK,[6] the case of Tony Nicklinson is one in which, if successful, would have gone one step further and legalised euthanasia.

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Coffee House Chat (UK) – Assisted suicide – your thoughts –  thoughts from everyday people

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Practical Ethics – Euthanasia and Human Rights – University of Oxford (8/21/12)

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Locked in to euthanasia – mercatornet.com (8/21/12) – There can be no more difficult case for dispassionate discussion than the fate of Tony Nicklinson, a totally paralysed British man who wants to end his life. Last week the UK High Court denied his request for euthanasia. (video)

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In Britain, ongoing struggles over laws regarding euthanasia by Simon Caldwell, Catholic News Service (8/22/12) – The Catholic Church, not wishing to see the debate presented as a struggle between faith and “progress,” is generally taking a back seat, but is listed as one among dozens of medical, disabled rights and religious charities that form the broad coalition of the Care Not Killing alliance.

Catholic doctors are more outspoken than church leaders, however, and in recent months some have taken huge risks with their careers to warn the public that a system designed to care for people in their final hours is operating effectively as a euthanasia pathway.

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Paralyzed UK man dies after losing assisted-suicide case(8/22/12) – (video) A British man suffering from “locked-in syndrome” who fought a long legal battle over assisted suicide died Wednesday, his family said.Tony Nicklinson, 58, had been refusing food since last week, contracted pneumonia over the weekend, and “went downhill rapidly,” said his lawyer, Saimo Chahal.”Before he died, he asked us to tweet: ‘Goodbye world the time has come, I had some fun,'” his Twitter account said.
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Melksham locked in syndrome sufferer Tony Nicklinson dies at home after contracting pneumonia by Will Frampton – Wiltshire Times (8/22/12) – Locked in syndrome sufferer Tony Nicklinson has died, his family have said.They said the 58-year-old died at his home in Melksham of natural causes at 10am.His wife Jane said on Twitter: “I have lost the love of my life but he suffers no more.”Last week he learnt he had lost his appeal against a decision to forbid him from assisted suicide.He was left paralysed by a catastrophic stroke while on a business trip to Athens in 2005.Mr Nicklinson’s lawyer Saimo Chahal Family said: “I am extremely sad to tell you that I received a call at 10.45am from Jane Nicklinson to inform me that her husband Tony died peacefully at home at about 10am this morning.
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Tony Nicklinson: fight to die with dignity “will not be forgotten” by Sarah Boseley – guardian.co.uk (8/22/12) – At 10am on Wednesday, Tony Nicklinsonfinally got what he wanted. In his Wiltshire home, surrounded by those he loved, he slipped into a peaceful death.Less than a week before, millions had seen him outside the high court in his wheelchair, racked with sobs. His wife, Jane, spoke to the TV cameras on his behalf, quietly explaining his distress at the refusal of the court to give him the assurance he had requested: that anyone who helped him to kill himself would not be charged with murder.Once she paused, to wipe away his tears. Even those who disagreed with him, including the judges, were deeply moved.
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BHA mourns Tony Nicklinson, campaigner for assisted dying – British Humanist Assn. (8/22/12) – Andrew Copson, BHA Chief Executive, commented, ‘Tony Nicklinson’s campaign was inspirational and his fight for the right of mentally competent adults to choose to end their lives woth medical assistance was a fight that we at the BHA very much supported. We will continue to campaign for the legalisation of assisred suicide, as will many others – their determination renewed by his example.’
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We need the right to a dignified death. But we need to acknowledge the risks involved, as well. by Tom Chivers – The Telegraph (8/22/12) – The trouble with us as a species is that we’re not very good at complexity and nuance. If we think something’s bad, we think it’s all bad; if we think something’s good, we think it’s all good. It’s been demonstrated that if we think something has plenty of benefits, we tend to subconsciously downplay its risks; likewise, if we think it’s risky, we’ll tend to assume it’s got no benefits.
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Paralyzed UK man dies after losing assisted-suicide case – CNN (8/23/12) – A British man suffering from “locked-in syndrome” who fought a long legal battle over assisted suicide died Wednesday, his family said.Tony Nicklinson, 58, had been refusing food since last week, contracted pneumonia over the weekend, and “went downhill rapidly,” said his lawyer, Saimo Chahal.”Before he died, he asked us to tweet: ‘Goodbye world the time has come, I had some fun,'” his Twitter account said.
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Widow backs assisted suicide campaign after husband’s death– Maidenhead Advertiser (8/23/12) – A widow whose husband died alone because he feared the consequences for her if she helped end his life has backed calls to legalise assisted suicide.Sheila King has added her voice to the campaign to change the law as she believes her husband Stephen would still be alive today if he had been granted the right to decide when to end his life.Instead she faced the heartbreak of finding his body hanging in the garage of their home in Bedford Close, Maidenhead, in April.”Had my husband been able to choose when to end his life he would have enjoyed a longer and happier one,” she said.”I just want to do something to help other people so they don’t have to be in that situation.”
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Pro-lifers to host European euthanasia meeting in Scotland– The Christian Institute (8/23/12) – Pro-life experts from around the world are gathering in Edinburgh next month for a symposium on euthanasia and assisted suicide.The Care Not Killing Alliance, which campaigns against attempts to weaken end-of-life laws across the UK, is hosting the meeting.The group says anyone who is “committed to opposing euthanasia and assisted suicide” is welcome.
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How an extraordinary day with Tony Nicklinson changed my views on right-to-die by Peter Stanford – The Telegraph (8/24/12) – There aren’t many meetings that change your instinctive notions of what is right and wrong, but the day I spent with Tony and Jane Nicklinson was one. It may be because I am a lifelong Catholic, for better or worse, and my Church is so unbending in insisting that God gives and takes away life. Or that I have spent 20 years as chairman of a disability charity and have seen too often the casual mistreatment of those whom society once labelled “in-valid”. Or simply that I had never previously had the debate about the right-to-die spelt out so uncompromisingly for me by someone in the midst of the issue.

But if I went into the Nicklinsons’ specially adapted bungalow in the Wiltshire town of Melksham fundamentally opposed to any concessions on euthanasia, I emerged with my arguments demolished. And this by a man who had lost the power of speech.

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Tony Nicklinson’s legacy: his case will save lives by Joan Smith – The Independent (8/26/12) – When Tony Nicklinson died on Wednesday, there was widespread sympathy for a man who had been paralysed from the neck down. The previous week he had wept in front of TV cameras, devastated by the High Court’s refusal to give him an assurance that anyone who helped him to die would not face a charge of murder. Photographs of Mr Nicklinson before his illness, looking healthy and tanned, offered a painful contrast with the helplessness he endured after a massive stroke in 2005. The case has redoubled calls for a change in the law on assisted dying.
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The ban on euthanasia is to protect us from ourselves by Peter Mullen – The Telegraph (8/28/12) – The debate about euthanasia is being obscured by the use of pernicious euphemisms. Let’s come clean and speak plainly. “The doctor’s right to end a life” means the doctor has the right to kill someone. Whichever way you look at this, it means a licence to murder. Those who campaign for euthanasia want a change in the law so that this sort of killing – for that’s what it is – should no longer be against the law. This has far-reaching consequences, for it means that, in some cases, murder will no longer be murder.
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Tony Nicklinson’s widow in campaign pledge– guardian.co.uk (8/28/12) – Jane Nicklinson, who, along with daughters Lauren and Beth, had backed her husband’s legal bid, echoed other right-to-die campaigners’ calls for Mr Nicklinson’s memory to live on through a continued battle to change the law that prevented doctors ending his life.Speaking to the BBC, Mrs Nicklinson said: “This is certainly not the end of the campaign. I do hope that someone takes it up. Even though we didn’t win, all the hard work for the case has been done. I hope at some point someone will come forward and carry on with what Tony started.”I think we always knew the chances of winning at this stage were slim – possible but slim – and we’d never been told anything different so we were prepared for it.”
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Tony Nicklinson Right-to-Die: Locked-in Sufferer’s Widow Urges Change in Law– The Huffington Post-UK (8/28/12) – Tony Nicklinson’s widow has said she hopes people will continue to campaign for a change in the law on assisted dying following her husband’s death.58-year-old Mr Nicklinson suffered from locked-in syndrome and died last week after losing a landmark High Court right-to-die case. He had been refusing food in the days leading up to his death and had contracted pneumonia.Following the decision he was visibly distressed, sobbing in front of cameras while Jane Nicklinson told reporters the ruling had left him “heartbroken.”
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Bishop urges caution after Nicklinson assisted dying case– Christian Concern (8/29/12) – Bishop Michael Nazir-Ali has warned that “moral chaos” will ensue if the Christian basis for the laws protecting life in the UK is rejected.He made the comments after a controversial article by former Catholic Herald editor, Peter Stanford, was published in the Telegraph last week (24 August).Stanford said that a visit to Tony Nicklinson’s home “changed his views” on the right-to-die issue.
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I hope Tony’s death will not end the fight– This is Bath (8/29/12) – The widow of ‘right-to-die’ campaigner Tony Nicklinson has said she hopes the battle to change the law on assisted dying will continue even without the brave Melksham man being around to fight it.Jane Nicklinson said she hoped ‘someone will come forward’ to continue the challenge to British law to allow those with ‘locked-in syndrome’, which left her husband reliant on others for everything, to be legally killed to end their suffering.
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Unitarians launch consultation on assisted dying– ekklesia.co.uk (8/30/12) – British Unitarians have begun a six-month consultation on the issue of assisted dying. By exploring a range of views on the issue, they say they are bucking the trend of faith groups, many of whom have taken a strong stand against assisted dying.The General Assembly of Unitarian and Free Christian Churches will conduct the consultation in the run-up to their next annual meeting in April. A discussion pack is being sent out to congregations to assist them in their deliberations.
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Bristol to host Green Party’s right-to-die debate– Bristol247.com (8/31/12) – A debate on changing the law to allow people such as right-to-die campaigner Tony Nicklinson to seek help to end their lives will take place next weekend in Bristol at the Green Party’s autumn conference.The party said it aimed to “provide the right to an assisted death within a rigorous framework of regulation, and in the context of the availability of the highest level of palliative care”.After looking at how assisted dying laws are formulated in the Netherlands, Switzerland and the USA, the debate will focus on presenting a solution that could gain the support of the public.
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Melksham man: Tony has shown law must change by Will Frampton – Wiltshire Times(8/31/12) –

Tony Nicklinson with wife Jane and daughters Beth and Lauren after the court decision Tony Nicklinson with wife Jane and daughters Beth and Lauren after the court decision.

Labour peer Lord Joel Joffe has joined other assisted dying campaigners in praising Melksham locked-in syndrome sufferer Tony Nicklinson.

Lord Joffe said his ‘incredible courage’ would eventually lead to a change in the law, under which those who help people end their lives currently face prosecution for murder.

“I think Tony Nicklinson’s incredible courage and determination has persuaded society the law must be changed to prevent terrible suffering,” said the peer.

“Tony correctly felt there needed to be a change in the law to permit him to end his life, and it is clear we do need a change in the law – the law must seek to find such a solution.

“MPs are not listening to society, their job is to take account of the views of their constituents and 80 per cent of the public is in favour of a change in the law.”

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Assisted Death Debate – News from July 2012

End-of-Life discussions about Assisted Dying/Suicide/Euthanasia in news articles, blogs, videos from the left, right and center during the month of July 2012. This is a place to find out what’s being talked about around the world as we sort out this highly emotional and controversial issue.

Become informed, open your mind,  join in the discussions. Our leaders need to know what people are thinking and we need to know what our leaders are considering in terms of laws. These are conversations we all need to have!

BLOGS

What is your opinion of assisted suicide for the terminally ill? Live Poll

Living with Dying: Major Myths about Death With Dignity by Melissa Barber (2/27/12)

the Front Door to Healthcare – Coming to a hospital near you: physician-assisted suicide  (7/2/12)

Salon – Where’s our right to die? by Santiago Wills (7/3/12)

HuffPost-Religion – A Scientific Honoring of Death by Rev. Michael Dowd (7/8/12)

Medical Talk – Ethics: Physician Assisted Suicide (7/9/12)

Secondhand Smoke – Swiss proves no brakes assisted suicide by Wesley J. Smith (7/9/12)

MedPageToday.com – Take Docs Out of Assisted Suicide Equation? by Emily P. Walker (7/11/12)

National Right to Life News Today – Pro-Euthanasia Forces at Work at Home and Abroad: The latest in the battle over assisting suicide by Jennifer Popik, J.D. (7/11/12)

The Economist – Time to Die (7/12/12)

White Coat Notes – Chelsea Conaboy: Assisted dying, without the doctor? Ethicist says physicians can help without prescribing lethal dose (7/12/12)

New Europe Post online – Dying in Court by Peter Singer (7/12/12)

The Economist – The quality of death: Grim reapings (7/15/12)

Compassion & Choices – The Evolving State of Physician-Assisted Suicide by Jamie Joyce, The Atlantic 7/16/12

David C. Stolinsky Blog – Coming Soon: A “Central Mechanism” for Assisted Dying (7/16/12)

Girl with a Cane – Changes to laws in Canada Regarding Physician-Assisted Suicide (7/19/12)

Playing the Devil’s Advocate – An Intriguing Objection to Euthanasia for Old White People (7/19/12)

BioEthics @ TIU – Physicians’ role in assisted dying by Steve Phillips (7/19/12)

Death with Dignity National Center – The Need for Carefully Crafted Death with Dignity Laws by Melissa Barber (7/19/12)

Secondhand Smoke – EU court won’t impose euthanasia by Wesley J. Smith (7/19/12)

LifeNews – 14% of all Dutch deaths involve euthanasia, assisted suicide by Wesley J. Smith (7/19/12)

Secondhand Smoke – Nitschke doubles down in Death-on-Demand by Wesley J. Smith 7/20/12

National Right to Life News Today – Right-to-Die movement has split into two warring camps, says Nitschke by Michael Cook (7/20/12)

LifeNews.com – Pro-Euthanasia movement splitting into two warring factions by Dr. Peter Saunders 7/20/12

emtcity.com – Physician Assisted Suicide (7/22/12)

National Right to Life News Today – EU court refuses to impose euthanasia by Paul Russell (7/23/12)

Policymic – Assisted suicide debate: Canada raises controversy after striking down ban by Lowell McDonald (7/25/12)

Not Dead Yet – Assisted suicide laws violate the ADA by Diane Coleman (7/25/12)

The Daily Caller – Death Panels on Steroids by Rita L. Marker & Wesley J. Smith of The Patients Rights Council (7/25/12)

The Tea Party Economist – Assisted Dying: The Death Panels Are Coming  by Gary North (7/26/12)

Secondhand Smoke – The Dutch Cook the Euthanasia Books by Wesley J. Smith (7/26/12)

LifeNews.com – Euthanasia backers now want assisted suicide without doctors by Wesley J.Smith (7/26/12)

Fr. Z’s Blog – Obamacare = Euthanasia (7/27/12)

White Coat Notes – Dr. Barbara Rockett: Physician-assisted suicide ‘in direct conflict’ with doctor’s role (7/31/12)

White Coat Notes – Dr. Marcia Angell: Ballot question to allow physician aid in dying respects patient wishes (7/31/12)

Sociology Lens – Physician-assisted suicide: A topic of growing importance by Candace Smith (7/31/12)

Euthanasia Prevention Coalition – Assisted Suicide: U.S. Overview by Margaret Dore (7/31/12)

JOURNAL ARTICLES

Reasons Why physicians do not have discussion about poor prognosis, why it matters, and what can be improved by Jennifer W. Mack and Thomas J. Smith in Journal of Clinical Oncology (7/2/12)

Redefining Physician’s Role in Assisted Dying by Julian J.Z. Prokopetz, BA and Lisa Soleymani Lehmann, MD, PhD in The New England Journal of Medicine (7/18/12)

VIDEOS

Euthanasia Debate  (6/30/12)
‘Canadians must act NOW against assisted suicide,’ says anti-euthanasia leader by Jean McCarthy – LifeSiteNews.com 7/3/12
Debating Euthanasia – Jennifer Tyron with panel 7/5/12 – Follow up to: Taking Mercy (3/21/12)
Aja Riggs, cancer patient, joins aid in dying lawsuit (New Mexico) (7/9/12)
Euthanasia debate with Philip Nitschke and Bernadette Tobin (7/20/12)
Sir Terry Pratchett on assisted dying (7/26/12)

BROADCASTS

Interview with Dr. Lisa Lehmann on the physician’s role in assisted dying for terminally ill patients (Director of the Center for Bioethics at Brigham and Women’s Hospital) – (7/12/12)

AARP senior end of life decisions by John Wright (7/20/12)

The Jefferson Exchange – Compassion & Choices: Oregon’s assisted-suicide law presents a number of hurdles for terminal patients to overcome to end their own lives. The group Compassion & Choices of Oregon works with the patients to overcome the hurdles.  Compassion & Choices provides access to a network of volunteers and professionals with experience in implementing Oregon’s Death With Dignity Act.  (7/30/12)

UNITED STATES

Central mechanism would remove physician from assisted-dying process by Sarah Guy( 7/24/12) – The development of a central state or federal mechanism in the USA that would confirm the authenticity and eligibility of terminally ill patients’ requests for death, dispense medication, and monitor demand and use, could remove physicians from the assisted dying process, say researchers.

Canadians and Britons would allow euthanasia under some conditions – Respondents in US are more likely to question whether doctor-assisted suicide should be permitted at all – Polls by country

Choice is an Illusion: A website opposing assisted suicide and euthanasia – many states

(News this month from California, Massachusetts, Montana, New Jersey, New Mexico, Oregon, Rhode Island, Texas, Wisconsin)

CALIFORNIA

Assisted suicide: compassion or crime? by Kate McGinty, mydesert.com (7/29/12)

MASSACHUSETTS

By whatever name, dignity by Lewis Cohen, MD, gazettenet.com (7/6/12)
Distilled to its essence, the ballot asks: Should dying people have the right to physician-assisted suicide?

In Massachusetts, during the months leading up to Election Day, the hierarchy of the Roman Catholic Church, pro-life groups, conservative politicians and segments of the disability community will unite to wage a fierce campaign.

Be prepared to hear from other opposition spokespersons that the law will target society’s most vulnerable populations. Get ready for fear-mongering to rival the rhetoric many of these same individuals have previously offered in their opposition to same-sex marriage, abortion and the right to choose birth control. We are going to hear claims that death with dignity sanctions elder abuse.

Do not expect the opposition’s leaders to cite the annual statistical report which the Oregon Health Authority publishes online. The 2011 data challenge all of these theoretical worries and concerns.

There is no factual basis for most of the arguments that will be offered, but they will make for thrilling election year drama.

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Death with Dignoty Act on November Ballot – abc40news, Springfield MA  (7/11/12) – w/video – Dr. Lewis Cohen, a local psychiatrist and professor at Tufts University School of Medicine, is one of the founding members of the petition.

The Death With Dignity Act is one of three initiatives that will be on the November ballot. If passed by voters the law would allow terminally ill patients to end their own life. “There are few people who we really can’t help with their suffering,” said Dr. Lewis Cohen.
“I can tell you as a psychiatrist a big piece of it is that people have to have the capacity to make this decision and they have to demonstrate it,” said Dr. Cohen.
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Beware slippery slope of ‘doctor-prescribed suicide’ – Letter to The Herald News (7/15/12) – One of the questions on the ballot in November will be legalization of assisted suicide, a.k.a Death With Dignity, or more accurately known as doctor-prescribed suicide.
There is no dignity in suicide. It is a terrible tragedy. If this initiative passes, it will shift our approach toward the sick and dying in this state from one of compassion and care to one of encouraging self-destruction. Doctor-prescribed suicide is medical abandonment.  A doctor will not have to be present when the patient takes the lethal drugs.
The Massachusetts Medical Society voted last December to reaffirm its opposition to physician-assisted suicide.
Life is the most basic gift from God, a gift which is entrusted to our care, not that we have control over it.
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The Evolving state of physician-assisted suicide by Jaime Joyce, theAtlantic, 7/16/12 – Should terminally ill patients have the right to kill themselves? Voters in Massachusetts will soon decide. Last Wednesday, the Secretary of the Commonwealth announced that on November 6, 2012, when Bay State voters go to the polls to pick the next President, they will also have their say on a ballot measure called the Death with Dignity Act. If passed, the law would make Massachusetts the third state to give adults diagnosed with six months or less to live the option to end their lives using a lethal dose of doctor-prescribed medication.

A study released by the Health Research and Education Trust shows that Americans are living longer lives than ever before. As a result, more individuals and families will face difficult questions about end-of-life care. In 2011, the oldest Baby Boomers turned 65. By 2030, the number of Boomers between 66 and 84 years old will climb to 61 million, and six out of 10 will be managing chronic health conditions. For the elderly and others facing terminal illness, doctors have numerous ways to prolong life. Palliative and hospice care are available to help patients find peace and comfort in their final days. But there are some people who want another option, which is the right to end suffering by taking their own life at a time and place of their choosing.
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Push for “death with dignity” in Massachusetts picks up steam by Kevin B. O’Reilly, amednews.com (7/16/12) – Early polling results: Sixty percent of Massachusetts voters support “allowing people who are dying to legally obtain medication that they could use to end their lives,” according to a Western New England University Polling Institute survey of 504 voters conducted at the end of May. Twenty-nine percent said they opposed the idea, and 11% declined to answer the question.

“This statute has worked as intended in both Oregon and Washington,” Crawford said. “The scare tactics the opposition uses simply haven’t come to life.”
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Assisted suicide backers confident they’ll win in Massachusettes – LifeNews.com( 7/27/12) – Massachusetts is the latest battleground over euthanasia with an initiative on the ballot in November to adopt a statute similar to those in Oregon and Washington, which allow physicians to prescribe suicide for their patients. As in Oregon and Washington, the Massachusetts proposal states assisted suicide would be legal for residents of the state in cases where a doctor has determined the patient has less than six months to live. However, the examples of the two Western states have shown that those safeguards do not work.
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MONTANA

“Does the Board really want to put itself in the embarrassing position of overstepping its authority by condoning this procedure?” Montanans against assisted suicide and for living with dignity (7/18/12) – I am having trouble understanding why our Montana Board of Medical Examiners would step out on a limb and seemingly promote, or at least encourage physicians to go along with a procedure, Physician Assisted Suicide for the following reasons:
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NEW JERSEY

Racial differences in end-of-life planning: Why don’t blacks and Latinos prepare for the inevitable?– Rutgers (7/20/12) – Both religious beliefs and cultural attitudes toward receiving support from family members accounted for the gap between white subjects and minorities, said Carr.
Older blacks are more likely to believe that God controls the time and circumstance of someone’s death and that it’s inappropriate to interfere.
“Their thinking is, ‘this is not our decision to mess around with,” Carr said.
For Latinos, the starkest contrast involved entrusting one particular family member with durable power of attorney. Only four percent of Latinos chose a relative to voice decisions for the incapacitated patient. The likely explanation is that if you grew up in a culture that’s close-knit, you make decisions as a family unit, you’re not going to choose one person,’’ she said.
In both black and Latino families, she said, there is evidence that people are more likely to view caring for ill or aging members as the norm, whereas white subjects had a greater fear of “burdening’’ family with their illness.
Because blacks especially have higher rates of illness, shorter life spans and less access to preventive care, it’s especially important for them to discuss what kind of treatment they would want in the event of a terminal illness and what family members’ roles would be, Carr said.
(more)

New Jersey Euthanasia Laws

NEW MEXICO

Doctors, patient challenge New Mexico assisted suicide ban by Diane Carman, healthpolicysolutions.org (7/11/120 – The question before the court in New Mexico is absurdly simple and yet impossibly complex. What is the meaning of “assisting suicide”?
If a terminally-ill patient refuses a ventilator or a feeding tube and the physician yields to that decision, is that assisting suicide? If the patient is in excruciating pain and requests total sedation and no nutrition or fluids, can the doctor be held accountable for his death? What if the patient seeks a prescription from her physician so that when the pain of dying is overwhelming she can seek the ultimate relief on her own?
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Death with Dignity? More like war on New Mexico’s elderly! by Anna Maria Hoffman (7/16/12) – Currently, Doctors Aroop Mangalik and Katherine Morris, along with cancer patient Aja Riggs, are challenging New Mexico’s pro-life ban on assisted suicide in court. They ultimately want to prove that their loophole “aid in dying” argument—giving conscious terminally ill patients lethal medicine to die—is not assisted suicide. In their view, New Mexico’s assisted suicide ban does not take advanced terminal illness treatment into account and does not bar physicians from practicing “aid in dying” procedures. Looks like these plaintiffs are circumventing the state’s law to impose their pro-death will through court.
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NDY quoted in article on New Mexico assisted suicide case by Diane Coleman of Not Dead Yet (7/17/12) – Throughout the 1980’s and across the country, courts repeatedly and unequivocally answered “no” (i.e. no problem) to the first two questions, but Compassion and Choices (C&C) often raises the specter of being hooked to unwanted tubes and forced to endure unwanted medical treatments when advocating for something completely different than the well established right to refuse treatment.  Despite nearly 25 years of widespread public education about using advance directives to refuse unwanted treatment, C&C counts on people to forget these facts and conflate the issues.  C&C is pushing for the term “aid in dying” to include not only refusing treatment, palliative care, and hospice, but also assisted suicide, rolling it all into one focus group tested phrase.
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OREGON

Assisted Dying: Experts Debate Doctor’s Roleby Katie Moisse, abcnews.com( 7/13/12) – Peggy Sutherland was ready to die. The morphine oozing from a pump in her spine was no match for the pain of lung cancer, which had evaded treatment and invaded her ribs.

“She needed so much morphine it would have rendered her basically unconscious,” said Sutherland’s daughter, Julie McMurchie, who lives in Portland, Ore. “She was just kind of done.”

Sutherland, 68, decided to use Oregon’s “Death With Dignity Act,” which allows terminally-ill residents to end their lives after a 15-day requisite waiting period by self-administering a lethal prescription drug.

“Her doctor wrote the prescription and met my husband and me at the pharmacy on the 15th day,” said McMurchie, recalling how her mother “didn’t want to wait,” she said. “Then he came back to the house, and he stayed with us until her heart stopped beating.”

But not all doctors are on board with the law. In the 15 years since Oregon legalized physician-assisted dying, only Washington and Montana have followed suit, a resistance some experts blame on the medical community.
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RHODE  ISLAND

Rhode Island Euthanasia Laws

TEXAS

Houston man charged in wife’s assisted suicide by Philip Caulfield – NY Daily News (7/3/12) – Her husband, Mark Kelly, 47, reported his wife’s death, and admitted to police that he helped her kill herself because the couple was having financial problems.

Kelly was charged with aiding suicide, a state jail felony. He was being held on $2,000 bail and could get up to two years in prison if convicted.

WISCONSIN

Bishops urge against use of Provider Orders for Life-Sustaining Treatment (7/25/12) – The Roman Catholic bishops of Wisconsin recently expressed concern for “Upholding the Dignity of Human Life” in a statement warning against the use of Physician (or Provider) Orders for Life-Sustaining Treatment (POLST).
(more)

Wisconsin Bishops warn against POLST end of care document by Jean McCarthy – LifeSiteNews.com (7/26/12) –
In a statement issued yesterday, the Roman Catholic bishops of Wisconsin are warning against the end of life care document called Physician (or Provider) Orders for Life-Sustaining Treatment (POLST).  The bishops are concerned that use of this document could lead to acts of euthanasia.
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INTERNATIONAL

(News this month from Australia, Canada, China, France, Germany, India, The Netherlands, New Zealand, South Africa, Switzerland, Trinidad, United Kingdom)

AUSTRALIA

Euthanasia debate heating up in Tasmania by Alex Schadenberg, LifeSiteNews 7/2/12 – The euthanasia issue is heating up in Tasmania. The Tasmanian Parliament has debated euthanasia on several occasions and over the years it has had two inquiries into the feasibility of legalizing euthanasia with both enquiries deciding against legalization.

While in Tasmania, the big issue that the people shared with me was the crisis in healthcare that was occurring on the Island.

The Tasmanian people were very concerned that the Greens and Labor leaders are pushing euthanasia again to achieve cost savings in healthcare. Whether this is true or not, it should be noted that when the pressure to cut the cost of healthcare is mixed with euthanasia, that the pressure to die will soon outweigh the will to live.
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Opposition to relentless push for euthanasia legalization in Australia by Jason Rushton, LifeSiteNews.com (7/3/12) – More than 19 bills to legalise euthanasia have been introduced into Australian parliaments since 2002.

In the current South Australian parliament, a voluntary euthanasia bill has been introduced on five separate occasions, the latest one being defeated 22-20 as recently as June 15 of this year.
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Q&A with Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, and Labour MP Maryan Street (7/1/12)
Nitschke to establish euthanasia clinic in Tasmania, if euthanasia becomes legal by Alex Schadenberg, executive director Euthanasia Prevention Coalition, National Right to Life News Today (7/4/12) – Today I had the opportunity to speak to members of the Tasmanian parliament about why it is not safe to legalize euthanasia or assisted suicide. In response to a question from a member of the Tasmanian parliament, I reminded them that Philip Nitschke had already promised to establish a euthanasia clinic in Tasmania, if they legalize euthanasia.
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Is it possible to have safe, legal and rare euthanasia?  by Dr. Pravin Thevathasan, National Right to Life News Today (7/4/12) – A recent press release from the British Medical Journal states: “The BMJ supports a call from leading UK medical bodies to stop opposing assisted dying for terminally ill, mentally competent adults. Healthcare Professionals for Assisted Dying (HPAD) wants the British Medical Association and royal colleges to move their position from opposition to neutrality.”
It was an extraordinary failure of judgement on the part of what is probably the world’s most prestigious medical journal.
(more)

Spreading the anti-euthanasia message down under by Alex Schadenberg, LifeSiteNews.com 7/6/12 – There were more than 400 people who came to the Life Dinner to hear my talk in Melbourne.

Attending the Life Dinner were several political leaders including The Hon Kevin Andrews MP (Liberal) who in 1996, steered through the federal parliament the legislation that overturned the Northern Territories euthanasia legislation.

Hon. Kevin Andrews informed me that politics is not only the art of the possible, but a good plan creates possibilities and can be implemented. The Andrews bill accomplished what was first perceived to be impossible.
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CANADA

Is euthanasia legalized murder? Dutch doctors have gone from fighting death to administering it by Anne McTavish, TroyMedia.com (7/3/12) – Carter v. Canada (Attorney General) is a hard case, and it’s bad law. It’s about people with serious, debilitating, terminal illnesses who want doctors to kill them. It’s not just that they want to die, it’s that they want to die later and to have someone else do it in a way that won’t hurt.

The plaintiffs and Madam Justice Smith focused on the seriously ill people and their situation. I want to focus on the doctors and the rest of us who will be harmed if this decision becomes law.
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Let terminally ill choose: One writer’s eloquence changed my mind about assisted suicide by Naomi Lakritz in The Edmunton Journal (7/3/12) – … that’s not what this is about. We’re not talking about fomenting a Jack Kevorkianlike ghoulishness among physicians. This is not about doctors rushing in with blood lust in their eyes, ready to knock off any patient who gives them the nod – or even a patient who doesn’t. It’s not about doctors making decisions for patients; it’s about patients making decisions for themselves.
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Choosing Death: We have to talk about it in thespec.com, editorial (7/3/12) – Canada is inching closer and closer to a national discussion about assisted suicide. And it’s about time.
In its most recent edition, the Canadian Medical Association Journal is calling for a Canada-wide debate. Circumstances are pushing the nation in that direction: In Quebec, the Dying with Dignity Commission (an all-party group drawn from the National Assembly) recently issued a comprehensive report suggesting, in part, that doctors who help a terminally ill patient die by suicide not be charged criminally. And a judge in the British Columbia Supreme Court in June struck down laws banning doctor-assisted suicide as unconstitutional, ruling on the case of a B.C. woman who has Lou Gehrig’s Disease.
…the very central question is clear: When a person is dying, when their quality of life has deteriorated to the extent that they don’t wish to continue, ought there be some avenue that is not illegal? We don’t need to reinvent the wheel, since other countries including Switzerland, the Netherlands and Belgium have euthanasia social policy.
(more)

Where’s our right to die? by Santiago Wills, Salon (7/3/12) – …according to Howard Ball, a professor emeritus of political science at the University of Vermont, the legalization of physician-assisted death is a gesture of human compassion. As he details in his new book, “At Liberty to Die: The Battle for Death With Dignity in America,” the issue goes to the heart of bigger questions about the American soul — from the meaning of personal liberty to the importance of constitutional law.
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Another View: Let’s talk about assisted suicide in TheRecord.com (7/4/12) – In its most recent edition, the Canadian Medical Association Journal is calling for a Canada-wide debate. Circumstances are pushing the nation in that direction: In Quebec, the Dying with Dignity Commission (an all-party group drawn from the National Assembly) recently issued a comprehensive report suggesting, in part, that doctors who help a terminally ill patient die by suicide not be charged criminally. And a judge in the British Columbia Supreme Court in June struck down laws banning doctor-assisted suicide as unconstitutional, ruling on the case of a B.C. woman who has Lou Gehrig’s Disease.

The CMAJ editorial, provocatively headlined “Are we ready to perform therapeutic homicide?” makes the point that this is not a debate for courtrooms, lawyers and judges, but rather for average Canadians and their elected proxies in Parliament.

There’s the rub. The Harper government does not want this debate.
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Now’s the time to stand against euthanasia urges Canadian bishops’ group by Patrick B. Craine, LifeSiteNews.com (7/9/12) – “It is time to stand up and speak!” insists the Catholic Organization for Life and Family (COLF).

In a new reflection, the organization, which was co-founded by the Canadian Conference of Catholic Bishops and the Knights of Columbus, is calling on Catholics and people of good will to engage the debate on end-of-life issues. The plea comes in the wake of a British Columbia judge’s ruling that legalizes euthanasia and assisted suicide and the recent Quebec government report calling for “medical assistance in dying.”
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How about the right to cry for help? court ruling asserting a person’s right to assisted suicide reflects discriminatory attitudes toward the disabled – by Amy E. Hasbrouck, chair of Not Dead Yet, an international organization of people with disabilities who oppose the legalization of euthanasia and assisted suicide in The Gazette (7/9/12) – The long and the short of the reasons for judgment issued by Justice Lynn Smith is that legal provisions in Canada prohibiting assisted suicide law are unconstitutional because they impede disabled people’s rights to life, liberty and security of the person.

The judge believes that having a disability or degenerative illness is a rational reason to want to die, and that those of us with disabilities should be helped to die if we can’t do it neatly or efficiently ourselves.

The B.C. Supreme Court has chosen not to listen very closely to disability-rights advocates with more than 20 years of experience battling discrimination; instead, the court relied on the stories of people who have accepted the view that disability is undignified, and that people with disabilities should be given a streamlined path to death whenever they want it and however they want it.

Justice Smith assumes that, because it’s no longer illegal, suicide is somehow an affirmative right; and if you can’t do it the way you want to do it, then you should have the right to have someone do it for you.
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Churchgoers more likely to support euthanasia: Survey sunnewsnetwork.ca (7/10/12) – A new survey has found Protestant churchgoers are more likely to support doctor-assisted suicide in controlled situations than Canadians at large.
(more)
Assisted-suicide ruling to be appealed by Ottawa – Civil-liberties lawyer calls move ‘perplexing’ in case of terminally ill B.C. woman- CBC News (7/13/12) – The federal government will appeal last month’s ruling by the British Columbia Supreme Court that partially struck down Canada’s ban on assisted suicide, Justice Minister Rob Nicholson says.
The ruling declared that the Criminal Code section targeting anyone who “aids or abets a person to commit suicide” should not apply to physicians in cases where terminally ill patients request to die.

Judge Lynn Smith halted her decision for a year to give Parliament a chance to rewrite the law, which she deemed unconstitutional because it unfairly deprives people with degenerative illnesses of their liberty, and because it discriminates against those with a physical disability who might need assistance to exercise their right to take their own life.

But she also granted an immediate exemption for Gloria Taylor, one of the women who brought the suit, and her doctor.
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Update: Government of Canada Condemns Gloria Taylor to a Slow Death by Cathryn Wellner (7/13/12) – On Friday the 13th, the Conservative government of Canada dealt Gloria Taylor a cruel blow. Justice Minister Rob Nicholson announced his government will appeal the ruling that would have allowed her to die with dignity.
A month earlier the Supreme Court of British Columbia granted the 64-year-old woman, who suffers from ALS (Amyotrophic Lateral Sclerosis or Lou Gehrig’s disease), the right to request the assistance of her doctor if she wished to end her life.
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Conservative Government to appeal assisted suicide ruling after B.C.Supreme Court strikes down ban – National Post (7/13/12) – The landmark ruling last month said the ban is unconstitutional and gave Ottawa a year to rewrite it. Judge Lynn Smith also granted an immediate exemption to the law, allowing Gloria Taylor, one of the women who brought the lawsuit, to die with a doctor’s help.

In a statement, Nicholson said the government intends to seek a stay on all aspects of the ruling, including the exemption for Taylor, while it goes to the British Columbia Court of Appeal.
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It’s time for a national debate on assisted suicide– The Gazette (7/16/12) – Call it what you will – assisted suicide, euthanasia or therapeutic homicide – it is an issue that politicians are reluctant to engage, but one which is not going away.

Last month, a British Columbia Supreme Court judge ruled that Canada’s ban on assisted suicide is unconstitutional on grounds that it violates two sections of the Charter of Rights and Freedoms concerning the right to equality, and the right to life, liberty and security of the person.

The ruling did not strike down the law, but rather ordered the federal government to amend the provisions of the Criminal Code that currently make it an offence to counsel or assist someone to commit suicide. It did, however, extend an exemption for a plaintiff in the case, a 64-year-old B.C. woman suffering from Lou Gehrig’s disease (or ALS) to die with a doctor’s assistance.
(m0re)

Who decides how we die? – Edmunton Journal (7/16/12) – Why has Justice Minister Rob Nicholson appealed the B.C. ruling that struck down the law that makes physician-assisted death illegal in Canada? By refusing to allow Gloria Taylor, who is dying from Lou Gehrig’s disease, the right to a doctor-assisted death, Nicholson is committing her to a painful death. That is not justice. It’s unnecessary cruelty.
Nicholson states the laws surrounding euthanasia and assisted suicide exist to protect all Canadians, including the most vulnerable such as the sick, the elderly and people with disabilities. B.C. Supreme Court Justice Lynn Smith agreed, but after sifting through mountains of evidence concluded that in countries allowing medically assisted dying, there is no threat to these groups. Nicholson is ignoring this evidence.
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Assisted-suicide slope not so slipperyby Arthur Schafer, WinnepegFreePress.com (7/19/12) – Gloria Taylor, a British Columbia ALS patient, insists it should be up to her to decide when the prospect of continued life is worse than the prospect of hastened death. Once she reaches that point, however, she may no longer be physically able to end her own life. So, she claims, it is her right to seek assistance in dying from a willing physician.

“What I want is to be able to die in a manner that is consistent with the way that I lived my life. I want to be able to exercise control and die with dignity and with my sense of self and personal integrity intact,” she has explained. “I want to be able to experience my death as part of my life and part of my expression of that life. I do not want the manner of my death to undermine the values that I lived my life in accordance with…”

A great majority of Canadians supports Taylor’s position. Similar support existed 19 years ago for Sue Rodriguez, another ALS patient who took her case all the way to the Supreme Court. Rodriguez lost, but only very narrowly, by a five-to-four vote.

Despite strong public support for decriminalization of physician-assisted suicide, it remains illegal in Canada. Attempting suicide ceased to be a crime in 1974; but aiding someone to commit suicide remains an offence punishable by up to 14 years in prison. The voluntary request of the patient — even when she is a competent adult, rational and fully informed — is no defence.

In a dramatic decision, however, the British Columbia Supreme Court has ruled it is Taylor’s constitutional right to decide for herself whether she wants a physician to assist her to die. The federal government is appealing this decision. Ultimately, the Supreme Court of Canada will have to rule.
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It’s expensive to support the disabled– suicide kits are $39.95by Rhonda Wiebe (7/21/12) – Arthur Schafer’s portrayal of comments on the merits of physician-assisted suicide need challenging (Assisted-suicide slope not so slippery, July 19). Schafer, like many supporters of physician-assisted suicide (also known as “doctor-prescribed death”), does not seem to have considered the wider issues facing Canadians with disabilities, including the ongoing social prejudice and discouraging lack of living supports that we encounter on a daily basis.

The recent decision in the British Columbia Supreme Court regarding the constitutional right of Gloria Taylor, an ALS patient, to end her own life rather than live with disability only confirms what we with disabilities already know — that many Canadians believe it is better to be dead than disabled. What also became clear in the decision is that the judge believes it is better to be dead than disabled. The judgment was pronounced without considering the message it sends to all of us who believe that despite profound functional limitations, we want to live.
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Our right to die – cottagecountrynow.ca (7/20/12) – Last week the Canadian government announced plans to appeal a British Columbia court decision allowing doctor assisted suicide.
Last month, the British Columbia Supreme Court struck down a ban on doctor assisted suicide, but granted a one-year stay to give Parliament time to rewrite the law. There was an exception to the stay, though, that allowed applicant Gloria Taylor, who has ALS or Lou Gehrig’s disease, to end her life when she sees fit with the help of a doctor.
The government’s decision to appeal the ruling is questionable.
Anyone at death’s door should have a right to die when and how they see fit. According to Section 7 of the Canadian Charter of Rights : “Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.”
Not everyone agrees with interpretations of the section that it includes allowing a terminally ill person to die with medical help, but it’s a worthwhile interpretation.
A person of sound mind, who is suffering from an ever-worsening debilitating condition should have the option of choosing a humane death, not constant pain with no quality of life. That’s not living.
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Medical Nightmare: Doctors won’t let wife act on behalf of ailing husband by Peter Baklinski  – LifeSiteNews.com (7/20/12) – An Ontario woman is crying foul after a team of doctors effectively denied the woman her legal right to act on behalf of her husband who was hospitalized after a stroke. The woman is fighting to regain control of her husband’s medical treatment.

Marilyn met with her husband’s team of doctors who not only refused to change his drug regimen, but threatened that if she did not comply with the drug plan, she would loose her legal power of attorney over her husband.

“Not only did the meds not get changed, but I was threatened over and over,” she said.

One doctor allegedly told Marilyn: “One of us has to go, and it’s going to be you.”

“I was just telling them the truth as I knew it, hoping that they would change the meds, but it didn’t happen that way,” she said. “They have never honored my legal power of attorney.”

She alleges that doctors were responsible for bringing her before the Consent and Capacity Board so that she could be deemed “incapacitated” to represent her husband.

“They’ve put him on palliative care against the wishes of the family,” she said, adding that he is not receiving adequate hydration.

Not only this, but Marilyn says that she was barred from visiting her husband in December, but has since regained permission to visit under supervision.

“Putting this in perspective, if doctors are already imposing decision on patients as ‘medical treatment,’ how long does it take before they start imposing euthanasia and assisted suicide on patients as a form of ‘medical treatment’?” Alex Schadenberg, director of Canada’s Euthanasia Prevention Coalition asked.

Schadenberg pointed out that many doctors would not proscribe such treatment, but added that “there will always be some who will abuse the power that they have been given to take lives.”
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Ask the religion experts: Does the renewed debate on doctor assisted suicide say anything about the sanctity of life in modern times? – The Ottawa Citizen (7/21/12) – Cases in which there may or may not be doctor-assisted suicide are anything but abstract. This means discussions about this matter need to be undertaken within the wider context of the Canadian health-care system. For that matter, it cannot be addressed through law or medicine alone. We need broad reflection on the experience of death and dying.
Requests for doctor-assisted suicide appear to be signs of the failure of human community. It is difficult, if not impossible, to regard life as sacred if we have no assurance that we will be supported in all circumstances. We need to be certain that we will not be forced to endure dehumanizing medical procedures. We need confidence that we will not be abandoned in our suffering. With all the financial strains that our health-care system is facing, terminally ill people need to know that assisted suicide is not being promoted because it is actually cheaper than good palliative care.
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Dying in Court by Peter Singer – Aljazeera.com (7/21/12) – A Canadian’s fight for the right to die could provide an international precedent in the case for assisted suicide.
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Appeal is cruel by John Warren – Calgary Herald (7/21/12) – By refusing to allow Gloria Taylor, who is dying from Lou Gehrig’s disease, the right to a doctor-assisted death, he is committing her to a painful death.
That is not justice. It’s unnecessary cruelty.
(more)

Medically assisted suicide: Compassionate or criminal?– The Vancouver Sun (7/23/12) – Striking down laws against assisted suicide and euthanasia puts lives at risk and is likely to lead to the untimely deaths of vulnerable people whether they choose it or not.

Those who insist it should be legal out of respect for personal autonomy, so individuals have the free choice, don’t realize that legalizing it may have the opposite effect.
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Depression, not pain, main reason patients request euthanasia by Anne McTavish – Troy Media (7/24/12) – Yet again, our courts have been asked to change the law and allow doctors to actively end a person’s life (euthanasia) or to provide a patient with the drugs to kill themself (physician-assisted suicide, or PAS).
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BMA doctors argue assisted suicide is ‘never justified’ as they vote against euthanasiaby Claire Bates, Anglican Mainstream (7/28/12) – Doctors have reiterated their opposition to assisted dying at the British Medical Association’s conference today.

Campaigners wanted delegates to agree to take a neutral stance on the issue, but members of the BMA voted against this proposal. One delegate argued that killing patients was ‘never justified’ likening it to murder.

The Healthcare Professionals for Assisted Dying (HPAD) had called for the BMA to move its position from opposition to ‘studied’ neutrality.
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CHINA

10-year old American boy receives euthanasia – news.xinhuanet.com (7/23/12) – photo journey of the family with a 10-year old American boy diagnosed with neuroblastoma who goes through two years of treatments then chooses euthanasia to make his transition

FRANCE

President launches euthanasia debate – The Connexion (7/18/12) – PRESIDENT Hollande has reignited debate on euthanasia, saying he wants to “go further” than the existing “Leonetti Law” on the end of life, which rules it out. Visiting a hospice in the Hauts-de-Seine, the president said he wants to put in place a reform of care for the terminally ill in the “coming months,” possibly allowing for a form of assisted dying.
He has charged the president of a national medical ethics committee, Prof Didier Sicard, with running consultations around the country to feed into reforms.
However euthanasia pressure group the Association Pour le Droit de Mourir dans la Dignité, says the professor has a Catholic bias to his views.
(more)

GERMANY

Assisted Suicide: Germany loses Strasbourg case – BBC News Europe (7/19/12) – After suffering a bad fall in 2002 Mr Koch’s wife needed artificial ventilation and constant nursing care. She wanted to end her life, but Germany’s Federal Institute for Drugs and Medical Devices refused to let her do so with sodium pentobarbital.
Mr Koch’s challenges on her behalf got nowhere in Germany as the courts cited the existing ban on active assisted suicide.
The Dignitas facility in Switzerland later enabled Mrs Koch to die.

European court rules on euthanasia debate – Deutsche Welle (7/19/12) – The European Court of Human Rights issued a decision Thursday on whether states may refuse to assist in a suicide. Germany’s laws on assisted suicide draw a fine line between what’s permitted, and what’s not. Questions remain.
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Strasbourg hits euthanasia ball back into German courts – Deutsche Welle (7/19/12) – The European Court of Human Rights has ruled that it’s up to individual countries to decide on euthanasia. It also decided, however, that the German courts should not have thrown out a widower’s appeals.
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INDIA

Government not in favor of euthanasia– The Times of India (7/28/12) – The minister said the law of the land prohibited active euthanasia and the Supreme Court had laid out guidelines for passive euthanasia. “In this situation, there’s no need for us to recommend anything. We feel our effort should be to help a person live, whatever be the situation. It’s about compassion and service.”

However, members were divided over the issue. Referring to the case of HD Karibasamma, a teacher in Davanagere who is seeking euthanasia due to health problems, Shivayogi Swamy said: “It’s torture for the patient and family members. It’s like death every minute. Moreover, such cases have financial implications. Several countries have legalized euthanasia. We should pass a resolution and send it to the Centre.”
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THE NETHERLANDS

Thousands in Netherlands die without consent since euthanasia OK by Steven Ertelt, lifenews.com  (7/4/12) – Alex Schadenberg, the executive director of the Euthanasia Prevention Coalition, has a message for Canadians: contact federal Justice Minister Rob Nicholson now, and urge him to appeal the recent decision by Justice Lynn Smith in British Columbia striking down Canada’s laws on assisted suicide. (video)

Legalising assisted dying ‘doesn’t lead to more opting death’by Stephen Adams, The Telegraph (7/11/12) –

The study, published in The Lancet, found rates before and after legalisation in 2002 were comparable.

The figures have been leapt upon by advocates of a change in the law here, who say they show there would be no “slippery slope” towards more people choosing assisted dying.

But opponents warn it shows there has been a big rise in the use of methods that border on assisted dying, such as continuous deep sedation.

In 2002 The Netherlands became the first country in the world to legalise assisted dying, although it had been tolerated since the 1970s. The rules only cover patients with an incurable condition who face unbearable suffering.

The Dutch academics found that between 1990 and 2001 the rate of euthanasia and assisted suicide cases rose from 1.9 to 2.8 per cent of all deaths.
(more)

Dutch euthanasia figures present muddled picture by Michael Cook, BioEdge (7/14/12) – It is true that there is a “V” shaped curve in the number of cases of voluntary euthanasia. In 2001, before legalisation, about 2.6% of all deaths were due to voluntary euthanasia. In 2005, this dropped to 1.7%, and rose in 2010 back up to 2.8%.
But what accounts for the drop? It was not lack of interest. The proportion of patients requesting euthanasia rose from 4.8% of all patient deaths in 2005 to 6.7% in 2010. And doctors were also more willing to grant it. In 2005, 37% of these requests were granted and in 2010 45%.
(more)

Doubts emerge about Dutch guidelines for terminal sedation by Michael Cook (7/20/12) – Should deep, continuous sedation at the end of life really be treated as normal medical practice in the Netherlands, ask three Dutch authors in the Journal of Medical Ethics. Although they do not appear to oppose euthanasia, they argue that “morally problematic aspects inherent to palliative sedation do not get the attention they deserve” under current guidelines. Since palliative sedation accounted for more than 12% of deaths in the Netherlands in 2010, this is an important issue.

Although euthanasia – which ends a patient’s life immediately – is the most visible and controversial aspect of end-of-life care for international observers, the innocuous-sounding treatment called “palliative sedation” (also called “terminal sedation” by some authors) also has been the centre of controversy in the Netherlands. In 2003, the then-attorney-general argued that the death of a deeply sedated patient because water was withheld was culpable homicide. However, his view did not prevail.
(more)

The Lancet proves euthanasia deaths are rising in The Netherlands by Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition (7/17/12) – The long awaited 2010 nationwide examination of the euthanasia law in the Netherlands was published in The Lancet on July 11, 2012. The study found that:

* the number of euthanasia deaths has grown significantly since 2005 (4050 in 2010, 2425 in 2005)

* the under-reporting of euthanasia in the Netherlands has grown since 2005 (23% in 2010, 20% in 2005)

* there is a growth in deaths by terminal sedation (12.3% in 2010, 8.2% in 2005)

* the percentage of requests for euthanasia being fulfilled has increased (45% in 2010, 37% in 2005)

* the number of deaths without request or consent has decreased (300 in 2010, 550 in 2005)

The media decided to ignore the significant growth in the number of euthanasia deaths since 2005, by reporting that the current percentage of euthanasia deaths in the Netherlands is similar to the percentage of euthanasia deaths in 2001, before it was officially legalized.

NEW ZEALAND

Panel discusses the euthanasia debate in New Zealand – TVNZ (7/1/12) -interview with Auckland Chamber of Commerce Chief Executive, Massey University Vice-Chancellor, Political Scientist and a cancer patient

Will assisted death be made legal by Noel Cheer, BusinessScoop (7/9/12) – Will Assisted Death be made legal? With Maryan Street’s Private Member’s Bill waiting to be balloted, the “voluntary euthanasia” debate has effectively been re-opened. The insistence that “I own my body” has lead to the claim that …Will Assisted Death be made legal?

With Maryan Street’s Private Member’s Bill waiting to be balloted, the “voluntary euthanasia” debate has effectively been re-opened.
(more)

Euthanasia may again test our politiciansby Katie Bradford-Crozier – newstalkzb.co.nz (7/24/12) – The controversial topic of euthanasia could once again be about to test our politicians.

Labour’s Maryan Street is submitting a Bill to the Members’ ballot that would see euthanasia decriminalised.

There’d be strict conditions, such as two separate medical practitioners having to deem the person concerned is of sound mind, has a terminal illness and hasn’t been coerced in any way.

Ms Street is hoping recent high profile cases will make MPs realise the time is right to take another look at the issue.
(more)

Euthanasis law would ‘force doctors to lie’by Natasha Burling – newstalkzb.co.nz (7/27/12) –

A doctor who cares for dying people says the introduction of a law legalising euthanasia would force doctors to lie.

A Bill decriminalising the practice has been put in the member’s ballot by Labour MP Maryan Street.

Capital and Coast palliative medicine consultant Dr Sinead Donnelly says if it was passed, it would be a disaster for society.

She says under the Bill, doctors would have to say the person’s underlying illness was the cause of death, not the lethal injection.

“And in this legislation they want the doctor to lie, to tell a lie, in addition to killing the patient, or to giving the patient, the person, the injection that killed them.”

Dr Donnelly says the legislation is incredibly poor and is shocked by it.
(more)

Man pleads guilty to assisting suicide by Anna Cross newstalkzb.co.nz (5/4/12) – Lesley Martin helped her ill mother die and says people are determined to have a peaceful and dignified death, so they take matters into their own hands.
She says it happens far more than what’s reported.”There is a well established euthanasia underground accessed in any country where legislation isn’t in place for people to access medically assisted dying openly and honestly.”

Euthanasia backers cite fear of burdening others by Bronwyn Torrie (7/27/12) – Healthy pro-euthanasia pensioners would rather cut their lives short than be a financial drain on society, a study shows.
Auckland University researchers interviewed 11 healthy men and women aged between 69 and 89 on why they supported voluntary euthanasia.

Reasons included not wanting to be a burden on their families and healthcare resources and fears of losing their independence and dignity.

“If you couldn’t do your basic care, couldn’t wash yourself or go to the loo by yourself, I don’t want to go on after that,” an 86-year-old woman said.

“And I don’t expect [my husband] wants me to go on like that either, or my family.”

Being remembered in “a good way”, not as a shadow of their former selves, was also important. Many had watched a loved one die and did not want to be in a position where they could not make decisions for themselves.
(more)

SOUTH AFRICA

Death is inevitable, pain is optional by Thalia Randall – Mail&Guardian (7/6/12) – Some believe that proper palliative care goes a long way towards countering arguments for euthanasia.
(more)

South Africa Doctors ‘Secretly Help People Die’– News24.com (7/12/12) – South Africa should legalise euthanasia as many doctors are already secretly helping elderly patients to die, Western Cape University Prof Sean Davison said on Thursday.

“Many doctors have said to me privately that they’ve helped people to die… at their request. It’s the choice of the doctor [though]… and they have to do it behind the scenes illegally,” he said.

With no choice whether to die or not, critically ill patients had to rely on the graciousness of their doctor.

“If you don’t have a law change, you might be playing Lotto with your doctor.”
(more)

SWITZERLAND

Canton votes for assisted suicide– thetablet.com (6/29/12) – Churches in the Swiss canton of Vaud have condemned a move that will permit assisted suicide in nursing homes and hospitals in the canton.

On 17 June, almost two-thirds of voters (62 per cent) in the canton voted in a legally binding referendum in favour of a proposal that would oblige nursing homes and hospitals to allow assisted suicide, provided the person who wishes it is suffering from an incurable illness or injury and is of sound mind.

Local Bishop Charles Morerod of Lausanne, Geneva and Fribourg, said the consequences of the decision were “terrible”.

Finding a place for assisted suicide in society by Clare O’Dea, swissinfo.ch (7/9/12) – The two main Swiss assisted suicide organisations – Exit and Dignitas – made it possible for 560 people to end their lives in 2011. This equates to one in three of all suicides in Switzerland.

While the right to die is consistently backed by a majority of the electorate, there are details within the practice of assisted suicide that split opinion, such as the vote in canton Vaud last month over exercising the right to die in a residential care home.

Voters in the French-speaking canton accepted the local government’s proposal to oblige nursing homes and hospitals to accept the practice only when the person in question is suffering from an incurable illness or injury.
(more)

Swiss voters OK assisted suicide in nursing home by Charlie Butts, onenewsnow.com (7/9/12) – The majority vote in the canton of Vaud was 62 percent in favor of bringing assisted suicide into the nursing homes. Rita Marker of the Patients Rights Council tells OneNewsNow the vote forces hospitals and nursing homes to accept assisted suicide.
(more)

Legalization of Euthanasia has not altered prevalence – PriMed Journal (7/11/12) – “In conclusion, eight years after the enactment of the Dutch euthanasia law, the incidence of euthanasia and physician-assisted suicide is comparable with that in the period before the law,” the authors write.

TRINIDAD

Death with Dignity by Leonard Bernstein, Trinidad Express Newspapers  (7/30/12) – The “playing God” argument is a non-starter. For those who do not believe in a personal, vengeful God, it is meaningless. For those who do (as noted by Peter Singer), “God” allows them to make choices about these matters as about all others in their lives. Religious authorities not only feel that they have the right to set what they consider the moral and ethical parameters, but that their view should prevail for all members of society no matter the individual circumstances of, say, someone’s possibly painful imminent death. However, many others take issue with their edicts and want the autonomy to decide for themselves.
(more)

UNITED KINGDOM

BMA continues to oppose legalizing assisted dying – bma.org (6/27/12) – Doctors and medical students decided to maintain their opposition to legalising assisted dying.
The meeting decided not to move to a position of neutrality and also rejected a call to say that assisted dying was a matter for society and not for the medical profession.
Retired Manchester consultant in geriatric medicine Raymond Tallis spoke in favour of changing the BMA stance.
He emphasised that ‘neutrality did not imply indifference’ and ‘the medical profession must retain a central role in ensuring and defining safeguards’.
Professor Tallis said guidelines made it clear that doctors and nurses who helped with assisted dying will currently be prosecuted.
‘Assistance is therefore delegated to amateurs, who have to take on a dreadful responsibility at a time when they are already greatly distressed and may well be incompetent to carry it out,’ he said.
(more)

Assisted death or assisted living by Jill Shaw Ruddock – huffingtonpost – (7/3/12) – This week in the UK there is a renewed push by MPs to review the current guidelines regarding assisted suicide on compassionate grounds. Lord Falconer, who heads up The Commission on Assisted Dying reported that the current legal status is inadequate and incoherent. Understandably there are concerns that the elderly could be vulnerable to those who don’t have their best interests at heart.
(more)

Promoting caring, not killing by Ruth Bessant, Christian Today (7/2/12) – We are currently seeing a great deal of pressure applied by those wanting to change the law on assisted suicide with increasing discussion about whether care of the dying should include the option for a person to choose to end their own life with medical assistance, so-called physician-assisted suicide (PAS).
(more)

Patients dying in hospital in pain and lacking dignity: survey by Rebecca Smitg, Medical Editor, The Telegraph (7/3/12) – The survey, by the Office of National Statistics, found that half of families said hospital nurses did not always treat their dying family member with respect.
Almost a third said the quality of care in hospital was fair or poor and only 35 per cent of families rated pain relief in hospital in the final two days as excellent.
Hospital care was rated worse than that received by patients dying at home, in a care home or in a hospice on almost all of the 59 questions.
It is the first time such a survey has been conducted and responses were received from more than 22,000 families.
(more)

Solutions for our care crisis – Letters to guardian.co.uk (7/2/12)
Report on rally and mass lobby of Parliament to resist euthanasia – Christian Concern 7/4/12 – On 3 June, campaign group Care Not Killing, of which Christian Concern is a member, held a rally and mass lobby of Parliament in order to promote better palliative care and oppose the legalisation of assisted suicide and euthanasia.

Their speeches contained a range of arguments against weakening the current laws on assisted suicide and euthanasia.

Delegates later went to Parliament to talk to their MPs about the issues and highlight their opposition to any relaxation of the current laws.
(more)

The legalization of assisted suicide– don’t be fooled, it is primarily about money by Dr. Peter Saunders, CEO of Christian Medical Fellowship – National Right to Life News Today (7/4/12) –

Today, according to the Sunday Times, Lord Falconer will publish his new bill on assisted suicide.

In line with the recommendations of his sham ‘Commission on Assisted Dying’ he will push for doctors being given the power to help mentally competent adults with less than one year to live to kill themselves.

There has been surprisingly little media coverage about this event, but Dignity in Dying (the former Voluntary Euthanasia Society) are planning a mass lobby on Parliament tomorrow to launch an ‘enquiry’ into this new bill which they hope will be debated in the New Year.

Over the last six years there have been three failed attempts to legalise assisted suicide in Britain since 2006 all of which have failed due to concerns about public safety.

Right-to-Die groups in England increase lobbying efforts – by Myles Collier, Christian Post (7/5/12) – There is considerable attention being brought to assisted suicide and euthanasia in England recently. Several groups in favor of changing laws concerned with such acts have increased their lobbying of members of the British Parliament.

Dr. Peters Saunders, regarded as the leading advocate of right-to-life supporters, has cautioned that there will be an increase in the level of activity by those individuals and organizations that are pushing for new laws for those who wish to end their lives.

“Their glossy propaganda inserts are spilling out of commercial publications; they are spending hundreds of thousands; and clearly believe this is their year,” Saunders told the Christian Institute.
(more)

Draft Assisted Dying Bill is an important step towards a compassionate law on assisted dying– British Humanist Assoc. (7/4/12) – The All Party Parliamentary Group on Choice at the End of Life has launched a consultation on a draft Bill that would enable mentally competent adults with a terminal condition to seek medical assistance to end their life. The consultation has been welcomed by the British Humanist Association (BHA) as an ‘important step towards an ethical and compassionate law on assisted dying that protects the vulnerable’.

The draft Bill largely draws upon the recommendations of the independent Commission on Assisted Dying, which examined the problematic approach to the issue of assisted dying in the UK. At present, assisting another individual to die remains illegal, however the Director of Public Prosecution’s revised prosecuting guidelines recommend that amateur assistance for compassionate reasons should not be prosecuted, and large numbers seek assistance abroad. As a result, assistance continues to occur, but outside of a legal framework of safeguards that protect the vulnerable.
(more)

Support of doctor-assisted suicide by Bonnie Gardiner – YouGov.co.uk – (7/5/12) – 69% Britons say law should allow doctors to assist terminally ill to die; 46% if illness not terminal

Over two thirds of the British public have expressed support for the laws on assisted suicide to be changed so that it would be legal for doctors to assist in ending the life of someone suffering a terminal illness, our poll shows.

Support is not as strong for the aided death of patients whose illness is painful and incurable but not terminal, with around half in favour and one third opposed.
(more)

Why legalizing assisted suicide for anyone at all will inevitably lead to incremental extension by Peter Saunders – LifeSiteNews.com (7/6/12) – Pro-euthanasia activists always make a great play of how their proposals to help people kill themselves are extremely modest and are bound by ‘robust safeguards’.

Dignity in Dying, the former Voluntary Euthanasia Society, is a world leader in this art and their new draft bill, championed by Lord Falconer, is a classic example.

It’s only for the mentally competent, only for the terminally ill, only for adults they say.

There will be no killing of children, disabled people or demented people. It’s all going to be strictly controlled.

In fact it is only the beginning for two main reasons.
(more)

Euthanasia could be better than costly social care – pensioner – thisisgloucertershire.co.uk (7/10/12) – “The big question is: Who is going to pay for it?

“I often think that pensioners want to live in dignity and die in it too, and to that end one has to think about euthanasia.

“A lot of the success of this will rest on how much the social care will cost everybody, because a lot of people think the Government has limitless amounts of money, but it does not.”

In an announcement tomorrow, the Government is due to announce a new policy of national eligibility for free social care by 2015.
(more)

Former nurse urges Golders Green MP to back assisted suicide bill by Syma Mohammed, Ham&High (7/13/12) – A former nurse who was awarded an OBE for services to palliative care, is supporting a bill to allow terminally ill patients to have an assisted death.

Harriet Copperman, 67, of Diploma Avenue, East Finchley, lobbied her MP Mike Freer on Wednesday of last week after a draft bill was launched the day before.

Until this year, she was on the steering group of Healthcare Professionals for Assisted Dying (HPAD), an action group which supports the bill.

Ms Copperman said: “I spent all my time in care not being in favour of assisted dying.

“While palliative care can help a small population of people, I have come to appreciate assisted dying can be a part of palliative care.”
(more)

Legalising mercy killing could pressure the elderly into dying early, claims the writer PD James by Richard Alleyne – thetelegraph.co.uk (7/15/12) – James, who admits she herself fears a painful and undignified death, said that while a person should be allowed to choose to commit suicide if their life was “intolerable”, she was “less assured” by the idea of allowing others to do it for them.
She said that murder has to remain a “unique crime” and it would be dangerous to water it down by allowing euthanasia.
(more)

Breast Cancer Discussion Boards: A place to talk about death and dying issues

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Assisted Death Debate – News from May 2012

End-of-Life discussions about Assisted Dying/Suicide/Euthanasia in news articles, blogs, videos from the left, right and center during the month of May 2012. This is a place to find out what’s being talked about around the world as we sort out this highly emotional and controversial issue.

Become informed, open your mind,  join in the discussions. Our leaders need to know what people are thinking and we need to know what our leaders are considering in terms of laws. These are conversations we all need to have!

BLOGS

Dike Drummond, MD: Death with Dignity in the emergency department (5/9/2012)

The Non Sequitur by John Casey: Bad Company (5/5/2012)

The New Old Age Blog: Massachusetts Debates ‘Death With Dignity’ (5/29/2012) –  At the end a rush to the ER (5/6/2012) – Among the very ill confusion about life’s end (4/6/12)

American Medical News (Opinion) – Obstacles in providing end-of-life care (5/7/2012)

Pain Policy & Palliative Care – Relieving the supreme Court’s Pain…  Revisiting the constitutional right to Palliative Care (5/12/2012)

GeriPal – A Geriatrics and Palliative Care Blog: A Thin Reed to Hang On by guest author, Barbara Coombs Lee, President of Compassion & Choices (5/16/2012)

Secondhand Smoke by Wesley J. Smith: Palliative Sedation Not = To Terminal Sedation/Euthanasia  5/18/2012 – Should we kill Alzheimer’s patients? 5/24/2012

Physician-assisted death commercial

Book Recommendation – In Search of Gentle Death: The Fight for Your Right to Die With Dignity by Richard N. Cote

UNITED STATES

(Arizona, California, Connecticut, Georgia, Hawaii, Kansas, Maine, Maryland, Massachusetts, Minnesota, Nebraska, New Mexico, New York, Oregon, Texas, Vermont, Washington)

Arizona

Prescott man kills wife, self, after telling police they planned suicide (The Repubilc 5/4/12) – Police in Prescott say an 88-year-old man killed his wife and them himself after calling 911 and saying both were terminally ill and planned to commit suicide.
Police spokesman Lt. Andy Reinhardt says the man called police at about 8 p.m. Thursday from a medical center parking lot and told dispatchers where they could be found. Arriving officers discovered the man dead of a self-inflicted gunshot wound and his wife severely wounded. She was flown to a Phoenix hospital where she died.
Reinhardt says the couple lived in a nearby assisted living facility and had apparently walked to the medical center where they were found.
The couple were identified as Robert Grossman and his 85-year-old wife Joanne Grossman.

California

92-year-old retired school teacher faces sentencing for selling helium suicide kits (CBS News 5/7/2012) – A 92-year-old retired school teacher who sold $40 helium kits to people who could use it to kill themselves faces sentencing in San Diego for failing to file federal tax returns.
Sharlotte Hydorn faces a maximum term of one year in prison when she is sentenced Monday by U.S. Magistrate Judge Bernard Skomal.
The Spokane, Wash, native began assisting physicians with patient suicides after her husband, Rex, died of colon cancer, said Charles Goldberg, her attorney. Her husband was in “agonizing pain” and did not want to die “filled with tubes in a hospital.”
(more)

Assisted suicide or a show of love? by Tony Perry, Los Angeles Times 5/16/2012 – SAN MARCOS, Calif. —When paramedics arrived at the Purdy home March 20, Margaret was seated in her favorite chair in the living room. The morning sunshine streamed in through a picture window that overlooked a valley. A plastic bag was over her head, tied securely at the neck.
A suicide note in her handwriting was in a folder on her desk, beneath a shelf with books about death and dying. She had written that the pain from her various medical conditions had become unbearable.
Alan Purdy met the paramedics at the door. He said that his 84-year-old wife had taken 30 sleeping pills mixed with applesauce and then suffocated herself.
(more)

Dr. Drew – Is suicide ever OK? – interviews John West, author of The Last Goodnights: Assisting My Parents With Their Suicides (4/2012)

Colorado

Death with dignity: why Coloradans should legalize assisted suicide by Sam Smith, The Catalyst 5/20/2012 – Here in Colorado, we have a statute in place that explicitly criminalizes assisted suicide. Thirty-three other states, from Florida to Alaska, have statutes that do the same. Nine more states, from Vermont to Idaho, criminalize assisted suicide through common law. The other eight states, from North Carolina to Utah, have not criminalized nor legalized assisted suicide.

The fact of the matter is that even if you are against assisted suicide on a religious or moral ground, it should not be up to you what people do with their lives and deaths. People should be able to control their own lives–it’s that simple. Just like abortion is legal and regarded as a matter of choice, assisted suicide should be legal and regarded as a matter of choice.

Some terminally ill patients are allowed to end their lives by refusing medical treatments; in all fairness, those who don’t have that option should be allowed to choose death.

Connecticut

CT Golden Years: Euthanasia, Death Penalty for Connecticut’s Seniors? by Ron Winter (ctwatchdog.com 5/2/2012) – In April Connecticut officially abolished the death penalty for people convicted of murder, making it the 17th US state to do so, even though a majority of state residents wanted to keep it intact.
But as one class of residents gets a reprieve, another class may be vulnerable to continuing efforts across the country to deprive them of life, quite possibly without their knowledge or consent.
(more)

Georgia

Georgia Governor signs ban on assisted suicide by Patrick B. Craine (LifeSiteNews.com 5/2/12) – Georgia Gov. Nathan Deal has signed a bill banning assisted suicide that will now take effect immediately.
The bill, HB 1114 sponsored by Rep. Ed Setzler (District 35), was passed in response to last February’s decision by the Georgia Supreme Court that struck down the state’s previous law that pro-lifers considered weak and ineffective. It had only prevented advertising assisted suicide services, but did not prohibit the procedure itself.
“Stopping the immoral and barbaric practice of killing in the name of compassion is the right thing to do,” said Dan Becker of Georgia Right to Life. “Governor Deal deserves credit for endorsing this measure.”
“Any society that claims to value life cannot justify taking a life lest we risk establishing a public policy with its attendant expectation of a ‘duty to die,’” Becker said. “The Hippocratic Oath says, ‘I will give no deadly medicine to any one if asked, nor suggest any such counsel …’”
“We should instead devote our knowledge and resources to helping people in desperate situations,” he added.

Assisted Suicide Group Indicted (Kennesaw Patch by Gaetana Pipia 5/15/2012) – A Kennesaw man and three other members of the nonprofit Final Exit Network right-to-die group were indicted Friday for their alleged roles in the 2007 suicide of a Minnesota woman, reported Apple Valley Patch.
Thomas “Ted” Goodwin, 65, of Kennesaw and Punta Gorda, FL faces a felony charge of assisting 57-year-old Doreen Dunn to commit suicide and a gross misdemeanor charge of interference with a death scene.
An autopsy initially found that Dunn died of coronary artery disease. But Minnesota authorities reopened their investigation into her death in late 2009 after Georgia officials contacted them about a similar case.
Goodwin was arrested in Georgia in 2009 and accused of assisting in the suicide of a 58-year-old Cumming man, but the charges were dismissed against him and three others in February of this year. Georgia’s Supreme Court cited free speech violations as the basis for its unanimous decision. At the time, Georgia law prohibited advertising assisted suicide services, but not the act of assisted suicide itself.
(more)

Hawaii

Civil Beat Poll – Assisted Suicide Support Strong by Michael Levine (Honolulu Civil Beat 5/4/12) – Hawaii voters support the rights of doctors to help terminally ill patients end their lives by better than a 2-to-1 margin, according to The Civil Beat Poll.
Liberal, well-educated and wealthier voters were most likely to say physician-assisted suicide — also known as “death with dignity” — should be legal, the survey of 1,162 registered voters1 found.
Proponents have argued that death with dignity is already legal in Hawaii. Doctors and have formed an aid-in-dying advisory council and are already offering to help terminally ill patients end their lives.
Past attempts by the Hawaii Legislature to clarify the legal status of assisted suicide have failed. They’ve been opposed primarily by religious groups like the Catholic Church. As of today, death with dignity is legal in Oregon, Washington and Montana.
(For more about the status of aid in dying in Hawaii, read Chad Blair’s two-part interview with Compassion & Choices: A Conversation About Aid In Dying In Hawaii and How Other States Treat Aid In Dying)
Civil Beat asked voters, “Do you believe that doctors should be allowed to help terminally ill patients end their lives?”
(more – lots of charts)

Kansas

Death with dignity by Hilda Enoch, Lawrence 5/1/12 (LJWorld.com) – To the editor: This may be the next needed and, one day in Kansas, protected human right: the right to die with dignity, for those requesting it, physician-assisted dying, an earnest choice between a patient and her/his physician in the privacy of their shared conversations.
The anguish of imposing on one’s loved ones that prolonged period of enduring the suffering and irreversible deterioration of one so well-loved, when it’s against her/his wishes should be finally eliminated, not to mention the costs to the family of those last excruciating months. Shouldn’t such compassion be among the personal choices afforded the person who is dying? It’s her life, isn’t it? Let it end with her personal wishes for a death with dignity and compassion.

Death With Dignity: How Doctors Die (Doctors routinely administer intensive care to patients who say they want it, but many refuse lifesaving treatment themselves. by Ken Murray (Utne Reader May/June 2012) – Doctors die, too. And they don’t die like the rest of us.
Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment.
(more)

Lousiana

Bill would strengthen La. ban on euthanasia (KATC.com News 5/29/2012) – A bid to strengthen Louisiana’s ban on euthanasia is headed to the governor’s desk after receiving final legislative passage.
The state has a prohibition in criminal law against euthanasia and assisted suicide. The bill (House Bill 1086) by Rep. Alan Seabaugh, R-Shreveport, will add the prohibition to the state’s medical consent law.
Seabaugh’s proposal will spell out that someone authorized to approve medical procedures for another person may not approve any procedure that would be considered assisted suicide. That prohibition also will extend to include surgical or medical treatment for the developmentally disabled or nursing home residents who may be unable to make their own medical decisions.
Gov. Bobby Jindal supports the bill.

Maine

Obama administration is no Third Reich by Maureen Gill, Journal Tribune 5/16/2012) – In Hitler’s Third Reich, euthanasia became a euphemism for the secret, systematic murder of the mentally and physically disabled, and it predated the genocide of the Jews by two years. It was but one of many eugenic measures to secure the “racial purity” of the German nation. The euthanasia program was intended to eliminate what eugenicists considered “life unworthy of life” – individuals whom they believed were genetic and financial burdens to the nation.
Hitler called such people “useless eaters.”
One of the topics I’ve lectured about in the college classroom and public square is whether America’s physician-assisted suicide movement represents a moral slippery slope analogous to Germany’s descent into madness. This is a discussion uniquely suited to my training as a historian with expertise in German fascism and medical ethics. Since passage of the Patient Protection and Affordable Care Act, often called “Obamacare,” such discussions expanded with a plethora of nonsense about “death panels” and rationing. This hyperbole has taken a particularly venal turn since the Department of Health and Human Services initiated efforts to protect women in the workplace from the overreach of their employers, relative to insurance coverage for contraception. President Obama has also been under attack for his administration’s pro-choice stand and defense of same-sex marriage.
(more)

Maryland

Baltimore Doctor Who Helps Terminally Ill Patients End Their Lives Faces New Charges (CBS Baltimore 5/15/2012) – These charges are just the latest legal challenge for the right-to-die movement.
Dr. Lawrence Egbert from Baltimore is the modern-day Jack Kevorkian. He’s been arrested numerous times for illegally assisting in suicides.
Egbert was medical director of the Final Exit Network, a group that offers support and a suicide plan for people suffering from a variety of fatal diseases and conditions. Authorities in Minnesota are the latest to criminally charge the doctor and his colleagues. In 2007, prosecutors say Egbert traveled to the Twin Cities to see a patient.
(more & video interview with Dr. Egbert)

Massachusetts

Physician-Assisted Suicide Ballot Push In Massachusetts by Jessica Pieklo (4/30/12) – This November voters in Massachusetts will do more than just help elect a president. They may get a say on whether or not terminally ill individuals should have the ability to get a fatal prescription and control the terms of their own death.
Patient advocates are pushing a ballot initiative to legalize the practice they call “Death with Dignity,” or more commonly known as physician-assisted suicide. If the measure makes it on the ballot, and if voters approve it, Massachusetts would become the third state, joining Oregon and Washington, where voters have explicitly endorsed it.
(more)

Konchok Rangdrol’s Blog: Support the Massachusetts Death with Dignity Act 5/15/2012

Legal Challenge to Assisted Suicide Initiative! Mass Against Assisted Suicide (5/18/2012) – On Thursday, May 17, 2012, Massachusetts voters including members of the disability rights group Second Thoughts filed a challenge before the Supreme Judicial Court regarding the proposed ballot language for the measure that, if approved, would legalize assisted suicide in the state.
“The ballot language is clearly misleading,” said Second Thoughts director John Kelly of Boston. “We want the voters of Massachusetts to know exactly what they are voting on this November,” he said.

Doctor-prescribed suicide may not bring ‘dignity,’ say workshop presenters by Christopher S. Pineo (PilotCatholicNews.com 5/25/2012) – The realities of physician assisted suicide could reverse social stigmas against suicide, de-personalize care for people facing terminal illness, and create undignified final moments of life. Those points were the focus of the speakers at the Braintree presentation of the Archdiocese of Boston’s educational campaign “Doctor-Prescribed Suicide is Suicide… and suicide is always a tragedy!” Similar education sessions were held through the archdiocese during the month of May.
(more)

Death with Dignity or Murder? Francesca Bastarache interviews Dr. Marcia Angell and Heather Clish  5/24/2012 – Dr. Marcia Angell, former executive editor of the New England Journal of Medicine, now a senior lecturer in social medicine at Harvard Medical School; Time Magazine named her one of the 25 most influential Americans, is a woman on a mission. I assure you. She is NOT amusing herself.  If she has anything to say about it, this fall we will be voting in Massachusetts for the Death With Dignity Act.

Death Panels: Massachusetts is about to approve them by Julia Goralka, The Washington Times Communities 5/29/2012 – I am dying. I don’t have an incurable illness or suicidal thoughts, although with three teenagers those thoughts have flitted through my mind occasionally. At 48, I am not old; I am snuggling nicely into middle age. But make no mistake. I am well aware that I am dying. And so are you.

Minnesota

Minnesota grand jury to review right-to-die case (10tv.com 5/8/2012) – A grand jury is expected to hear evidence this week about the involvement of a national assisted suicide group in the death of a Minnesota woman in 2007.
Apple Valley resident Doreen Dunn, then 57, suffered through a decade of intense, chronic pain before she reached out to the New Jersey-based Final Exit Network. She used helium and a plastic bag to suffocate herself in May 2007, said Robert Rivas, a Florida attorney representing the group. He said he believes four members are now at risk of indictment.
Dakota County Attorney James Backstrom issued a statement Monday confirming his office is investigating Final Exit Network and that he will be convening a grand jury.
(more)

Should assisted suicide be an option for people in chronic, incurable pain? (MPR by Eric Ringham 5/9/2012) – opinions

Minnesota prosecutor obtains grand jury indictment of Final Exit Network and four of its volunteers (5/15/2012) – James Backstrom, the Dakota County prosecutor, called a press conference to deny that he has initiated a war on the right-to-die movement by securing a 17-count indictment against Final Exit Network and four of its volunteers.
As Final Exit Network had predicted, the grant jury handed down the indictment on Friday, May 11, 2012.  But the indictment remained sealed until Monday, when Backstrom called a 3 p.m. press conference to release the indictment and plenty of misinformation about Final Exit Network.
“It is appalling that the government would spend so much of its resources in this political prosecution,” said Final Exit Network’s president, Wendell Stephenson.  “We look forward to an opportunity to bring out the truth about Final Exit Network’s compassionate volunteers in court.”
(more)

Legal fight looms in Apple Valley suicide case by Katie Humphrey, Star Tribune (5/15/2012) – Dakota County Attorney James Backstrom announced Monday that a local grand jury had indicted the Final Exit Network and four of its members on 17 counts of assisting a suicide and interfering with a death scene.
The network faces four counts, two of them felonies. Altogether, the grand jury returned indictments on nine felonies related to assisting in a suicide and eight gross misdemeanors for interference in a death scene.
“If the people of our state wish to authorize assisted suicide, this should be done through clearly defined laws enacted by the Minnesota Legislature with proper restrictions and requirements to ensure the protection of a terminally ill patient and the direct involvement of the patient’s physician and immediate family,” Backstrom said during a news conference at the county law enforcement center in Hastings.
Lawyers for the network and one of the defendants vowed vigorous defenses, starting with a motion to dismiss the case, arguing that the Minnesota law prohibiting assistance of a suicide is overly broad and violates the First Amendment right to free speech.
(more)

Dr. Jon Hallberg: Clearing up confusion about palliative health care – MPR 5/16/2012 – ST. PAUL, Minn. — Palliative care is an approved medical subspecialty that’s present in 85 percent of larger hospitals. But a new survey in the Journal of Palliative Medicine shows that many patients and health care professionals are still confused about the concept. Many even confuse palliative care with euthanasia. (more: transcript & broadcast)

Legal, moral struggles to ‘death with dignity’ (StarTribune Editorial  5/19/2012) – Facing serious illness, most of us don’t want to suffer ourselves or stand by and see another person in pain.
That sentiment is understandable, especially in cases of terminal illness. However, it’s still illegal in most states, including Minnesota, to help someone end their life.
(more)

Nebraska

The Choice of Life or Death (1011now.com 5/14/2012) – Doctor assisted suicide, death by choice or dignified death, whatever you chose to call it, it’s an issue many are fighting for — the freedom to choose when and how you die.
It emerges as the most controversial cultural issue in a recent Gallup Poll. Americans are divided 45% to 48% over whether it is morally acceptable or morally wrong.
One Lincoln couple made that choice.
“It’s going to be a process, but I get it and I am so ok with it and I am happy they are together,” said Kim Miller, the daughter of Carol and Ray Miller.
It’s hard to imagine what it must feel like to lose a parent.
Imagine the heartbreak of losing both your parents at the same time because they took their own lives.
To help you understand why the family is so ok with it, you first have to know the great love story of Ray and Carol Miller.
(more)

New Mexico

Cancer patient joins NM ‘right-to-die’ law fight (NECN.com 5/9/2012) – ALBUQUERQUE, N.M. (AP) — A 48-year-old Santa Fe woman with advanced uterine cancer is joining two doctors in their challenge against a decades-old New Mexico law that prohibits doctors from helping terminally ill patients die.
Aja Riggs publicly announced her decision to join the lawsuit during a news conference Wednesday in Albuquerque.
The lawsuit asks courts to clarify a state law that makes assisted suicide a felony. Lawyers intend to argue that the state law does not legally prohibit doctors from ending the lives of terminally ill patients.
According to the lawsuit, the doctors, both who work at the University of New Mexico Health Science Center, seek to be allowed to prescribe medication to terminally-ill patients who want to end their lives.
The American Civil Liberties Union of New Mexico is helping with the lawsuit.

Some want a choice at the end of the road by Leslie Linthicum, ABQJournal 5/30/2012 –  “I’m actually going to take a pen and write a prescription for something that will end someone’s life.”
That was Katherine Morris, an oncologist and surgeon, facing a documentary filmmaker’s camera and summing up her role in helping an Oregon woman with terminal cancer give herself a lethal dose of barbiturates.
The film, a Sundance Film Festival winner last year, is called “How To Die in Oregon” and it follows Cody Curtis, a 54-year-old woman with advanced liver cancer, as she prepares for and then carries out what is commonly, but inaccurately, called “physician-assisted suicide.”
Morris is at UNM’s Cancer Center now, and she is one of two New Mexico oncologists bringing a lawsuit that asks the court to make a distinction between “assisting suicide,” which is a felony in New Mexico, and a physician “aiding in dying,” which is doing just what Morris did twice in Oregon — prescribing a lethal dose of medicine, usually Seconal pills, to mentally competent patients who are terminally ill and want to choose their time to die.
(more)

New York

New York assisted suicide bull loses support by Hillary Senour, EWTN News, Global Catholic Network 5/27/2012 – A bill that would have helped legalize physician-assisted suicide in the state of New York has lost its only sponsor thanks to the influence of the New York State Catholic Conference.
In early May, director of Pro Life Activities for the Conference, Kathleen Gallagher, met with bill sponsor Assemblyman Eric Stevenson (D-Bronx) and convinced him to remove his support.
(more)

Daunting questions on our fate – Michael Brannigan, timesunion.som 5/31/2012 – Does the case for terminal sedation actually weaken the case against physician-assisted suicide?
Terminal sedation, more clinically referred to as “palliative sedation,” is a legally sanctioned alternative to physician-assisted suicide, a last resort in palliative treatment. It involves inducing and maintaining unconsciousness in a terminally ill patient until the patient dies, and is often accompanied by withholding or withdrawing medical feeding and hydration.
For example, if, in my advanced cancer, I experience intolerable pain, delirium, dyspnea or distress, to alleviate these unmanageable symptoms I let my physician sedate me into unconsciousness until I die. Sort of like undergoing anesthesia before surgery, without waking up.
(more)

Five tips for families facing end-of-life care by Alexandra Sofferlin, Time Healthland (5/31/2012) – In this week’s TIME cover story, “The Long Goodbye”, journalist Joe Klein writes about the loss of his parents. They both suffered from dementia and died within months of each other. Through their end of life, Klein became his parents’ death panel. Video – How to Die
For the many other families facing the same journey, experts’ best advice is to prepare early. As with most difficult transitions, caring for a parent or loved at the end of life is easier if you’ve planned for it. Trying to make the best possible decisions about care often leads to added stress and confusion, especially if your family is already in a difficult situation. “It’s all pre-planning really,” says Malene Smith Davis, CEO of Capital Caring, which provides palliative care and guidance for families. “People really do cope well if they have a conversation about care with their families early. When families don’t have the conversation, that’s when there’s turmoil because no one is prepared and it’s inevitable.”

Oregon

Dragging out death has become an unpleasant societal epidemic by Todd Huffman, OregonLive.com (5/21/2012) – So desperate are we to prolong our curtain calls that hospitalizations during the last six months are rising. The average time spent in hospice and palliative care, which stresses comfort and quality of life once an illness becomes incurable, is falling. The fatally and frightened ill, or their anguished surrogates, are choosing needless medicine over comfort care, compounding and prolonging physical torments beyond any sensible point.
We have become a society that does not allow those who are close to death to die quickly and peacefully.
As a result, people today are actually sicker than ever as they die. Patients agree to treatments in the end more injurious than was their illness. Families push for treatment, only to discover that there are worse things than having someone you love die.
(more)

Texas

Euthanasia is a choice we don’t have yet (The Daily News-Galveston by Pepper Montague 5/9/2012) – In the state of Texas, if we choose, we can be taken off life support, kept out of pain and “allowed” to die, but it is illegal to be “assisted” in dying. There is a problem with that.
(more)

Vermont

Momentum in Montpelier for Death with Dignity Bill by Dick Walters, President Patient Choices at End of Life Vermont (5/3/12) – The majority of Vermonters support the Death with Dignity bill. They can be proud of the progress made in the 2011-12 legislative session toward enactment of this civil right. The issue has gained real momentum in the state capital.
The Death with Dignity bill would give terminally ill patients with fewer than six months to live the option – the choice – to request medication that they would self-administer as a way to control the timing and manner of their death.
(more)

Washington

Wash. Death with Dignity Act annual report released by Dan Thesman (KVEWTV.com 5/2/12) – OLYMPIA– The state’s third annual Death with Dignity Act report released today shows that 103 people requested and received lethal doses of medication in 2011. Since the 2009 law was passed, 255 terminally ill adults have received medication in Washington.
According to the report by the Washington State Department of Health, the 103 prescriptions were written by 80 different physicians and dispensed by 46 different pharmacists. The report covers January 1 to December 31, 2011. Participation increased 16 percent in 2011 from 2010.
(more)

One story behind Washington 2011 Death with Dignity Act Statistics by Colin Fogarty, OPB News 5/2/12) – The latest statistics on Washington’s Death with Dignity Act show a steady increase in the people who have legally ended their lives under the law. Seventy terminally people hastened their deaths in 2011 with the help of a doctor’s prescription. That’s according to a new report out Wednesday from the state Department of Health. Since 2009, a total of 255 terminally ill adults have ended their lives in this way.
Meg Holmes of Seattle held brain cancer at bay for 16 months. Surgeries and radiation couldn’t keep her down. Seven months after an MRI in March, Meg lost her ability to see and move around. And then suddenly… “She told me out of the blue that she had been thinking about the Death with Dignity Act and now that was something she was really interested in,” her husband said.
(more & listen to story)

Access to Aid in Dying Brings Peace of Mind (blog.compassionandchoices.org 5/2/12) – Compassion & Choices of Washington, a nonprofit organization that advocates excellent, patient-centered end-of-life care and stewards Washington’s Death With Dignity Act (DWDA), today responded to the state’s report on its third year of experience with the DWDA. “The report shows patients benefit from the peace of mind and comfort the law provides,” said Robb Miller, the group’s executive director. “The reports required under the DWDA confirm the safety of aid in dying. The law is working as intended and with no unintended consequences.”
The number of written requests, filed with the state under the provisions of the Act, rose only slightly, from 95 in 2010 to 103 in 2011. The number who self-administered medication to achieve a peaceful death in 2011 was 70. Of all the Washingtonians who died in 2011, those who self-administered life-ending medication obtained under the law represent only about 1 in 500.
(more)

INTERNATIONAL

(Argentina, Australia, Belgium, Canada, France, Germany, Ireland, New Zealand, Oman, Scotland, South Africa, Switzerland, United Kingdom)

Argentina

Argentina’s senate votes for “dignified death” law (CBS News 5/10/2012) – BUENOS AIRES, Argentina – Argentina’s senate on Wednesday overwhelmingly approved a “dignified death” law giving terminally ill patients and their families more power to make end-of-life decisions.
The law passed by a vote of 55 to zero, with 17 senators declaring themselves absent. It passed the lower house last year.
Now Argentine families won’t have to struggle to find judges to order doctors to end life-support for people who are dying or in a permanent vegetative state. Getting such approval can be very difficult in many countries, particularly in Latin America, where opposition from the Roman Catholic church still runs strong.
(more)

Australia

Suicide on agenda at forum – SunshineCoastDaily.com.au (5/13/2012) – The Your Death Your Choice community forum will tackle a range of controversial issues when it is hosted by Palliative Care Queensland and Cancer Voices Queensland, two of the state’s leading advocacy bodies for cancer and end of life.
“Queenslanders are suffering more and more because the Queensland Government has no end-of-life policy, and unlike other states, Queensland has no statewide plan for providing palliative care,” said Associate Professor Rohan Vora, president of Palliative Care Queensland.
(more)

Call for action by parliament on euthanasia by Lisa Cox, canberratimes.com.au 5/17/2012) – When he talks about euthanasia, Professor Bob Douglas borrows a line from a former health minister by saying it’s an issue that has politicians ”hiding under their desks”.
Studies have shown that the number of Australians who support voluntary euthanasia is greater than the number that oppose it.
A poll published last year by the Australia Institute put the figure in favour at three in four. Other surveys have had the percentage as high as 85 per cent.But despite the apparent endorsement, there has been no policy change around assisted dying and attempts to have legislation passed have failed.
(more)

Belgium

Euthanasia should also be possible for minors – FlandersNews.be 5/5/2012 – The Flemish socialist lawmakers Marleen Temmerman and Myriam Van Lerberghe want to make euthanasia possible for minors and those suffering from dementia. That’s according to a report in De Standaard. The two politicians are planning to propose a bill by the end of May.
They hope that the time is right to liberalize euthanasia. It should also be allowed for minors, people suffering from dementia or people who are permanently unconscious.
“Society is ready for this”, Ms Temmerman argues. She claims that a big majority of the people agrees with her, especially when a patient previously indicated that he or she would like to escape from this life in these special cases mentioned above.
(more)

Canada

Edmunton

Alzheimer’s and euthanasia by P.J. Cotterill, Edmonton Journal 5/23/2012 – I couldn’t agree more with the Calgary Herald’s editorial that Canada needs to copy the U.S. idea of a national Alzheimer’s plan.
Given Alzheimer’s current incidence and expected increase because of our aging population, we need to pay more attention to this dreadful disease and other forms of dementia.
Because a cure appears distant, however, any national plan should include legalized voluntary euthanasia, allowing those who do not wish to continue living without a functioning brain to die with dignity and less suffering.

Montreal

Term ‘medical aid in dying’ only confuses issue by Eric W. Mauser, Catholic Times Montreal 5/28/2012 – The recommendations of the Select Committee on Dying with Dignity have been tabled and the first round of public consultation concluded, but the most important public debate is yet to take place, according to the English Speaking Catholic Council (ESCC) and like-minded organizations.
The committee’s report recommended expansion of palliative care in Quebec asked the National Assembly to legalize euthanasia and physician assisted suicide, which the report calls “medical aid in dying.”
While there is near unanimous approval for improving palliative care throughout the province, the provisions for “medical aid in dying” are cause for alarm, some groups say.
(more)

Saskatoon

A conversation about medically-assisted suicide at a Saskatoon library – Heads of major Canadian organizations debated the legalization of medically-assisted suicide – Reported by Jared Knoll, CKOM NewsTalk 650 5/3/12) – Saskatoon’s Frances Morrison Library hosted a public debate Thursday night on the legalization of medically-assisted suicide.
Wanda Morris, executive director for Dying with Dignity, faced off against Alex Schadenberg, executive director with the Euthanasia Prevention Coalition.
Morris said that it’s a matter of choice and compassion.
(more)

France

Pope urges France’s Hollande to ‘respect life’ (expatica.com French News 5/16/2012) – Pope Benedict XVI has urged French President Francois Hollande to “respect life” — a reference to abortion and euthanasia, the I.Media news agency for Vatican affairs reported on Wednesday.
The pope congratulated Hollande on his appointment and said he should protect “the dignity of everyone.” The Socialist Hollande supports euthanasia for terminal patients, a stance that is worrying the Catholic Church.
Hollande has also proposed including legally-enshrined principles of secularism in the French constitution.
“I ask God to help you so that, respecting its noble moral and spiritual traditions, your country may continue with courage its efforts to build an ever more just and fraternal society,” the pope said.

Video – Riz Khan: Should assisted suicide be allowed debate (3/9/2012)

Germany

German doctors vote against commercial suicide – BioEdge (May 5, 2012) – Earlier this month the German Medical Association apologized for human rights violations by Nazi doctors and asked for forgiveness from victims and their descendants. It also admitted that “outstanding representatives of renowned academic medical and research institutions” had cooperated in the Holocaust enthusiastically, and not under necessarily under duress from Hitler’s government.
(more)

India

Video – Choosing to Die (India – Nurse Aruna Shaunbaug has been in a vegetative state since she was strangled and sodomized by a disgruntled ward clerk 37 years ago. The Supreme Court rejected a mercy killing plea to end this woman’s life. Children with a debilitating condition with no cure and no money for treatments. Is euthanasia a reasonable request? Cases of active and passive euthanasia (2 parts)

Ireland

Exit International Ireland reports growing interest in assisted suicide by James Fogarty, Medical Independent 5/17/2012 – Three to four Irish people a week contact Exit International, a group campaigning for the legalisation of assisted suicide, according to the group’s Irish spokesperson Tom Curran.
(more)

New Zealand

Man admits helping his wife die by Victoria Robinson, AucklandNow 5/4/12 – An Auckland man has admitted helping his wife die to end her suffering from multiple sclerosis.
Evans James Mott, 61, appeared in Auckland District Court this morning, where his lawyer, Ron Mansfield, entered a guilty plea on his behalf.
No conviction was entered, and Mansfield indicated he would seek a discharge without conviction at sentencing in the High Court.
(more)

Kiwis back euthanasia – by Sarah Harvey (stuff.co.nz 5/5/2012) – New Zealanders are in favour of euthanasia for personal reasons, and often because they don’t want money spent on themselves that could benefit younger, healthier people, a soon-to-be-released study will show.
The University of Auckland study by clinical medical ethics lecturer Phillipa Malpas, to be published in the New Zealand Medical Journal this year, discusses the ethical implications around end-of-life decision-making through a number of interviews with New Zealanders.
Malpas said she interviewed a group of people aged 65 and over who were healthy, and expressed interest in, or were part of, the Voluntary Euthanasia Society.
(more)

Legal euthanasia kills justice for all by John Kleinsman (Sunday Star Times-Opinion 5/5/2012)

The euthanasia debate – DPF’s Kiwiblog 5/6/2012 – If the debate is about how do we make euthanasia safe, rather than does a person have a right to end their own life, then that is a step forward.
We should firstly recognise that we already have unregulated passive euthanasia in New Zealand, where people are allowed to die, even though they could be kept alive. I think there is far greater risk in the status quo, than in legislating the circumstances under which someone’s wishes to die can be implemented with assistance.
(more)

YourNZ – links and news 5/4/2012 – Political and social information and discussions – left, right, out and in centre

The Bioethics Center Blog – If you can tolerate this, then will your granny be next? Colin Gavaghan on New Zealand’s euthanasia debate 5/15/2012

Oman (Sultanate of)

Oman Daily Observer (May 1, 2012) – Fresh Debate by David Barber – The cases of two men charged with helping terminally ill relatives to end their lives have sparked a fresh debate about voluntary euthanasia in New Zealand.
Opposition politician Maryan Street is pushing legislation that would allow a person to help someone end their life without facing criminal charges. Parliament last debated the issue in 2003 after a woman was jailed for 15 months on a charge of attempted murder after her terminally ill mother died.
(more)

Scotland

Dignity in Dying’s response to the Assisted Suicide (Scotland) Bill – 5/5/2012

Call for debate on assisted suicide (heraldscotland.com 5/9/2012) – A woman whose husband has suffered from Alzheimer’s disease for 17 years has called for the debate over the right to die through assisted suicide to include patients with dementia.
Liz Jamieson, whose husband Hugh was diagnosed with the condition in 1995, said patients who are newly diagnosed should be able to decide, with the help of lawyers and relatives, about ending their lives.
(more)

South Africa

Emotional reunion for prof by Daneel Knoetze (DailyNews-South Africa 5/3/12) – Davison also thanked South Africans for the messages of support, especially Archbishop Emeritus Desmond Tutu who sent a letter pleading for leniency to the judge in the case.
“In New Zealand they have a great admiration for Tutu. I have no doubt that I would have served jail time had it not been for his support,” said Davison.
In 2006, Davison gave his 85-year-old mother, Dunedin resident Patricia Davison, a lethal dose of morphine after she tried to starve herself to death.
(more)

Dignity SA petitions for assisted suicide – by Kaylee Kruser, Eye Witness News 5/5/2012 – Cape Town – Non-governmental organization Dignity SA believes terminally ill people should have the right to choose end of their life. The organization started a petition to bring a bill before parliament to legalize assisted dying after the return home of Professor Sean Davidson from serving house arrest in New Zealand after helping his mother die in 2006.

Campaign to legalize assisted suicide in SA – Mail & Guardian News 5/17/2012 – A controversial campaign to legalise doctor-assisted suicide and active euthanasia was launched in Cape Town on Thursday, spearheaded by the Ethics Institute of South Africa (EthicsSA) and Dignity SA.
The launch comes two weeks after the much-publicised return to South Africa of Dignity SA founder Sean Davison, following his five-month house arrest in New Zealand for assisting his aged mother to die.
(more)

Switzerland

Vaud Canton in Switzerland to vote on new step in Right to Die laws – The World Federation of Right to Die Societies (April 30, 2012) – Following the initiative of 3 October 2009 launched by EXIT ADMD Suisse romande,  a vote will be held in the Canton of Vaud on 17 June 2012, hoping to change existing Swiss law in such a way that assistance for suicide will also be allowed in Socio-medical Establishments (so called SME’s), as it is in private homes.
(more)

World-weary Swiss seniors seeks suicide help – The Local-Switzerland’s News in English 5/9/2012 – New figures show that more and more Swiss seniors are taking advantage of assisted suicide even when they do not suffer from any terminal diseases.
The latest reports from Exit, the organization that offers assisted suicide to the Swiss, show that one in every five French speakers and one in every three German speakers opting for assisted suicide are not suffering from a life-threatening illness, newspaper Tribune de Genève reported.
(more)

Switzerland voters rejected ban on assisted suicide for foreigners (jurist.org) – On May 15, 2011, voters in the Swiss city of Zurich rejected a proposed ban on assisted suicide for foreigners as part of a plan to stem the rise of “death tourism,” in which foreigners take advantage of Swiss assisted suicide laws. Assisted suicide has been legal in Switzerland since 1941 and permits a non-physician with no vested interest in a person’s death to provide passive assistance such as prescribing necessary drugs. In 2010, Switzerland’s Federal Council and Federal Department of Justice and Police (FDJP) had introduced legislation establishing stricter rules on assisted suicide based on a consensus of local governments and agencies. UK Director of Public Prosecutions Keir Starmer also published a policy in 2010 outlining public interest considerations against prosecution of those who assist in a suicide including, among other factors, efforts made to dissuade the victim.

Video – The Suicide Tourist (5 parts)

United Kingdom

Patient denied dignified death (itvNews 5/4/12) – The family of a brain tumour patient from Tameside believe he was denied the dignified death he wanted, because medics didn’t turn off an implant designed to keep his heart beating.
Brian Williams, from Hattersley, asked to drift off gently during his final hours at Tameside Hospital. But he’d had a personal defibrillator implanted in his chest for heart problems, years earlier, and it kept shocking him when he was close to death.
(more)

Supporters of euthanasia and abortion ‘use same arguments as the Nazi’s did to promote genocide,’ says Vatican newspaper – Daily Mail Reporter 5/5/2012) – The Vatican’s semi-official newspaper has angered supporters of euthanasia and abortions by suggesting they apply the same justifications that were used by the Nazis to champion their murderous eugenics programme.
(more)

MPS welcomes GMC guidance on assisted suicide but calls for greater clarity – 5/4/2012 – The Medical Protection Society welcomes the General Medical Council’s guidance for its Investigation Committee and case examiners when considering allegations about a doctor’s involvement in assisted suicide, but calls for greater clarity.
Assisted suicide is a complex issue and doctors need clarity, certainty and consistency on their professional and legal responsibilities, when placed in these difficult and emotionally charged situations.
(more)

Assisted suicide law will force chemists from their jobs, says Wirral pharmacist (Diocese of Shrewsbury 5/9/2012) – Rosemary Baker of Hoylake warned pharmacists that they could be ostracised and ultimately driven from their jobs if they refused to dispense lethal drugs needed for assisted suicides if British laws were further weakened by either Parliament or the courts.
Her warning was sounded in a full-page article in the highly-respected Pharmaceutical Journal this week entitled “Stop and think! Are pharmacists really prepared to assist people to die”.

Majority of Ambulance Trusts have polices to ensure patients are not treated or resuscitated against their wishes at the end of life (Compassion in dying 5/24/2012) – Mrs Davis* contacted Compassion in Dying, concerned that her wishes at the end of her life may not be respected by her local ambulance service. Paramedics had told her that they would not take her Advance Decision into account when transporting her, reporting that they would only respond to a Do Not Attempt Resuscitation (DNAR) form signed by her doctor.
(more)

MS sufferer rode wheelchair for two hours to kill herself (The Telegraph 2/24/2012) – The day before Carol Hutchins died, she arrived home in floods of tears after the lever on her buggy had jammed leaving her unable to throw herself over a 3ft fence and into the water.
Determined to end her life, Mrs Hutchins returned to the canal the following day and got the mechanism working to lift the chair above the height of the fence.
(more)

Acutely ill patients prevented from dying with dignity in hospital by Sarah Boseley, The Guardian 5/31/2012 – A third of acutely ill patients in hospital, many of them nearing the end of their lives, are not getting the best care and may be subjected to futile resuscitation attempts that prevent them dying with dignity, according to a new report.
The report, from doctors at the influential national confidential enquiry into perioperative deaths (NCEPOD), paints a disturbing picture. Focusing on patients who suffered cardiac arrest in hospital and were given cardiopulmonary resuscitation (CPR), it finds that less than a third (29%) got good care.
(more)

Video – Euthanasia clarification hearing for Debbie Purdy (10/2/08)
Video – Purdy loses appeal (10/29/08)
Video – Debbie Purdy: I’ve got my life back (7/30/09)

Assisted Death Debate – News from March 2012

End-of-Life discussions about Assisted Dying/Suicide/Euthanasia in news articles, blogs, videos from the left, right and center during the month of March 2012. This is a place to find out what’s being talked about around the world as we sort out this highly emotional and controversial issue.

Become informed, open your mind,  join in the discussions. Our leaders need to know what people are thinking and we need to know what our leaders are considering in terms of laws. These are conversations we all need to have!

Definitions

Direct active euthanasia is taking specific steps to cause the patient’s death, such as injecting the patient with drugs. This is usually an overdose of painkillers or sleeping pills.

Indirect active euthanasia is giving the patient a palliative drug that could lead to death.

Passive euthanasia is usually defined as withdrawing medical treatment with the deliberate intention of causing the patient’s death.

Assisted suicide is when a doctor provides a patient with the means to end his own life; however, a doctor does not administer it.

The Netherlands permits both physician-performed active euthanasia and physician-assisted suicide; the Dutch law requires that the patient be facing intolerable suffering but not that the patient be terminally ill, nor even that the suffering be physical. In contrast, the Oregon and Washington statues permit only the writing of a prescription for a lethal drug but not active euthanasia, they require that the patient be terminally ill, and they make no mention of suffering. “Euthanasia and Law in Europe” Griffiths, j., et. al. Hart Publishing, 2008. From a book review in the New England Journal of Medicine by Margaret P. Battin, PhD

Death With Dignity isn’t Suicide – The DWDA patient is terminally ill and wants to live; the suicidal patient has no terminal illness but wants to die.

World laws on Assisted Suicide

UNITED STATES

U.S. Supreme Court and Assisted Suicide Resources

In 1996, two Federal Circuit Courts of Appeal struck down laws prohibiting assisted suicide. The appeals on these rulings were heard by the U.S. Supreme Court January 8, 1997. The court unanimously overturned both Circuit Court rulings on June 26, 1997.

Justice John Paul Stevens: “He showed great empathy for suffering patients and their physicians in the physician-assisted suicide cases, writing in a concurring opinion that although he agreed that patients have no constitutional right to physician-prescribed lethal drugs, he might change his mind if such a prescription was shown to be “the only possible means of preserving a dying patient’s dignity and alleviating her intolerable suffering” (Vacco v. Quill) NEJM 362;24

At least 30 states have laws explicitly criminalizing assisted suicide. Another nine states criminalize the practice through common law.

American Medical Assn. News
The number of Washington state residents who died of physician-assisted suicide rose to 70 in 2011, up from 51 in 2010 and 36 in 2009, when the state’s Death With Dignity Act took effect. The Washington State Dept. of Health reported in May that 103 patients requested and received lethal doses of medications from 80 different physicians in 2011.
In addition to the 70 who died after ingesting medication, 19 died of natural causes. An additional five died, but it is unclear whether they took the medications. No reports were received for the remaining nine patients, indicating that they were still alive at year’s end.
The vast majority of the terminally ill patients who received life-ending medications feared loss of autonomy, dignity and ability to participate in activities that make life enjoyable. More than 90% were white, and 75% had at least some college education. Nearly 80% of the patients had cancer, said the report (doh.wa.gov/dwda/forms/DWDA2011.pdf).
Seventy-one patients in Oregon died of physician-assisted suicide in 2011. Since 1998, when Oregon’s first-of-its-kind law took effect, 753 patients in Oregon and Washington have died with physicians’ aid.

California

Woman charged with assisted suicide of vet

Victim of Alleged Assisted Suicide Remembered as Quiet, Good-Natured (Laguna Nigel Patch)

O.C. Woman Accused of Helping WWII Veteran Commit Suicide (LA Times blog)

Woman Arrested in Assisted Suicide of WWII Veteran Via Oxycontin-laced Yogurt (KPCC Radio)

Woman Accused in WWII Vet’s Suicide by Lethal Yogurt (US News)

Assisted Suicide Arrest Illustrates Death-on-Demand Logic of Euthanasia (National Right to Life News Today)

Defense in Assisted Suicide: Woman Unaware Vet Wanted to Die (OC Register)

Elizabeth Barrett, Woman Accused of Assisted Suicide, Claims She Didn’t Know Pills Would Kill (Huff Post Los Angeles)

Charges Filed in Yogurt-Assisted Suicide (KSN.com)

Woman Arrested After Grinding Oxycontin into Yogurt and Giving it to Healthy 86-year old veteran ‘in Apparent Assisted Suicide’ (UK Mail Online)

Calif. Woman Charged With Assisted Suicide (UPI.com)

Attorney: OC Woman Accused in Assisted Suicide Was Unaware Vet Wanted to Die (CBS News)

Woman Charged with Assisting Suicide of WWII Vet (RTT News)

Florida

Florida plans to bar some patients during flu epidemic by Sheri Fink, Sun-Sentinel (10.19.09) – “Florida health officials are drawing up guidelines that recommend barring patients with incurable cancer, end-stage multiple sclerosis and other conditions from being admitted to hospitals if the state is overwhelmed by flu cases.

The plan, which would guide Florida hospitals on how to ration scarce medical care during a severe flu outbreak, also calls for doctors to remove patients with poor prognoses from ventilators to treat those who have better chances of surviving. That decision would be made by the hospital.

The flu causes severe respiratory illnesses in a small percentage of cases, and patients who need ventilators and are deprived of them could die without the breathing assistance the machines provide.”

BUT FLORIDA DOES NOT ALLOW ASSISTED SUICIDE!

Georgia

Georgia high court strikes down assisted suicide law – The Supreme Court of Georgia has struck down — on First Amendment grounds — a state law intended to prevent assisted suicide. Reversal of the law means that a physician and three others who were charged with helping a man take his own life in 2009 are free from prosecution.

The wording of the law was too broad, encompassing not just the act of assisting a suicide but also related and constitutionally protected speech acts, the state Supreme Court ruled on Feb. 6… the high court said the state failed to provide an adequate explanation for or evidence about why a public advertisement or an offer to assist in an otherwise legal activity was sufficiently problematic to justify an intrusion on protected speech rights.

Case at a glance

Is a state law banning advertising of assisted suicide services constitutional?

The Supreme Court of Georgia said no. The court overturned the law, ruling that the state had failed to provide adequate explanation or evidence as to why an advertisement or an offer to assist in an otherwise legal activity was sufficiently problematic to justify an intrusion on protected speech rights.

Impact: Assisted suicide is now technically legal in Georgia, with no rules or regulations forbidding the practice.

Georgia Senate approves measure criminalizing assisted-suicide

Final Exit Network Inc. v. the State of Georgia, Supreme Court of Georgia, Feb. 6 (www.gasupreme.us/sc-op/pdf/s11a1960.pdf)

Hawaii

A Conversation about aid in dying in Hawaii – Every few years the Hawaii Legislature considers — and invariably rejects — legislation establishing physician-assisted suicide, also know as “death with dignity.”

The measures have primarily been opposed by religious groups, particularly the Catholic Church.

But Hawaii’s population is aging, and growing in size. The tremendous challenge of dealing with an ailing loved one was tragically illustrated just last week in the murder-suicide of an elderly Hawaii couple.

5 Hawaiian doctors offer assisted suicide to terminally ill patients – A group of Hawaii physicians is offering to write lethal prescriptions for terminally ill patients in a bid to test whether doctor-assisted suicide is allowed under state law.

In January, Dr. Nathanson co-founded the Physician Advisory Council for Aid in Dying, which now has five doctor members. The council has started a hotline to field queries from patients and doctors about end-of-life care issues and physician-assisted suicide. The idea is that Hawaii physicians who fear the legal consequences of writing life-ending prescriptions could refer their patients to the council for help, said Dr. Nathanson, 78.

“That’s the thing — I’m retired,” he said. “I think the worst that would happen is that they’d take my license away. I don’t think I’m going to put in any jail time. … My livelihood doesn’t depend on it, so I can be very brave.”

Dr. Nathanson said he is ready to be involved in the case that tests where Hawaii law stands on physician-assisted suicide.

Massachusetts

Massachusetts’s Death With Dignity Act ballot initiative  – H3884

Legal challenge to assisted suicide initiative – On Thursday, May 17, 2012, Massachusetts voters including members of the disability rights group Second Thoughts filed a challenge before the Supreme Judicial Court regarding the proposed ballot language for the measure that, if approved, would legalize assisted suicide in the state.

“The ballot language is clearly misleading,” said Second Thoughts director John Kelly of Boston. “We want the voters of Massachusetts to know exactly what they are voting on this November,” he said.

“The ballot language repeats the problems of the bill itself,” said Second Thoughts member Paul Spooner of Taunton. “The title is euphemistic, with the word ‘medication’ twisted beyond recognition. People will be led to believe that the measure is about palliative care, when it is about taking a lethal overdose — in other words, poison. Why not just call the act by its common and legal name, ‘physician-assisted suicide?'”

Massachusetts Dignity 2012– We’ve received an overwhelmingly positive response from people across Massachusetts who believe terminally ill patients deserve greater control over their end-of-life care. Hundreds of volunteers and donors have signed up to help with the effort. These decisions are deeply intimate and personal, and belong in the hands of individuals, not the government.

The proposed initiative gathered more than 84,000 signatures from voters for the initial qualification phase for which we only needed about 69,000 to move forward. After achieving that first step, the initiative was then put before the State Legislature for consideration and received a hearing. The next step in this process started yesterday when we filed the documents to request the petitions to put Dignity on the ballot.

The state constitution requires the petition to travel through the legislature where it is today. They had until May 1st to act on the petition but that didn’t happen. Now the petition has entered its next phase when we’ll need to collect about 20,000 more signatures by the end of June to put the question on the ballot in November.

Poll: Most support doctor-assisted suicide. Do you? (43% to 37%)

New Mexico

Patient joins doctor’s court case, asks for aid-in-dying option (Albuquerque, NM) – A 48 year old women with advanced ovarian cancer has joined a case asking a court to clarify the ability of mentally competent, terminally ill patients to obtain aid in dying from their physician if they find their dying process unbearable. Doctors have treated her with radiation and chemotherapy. For much of the time she has suffered debilitating exhaustion. In December she suffered neutropenia — an immune system “crash” — requiring hospitalization.
“That experience,” said Aja Riggs, “and the amount of pain and intensive medical treatment, has made me think: If this disease is going to take my life, I don’t need to go to the very end with it. I understand people can’t know how they’ll feel until they get there. So I don’t know. But I know I want to have the choice.”
The plaintiffs request a ruling that physicians who provide a prescription for medication to a mentally competent, terminally ill patient, which the patient could consume to bring about a peaceful death, would not be subject to criminal prosecution under existing New Mexico law, which makes a crime of assisting another to ‘commit suicide.’ The choice of a dying patient for a peaceful death is no kind of ‘suicide,’ the case asserts, and the physician does not assist such a patient in ‘committing suicide.’
“I’ve been thinking so much about having some control over the end of my life, and I felt I couldn’t talk about it with the people closest to me. I thought if it came to choosing a peaceful death, I would have to do it on my own to keep from implicating anyone else. To end that sense of fear and isolation that people have — about one of the most important incidents in our lives — it makes so much sense.” ACLU video

Oregon

The Death With Dignity Act in Oregon and Lane County – 13 years from Compassion & Choices Oregon.The Oregon DWDA was passed as a complex, double-safety-redundant process to address objections and predictions of doom by it’s opponents. The mechanical demands of the law represent an unfamiliar hurdle for the sympathetic physician and an enormous hurdle for a dying, emotionally distressed patient. The emotional hurdle for the first time sympathetic physician is not to be underestimated. As a result, only those patients who are educated enough and driven enough to push through the barriers, and have enough “time”, actually get to the final prescription. That currently amounts to .2% of the yearly deaths in Oregon. 83% of those who take the medication have cancer and 11% Amyotrophic Lateral Sclerosis.

Oregon Report shows more assisted suicides, more secrecy (National Right to Life News Today by Jonathan Imbody, Vice President for Government Relations for the Christian Medical Association. The Physicians for Compassionate Care Education Foundation  issued a critique of the Public Health Department of the Oregon Health Authority’s report for physician-assisted suicides for the 2011 year.

The shroud of secrecy surrounding assisted suicide is heavier than ever. With each passing year, Oregonians know less and less about what is really happening with assisted suicides in the state.

Oregon docs not evaluating for depression before assisted suicide by Gene Tarne, a senior adviser at the Lozier Institute. In 2009, officials with the Oregon Health Department called the ongoing decline in requests for psychiatric evaluation for those seeking assisted suicide a “worrisome trend,” noting that “[t]he decline in formal evaluation raises concerns that depression remains undiagnosed in some patients who request and receive a prescription under the DWDA.”

Vermont

Life Everlasting: The religious right and the right to die by Garret Keizer, Harper’s Magazine 2/05) – This is the ballad of Doctor Lloyd Thompson (a founder of one of Vermont’s first hospice programs), who may or may not have hastened a patient’s death. This is a song about American secular democracy, which may be under a sentence of death, and about those forces gathering at the gallows. Most of all, this is a song about who owns your life.

Vermont’s death with dignity effort (4/16/12)- In a press release posted on Patient Choices Vermont’s website, Dick Walters, president of the organization stated, “Despite this decision, we appreciate the attempt by our Senate supporters to bring this bill to the Senate floor for a vote. We celebrate their courage and willingness to discuss an issue that is so important to so many Vermonters. We look forward to the day when all Vermont legislators get a chance to vote on the Death with Dignity bill.”

Vermont Citizens Against Assisted Suicide – True Dignity Vermont is a grassroots, independent, citizen-led initiative in opposition to assisted suicide in Vermont. Vermonters deserve true dignity and compassion at the end of life, not death and abandonment. Killing is not compassion, and True Dignity Vermont will work to ensure our end-of-life choices respect the dignity of all Vermont citizens.

Death With Dignity Bill may not go to full Senate (VPR News) Senator Sears: “A lot of times bills are votes based upon what I think my constituents want, or what’s best for the state of Vermont, what’s best for my region, etc, etc. This is one, clearly a vote of conscience.”

We shouldn’t encourage suicide (Letter to Editor Times Argus)

INTERNATIONAL

Australia

A doctor in Australia, ““Developing palliative care services in Noosa is as important as being able to choose to die with a terminal illness.

“There needs to be better support for people dying at home. With personal experience, I can’t speak highly enough of those doctors who make themselves available when a person is dying at home and the community nurses do a wonderful and professional job in caring for the dying. But more thought needs to be given to back-up systems, especially concerning the availability of restricted drugs after hours.”

Godless Gross blog – A moral storm in a mortal teacup? Yet published research on assisted suicide laws are far from a slippery slope. A study of US state Oregon and the Netherlands, both of which have legislated for assisted suicide, shows that vulnerable groups are not ‘‘groomed’’ for suicide. Indeed in some studies the number of deaths by assisted suicide is utterly tiny (0.13 per cent in Oregon and 0.02 per cent in Switzerland).

These figures could be used to impugn both sides of the argument. There is no slippery slope, as feared by the churches, and there is no real need for reform, as argued by the advocates for change. There is no evidence that life will be so cheapened that we will then call for the killing of those with diminished capacity.

When you speak to doctors and look at these small numbers, is it all a moral storm in a mortal teacup?  The doctors I have spoken to don’t cry out for the power to kill but for the courage to be not too enthusiastic with invasive treatment. Saving the dying from futile care is far more important numerically than the politicised area of euthanasia.

Consumers call for euthanasia to be examined (CanberraTimes.com.au) – The legal status of voluntary euthanasia should be considered by a Senate committee inquiring into palliative care in Australia, according to the Health Care Consumers Association of the ACT.

The group has also used a submission to the Senate Community Affairs References Committee to renew calls for a second, ”secular” hospice to be built in Canberra to complement the Clare Holland House hospice.

We need to talk about euthanasia(CanberraTimes.com.au) – As the general population has aged, diseases which were rare only decades ago, are manifesting themselves. Cancers, wasting diseases and also dementia-related conditions, are now reaching epidemic proportions.

Medical technology has progressed over recent years to the point where a body can be kept “alive” by artificial means. Where once a condition might claim a life, today many patients are faced with enduring long periods attached to wires and tubes. ? Rather than enduring these indignities and dying in agony, many patients ask to be helped to die.

Belgium

Ten years after euthanasia law opposition simmers by Taylor Poole (UPI) – “Philippe Mahoux, the head of the Socialist Party in the Senate and one of the fathers of the euthanasia law in Belgium, said Parliament began debates about euthanasia in 2000 and eventually passed the law because there was a demand for it.

The three most common reasons for euthanasia requests are when a patient is suffering without prospect of improvement, when he or she is feeling a loss of dignity or experiencing pain, reported a study by Yanna Van Wesemael, a psychologist and researcher.

Wesemael’s 2011 study on the outcomes of euthanasia requests states that, since 2002, 48 percent of requests have been carried out. Some are withdrawn, some patients die before they receive approval and some requests are refused.

Lionel Roosemont (father of a 16-year-old child born with half a brain) says he sees signs that the attitude toward euthanasia in Belgium is increasingly found in other parts of the world, including the United States. He’s concerned that a similar law could be introduced in the United States if Americans, like Belgians, view being able to choose when to die as an issue of personal freedom.”

Read more: http://www.upi.com/Top_News/World-News/2012/03/16/Ten-years-after-Belgian-euthanasia-law-opposition-simmers/UPIU-7421331581626/#ixzz1vuWwUZAG

Canada

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition (Canada)- Legalizing euthanasia would leave the vulnerable unprotected (3/28/12) – On March 22, the Quebec government’s Dying with Dignity Commission released its recommendations concerning euthanasia and palliative care. The media reported that the commission recommended the legalization of assisted suicide in exceptional cases.

In fact, the commission recommends that euthanasia be legalized — but not assisted suicide — in Quebec. The commission’s recommendations are similar to Belgian-style euthanasia, which is not limited to exceptional cases.

The first half of the report contains recommendations for improving palliative care, including the need for greater public awareness of the full range of palliative care options available today. We at the Euthanasia Prevention Coalition (EPC) support these recommendations. EPC believes that improvements to pain and symptom management must be systematically implemented before the issue of euthanasia can be fairly addressed.

However, EPC vigorously opposes the second half of the report which recommends legalizing Belgium-style euthanasia.

Barbara Kay – Euthanasia report is reassuring but misleading(11/16/11) – The Royal Society of Canada (RSC) has recommended that the Criminal Code of Canada be amended so that people in poor health would have the right to physician-assisted suicide or euthanasia. The six-person panel, headed by Queen’s University bio-ethicist Udo Schuklenk, claims that fears of the elderly and the infirm of being hastened to death without their full consent are unwarranted:

“The evidence from years of experience and research where euthanasia and/or assisted suicide are permitted does not support claims that decriminalization will result in vulnerable persons being subjected to abuse or a slippery slope from voluntary to non-voluntary euthanasia,” reads a summary of the report’s findings.

B.C. woman asks for right to assisted suicide (8/5/11) – If Gloria Taylor has her way, Canadians may soon be able to choose doctor-assisted suicide rather than a prolonged and agonizing death. The Kelowna, British Columbia woman is suffering from Lou Gehrig’s disease. She is gradually losing her ability to walk, use her hands, swallow and even breathe.

In a CBC interview on June 29, 2011, Ms. Taylor talked about her decision to join the B.C. Civil Liberties Association’s suit challenging laws that criminalize assisted suicide. She has discussed her wishes with her family. Having watched Ms. Taylor’s slow, inexorable decline, they support her decision to request the option to legally commit suicide. She said, “No one in my family wants to see me suffer….I have the blessings of my family and all my closest friends.”

Death needs no assistance – The B.C. Catholic Paper (3/2/12)  – One of the primary purposes of good health care for the dying is the relief of pain and the suffering caused by it. Effective management of pain and palliative care in all its forms are critical in the appropriate care of the dying. We are grateful Catholic institutions are in the forefront of such treatment.

The truth that life is a precious gift from God has profound implications for our personal and social stewardship over human life. Because as social beings we live in community, we are not the owners of our lives, and therefore do not have absolute power over life and death.

We have a duty to preserve life. Yet this duty is not absolute, for life-prolonging procedures that are insufficiently beneficial or excessively burdensome may be forgone. Euthanasia or physician-assisted suicide, however, is never a morally acceptable option.

Montreal

Dying with dignity – Finally, some compassion, declares RPCU (Canada Newswire) – The Regroupement provincial des comités des usagers (RPCU) supports the recommendations in the report released by the Select Committee on Dying with Dignity, which include improved palliative care and medical assistance when dying.

“Palliative care must be available everywhere – including in patients’ homes, as recommended by the Committee,” asserted Pierre Blain, director general of the RPCU.

“Compassion and respect for human beings should override all other aspects when considering end-of-life issues.”

Assisted suicide to be allowed? (The Barrie Examiner by Giuseppe Valliante, QMI Agency – Canada may have just moved one step closer to legalizing assisted suicide, according to prominent author and emeritus professor at the University of Toronto, Wayne Sumner.

Sumner, author of Assisted Death: A study in Ethics and Law, told QMI Agency Friday that he thinks the Supreme Court of Canada will likely agree to rehear the case for assisted suicide and will reverse its position on the issue.

“The winds are tending to blow in that direction,” he said.

On Thursday, a nine-member multi-party committee of Quebec MNAs presented a report to the province’s legislature recommending what it called “medical aid to die.”

The committee recommended that Quebec’s legislature enshrine rules governing assisted suicide in the province’s Civil Code within a year. Moreover, it also wants the government to prevent its attorney general from prosecuting Quebec doctors who help their patients die — regardless of the Criminal Code of Canada.

Sumner said the Quebec report is “a logical progression from the existing state of affairs.”

Patients already have the right in Canada to refuse food and other end-of-life treatments, he said. Keeping assisted suicide illegal in Canada is based on an “irrational prejudice,” he said.

In a 5-4 decision, the Supreme Court ruled in 1993 that assisted suicide should remain illegal.

Quebec

Quebec report calls for euthanasia legislation (Globe and Mail) – Quebec is being asked to take the bold step of legislating a form of medically supervised euthanasia.
A report entitled Dying With Dignity that an all-party select committee tabled on Tuesday, includes a proposal called “medical aid to die” that is based on the opinion that dying is a part of life, and since medical assistance is used to prolong life, it should also be used in extreme cases to end it.

“Medical aid to die is more of an evolution than a revolution,” said Parti Québécois MNA Véronique Hivon, the committee co-chair. “The patient must be the one who asks the assistance. It cannot be in any case someone else who asks for it.”

After more than two years of sometimes difficult deliberations and public hearings, the committee proposed that the government legislate an end to the enforcement of long and painful deaths.

The committee insisted the proposal is in no way a form of assisted suicide but rather the ultimate health care solution for the terminally ill.

“This approach abandons the debate over the legalization of euthanasia to situate it in terms of appropriate end-of-life care,” Ms. Hivon said.

Allow doctor-assisted suicide in exceptional cases, Quebec panel says (The Record.com by Sidhartha Banerjee) – A landmark report in Quebec recommends that doctors be allowed to help terminally ill patients die, in exceptional circumstances, if they want to.

The report was released Thursday in the Quebec legislature after two years of work from the so-called Dying With Dignity Committee, a multi-partisan group of nine MNAs (legislature members).

The argument for allowing euthanasia — even in some exceptional cases — could trigger a national debate again in Canada on the controversial issue.

In 1992 assisted suicide hit the national radar when Sue Rodriguez, a B.C. woman, fought all the way to the Supreme Court of Canada for the right to kill herself. Rodriguez, who suffered from Lou Gehrig’s disease (amyotrophic lateral sclerosis or ALS), lost by a 5-4 decision. She killed herself anyway with the help of an unidentified physician in 1994.

Since then, the issue has surfaced a number of times in court where people have been charged with helping loved ones die, including three such cases in Quebec in the past few years.

The committee examined questions about the end of life and produced a 180-page report with 24 recommendations.

Euthanasia Prevention Coalition rejects Quebec euthanasia proposal and supports end-of-life care – The Select Committee on Dying with Dignity Committee in Quebec released its report today recommending that Quebec ignore the federal law that protects all Canadians, by legalizing euthanasia according to a Belgium model.

 The report defies parliament’s overwhelming defeat of a similar bill to legalize euthanasia by a margin of 228 to 59 after full-debate and across party lines.
The report does not adequately address concerns related to elder abuse, suicide prevention and vulnerability at the end of life, as addressed by the recent report by the parliamentary committee on palliative and compassionate care (November 2011)
The report splits its recommendations between improving palliative care and informing the public about their rights and options related to end-of-life decision making; and legalizing euthanasia.
Matt Gurney: Euthanasia a right long denied – Quebec’s Dying with Dignity Commission has done Canadians a service with its study on how best to cope with a dying citizen’s final days. The report, two years in the making, was tabled in the Quebec National Assembly on Thursday. It recommends that Quebec take steps to improve palliative care and allow patients receiving such care to do so in their home — worthy suggestions — but also recommends that Quebec offer a final option for those who seek it.
“Some sufferings can’t be relieved satisfactorily and the seriously ill who want to put an end to their sufferings, they deem senseless, come up against a refusal that isn’t in line with Quebec’s values of compassion and solidarity,” the report says. In these cases, the authors urge, Quebec should permit euthanasia (but not, interestingly, assisted suicide).
It will be a controversial conclusion, but probably more owing to the volume of opponents, rather than their numbers. Quebecers have generally been out in front of other Canadians in supporting legalized options for euthanasia: An Angus Reid poll in late 2010 found that 63% of Canadians generally support euthanasia, but that number rises to 78% in Quebec. Other polls show that a majority of Quebec’s doctors are also in support.

Not Dead Yet Responds to Report of the Quebec Commission on the Issue of Dying With Dignity (Seattlepi.com) – Disability rights advocates from Not Dead Yet react to the Report of the Commission on the Issue of Dying With Dignity in Quebec, Canada, noting that it contains some positive measures as well as fatal flaws.

The report of the Quebec parliament’s commission on dying with dignity contains some positive measures as well as fatal flaws, according to Amy Hasbrouck, a resident of Valleyfield, Quebec and board chair of Not Dead Yet, an international disability rights organization opposed to the legalization of assisted suicide and euthanasia.

“They have addressed some important issues related to palliative care and advance directives,” said Hasbrouck. “The Commission has made an effort to respond to the needs of people near the end of life. Unfortunately the commission’s work is marred by a lack of precision and does not take disability discrimination and elder abuse into account. These factors, along with reliance on good faith and inadequate ‘safeguards,’ mean the Commission has failed elders and people with disabilities.”

Quebec report in support of euthanasia condemned as dangerous betrayalby DeborahGyapong, Canadian Catholic News – Living with Dignity (LWD), a network of anti-euthanasia groups in Quebec, has condemned the province’s Select Committee on Dying with Dignity report’s support for euthanasia as “dangerous” and a “profound act of political betrayal.”After holding consultations across the province last year, on Mar. 22 the committee recommended the legalization of euthanasia for people experiencing constant, unbearable physical or psychological suffering.”From the outset of the committee’s consultation, Quebecers were guaranteed that their voices would be heard and that the direction they gave would be followed,” said Dr. Andre Bourque, president of LWD. “On the basis of that promise, Quebecers spoke forcefully against opening the door to euthanasia and assisted suicide.”

“The committee has arrogantly and dangerously broken its word to the very people it promised to heed,” he said.

France

Protestors call on candidates to change euthanasia laws by Collette Davidson – A French organisation led up to 2,000 members in protest in Paris on Saturday, to fight for the right to die in dignity. The group is calling for changes to French laws to legalise euthanasia. An opposing organisation held their own protest across town, against the practice.

The two French presidential front-running candidates remain opposed on the issue, with socialist François Hollande in favour of assisted suicide and President Nicolas Sarkozy against it.

Ireland

Public can decide over euthanasia – The Ulster Unionist leadership contest has moved into ethical questions after front-runner Mike Nesbitt suggested there should be a referendum on whether to legalise euthanasia.

Asked during an interview on BBC Radio Ulster’s Nolan Show for his views on a patient with an incurable disease who wants to be killed – something currently illegal in the UK – Mr Nesbitt said that it was an issue for the public rather than politicians to decide.

He said: “I’m conflicted on that because if it was me I would probably want to get out of the way.”

The Strangford MLA said if euthanasia was legalised there would have to be protections to “ensure that the people surrounding you are properly motivated [in ending your life]”.

And Mr Nesbitt, who had earlier in the interview proposed a referendum on whether to allow for an opposition at Stormont, said: “That’s one, again, where I think you should go to the people, it’s not necessarily a matter for a politician.”

However, when pressed on whether that meant he was prepared to support euthanasia with those protections, Mr Nesbitt said: “No, I didn’t say that. If the protections are there it’s still a matter of principle that I’m afraid I would struggle to support but I hope that I would never be in the way of my children and hopefully my children’s children when it’s my turn.”

Asked then if he was opposed to euthanasia, Mr Nesbitt said: “Yeah.”

Netherlands

Dutch pensioner’s decision: when to die with dignity by Nicolas Delaunay – With a deadly dose of barbiturates stashed in his home in a small eastern Dutch town, pensioner Hans Hillebrand is a “self-determinist”: he alone wants to decide when it’s time to die with dignity. “I shall be the director of my own final scene,” he said.

Hillebrand is one of a growing number of aging Dutch people who prefer to make their own decisions about when and where to die — and in a dignified way.

“Senior citizens today like to decide things for themselves, more than previous generations,” said Ton Vink of De Einder (The Ender in Dutch), an organisation dedicated to “informing” people who want to end their own lives.

More and more Dutch voices are being raised in support of a right to claim assistance to die with dignity after “an accomplished life” and not just when the requirements by law for euthanasia are fulfilled.

A citizens’ initiative called “An Accomplished Life” which supports the idea, has already gathered more than 117,000 signatures, more than the 40,000 required for a debate in the Dutch parliament, which was held in early March.

Even with the country’s liberal laws on euthanasia, a doctor still has the final say whether the criteria have been fulfilled for assisted suicide, namely unbearable and prolonged suffering caused by incurable disease.

Mercy killings: Dutch, Belgians mark a decade to legalizing euthanasia by Nicolas Delaunay, Agence France-Presse. Euthanasia provided to an Alzheimer’s patient for the first time last year.

“The (euthanasia) law has been positive, as it has made huge changes in patient-doctor relationships,” said Jacqueline Herremans, president of Belgium’s Association for the Right to Die with Dignity (ADME).

“Many taboos on the end-of-life have been lifted,” she said.

“It allows families to better prepare for it and accept the deaths of their loved ones. They can put in place the rituals, like good-byes and a last meal..,” she said.

While most countries forbid mercy killing, the issue is often not clear cut as some allow “passive” euthanasia, when the medical profession is not required to fight to save a patient, or others where patients can refuse medical care.

New Zealand

Will you support one courageous voice? by Ann David, Voluntary Euthanasia Society – It is a relief to know that one courageous politician is willing to swim against the tide of political disregard for the will of constituents.

Labour list MP Maryan Street has announced her intention to sponsor a bill to legalise voluntary euthanasia.

This is exactly what more than 70 per cent of New Zealand voters have been calling for with increasing stridency over a number of decades.

It will be a private member’s bill. This means it must be drawn out of the ballot box for consideration and it could languish in waiting for months or years before seeing light.

In the meantime, more cases will undoubtedly be brought before the courts seeking to criminalise the innocent.

Grief-stricken family members no longer able to resist the pleadings of their loved ones to assist them to die, or doctors who believe in respecting a patient’s rights to call a halt to suffering, will be on trial for succumbing to humanity.

Salvation Army cautions against end-of-life choice – The Salvation Army notes the intention of Maryan Street (MP) to introduce a Private Members “end of life choice” Bill to legalise voluntary euthanasia and/or physician-assisted suicide.

The Salvation Army believes euthanasia and assisted suicide are morally wrong regardless of illness, age or disability, and does not accept the view that euthanasia is “death with dignity”. It says there are two important misconceptions around euthanasia: that death is usually preceded by serious pain, and that modern medicine seeks to prolong the dying process for as long as possible.

“Society’s task is not to eliminate those who suffer, but to find better ways of dealing with their suffering,” says Major Stevenson, chair of The Salvation Army’s Moral and Social Issues Council.

The Salvation Army believes it is important to communicate by word and deed to the sick, the elderly and the dying that they are worthy of respect, they are loved, and that they will not be abandoned. Full palliative care should be available to anyone with a terminal illness.

Religious groups fight early exit bill – Euthanasia is ethically wrong, and individuals could be placed under more pressure from family members to choose an “early exit” if a new bill goes ahead, say the Salvation Army and the InterChurch Bioethics Council.

Both groups have come out against a proposed “end of life choice” member’s bill being drafted by Nelson-based Labour list MP Maryan Street.

The bill would make it legal for those diagnosed as terminally ill, and fully in control of their mental faculties, to choose to die, and for assisting clinicians or family members to be protected from liability.

Chairman of the Salvation Army’s Moral and Social Issues Council Major Garth Stevenson said euthanasia and and assisted suicide were “morally wrong”, and removing legal liability from health professionals and family could place individuals under undue pressure.

“By offering some the choice to end their life, even with the best of intentions, we may also be removing a choice from others who may consequently feel pressured to choose an `early exit’.”

Spain

Spain’s main conservative and socialist parties join in rejecting euthanasia billby Matthew Cullinan Hoffman – Under the slogan “life is a right, not an obligation,” the Plural Left, a coalition of three small socialist parties, offered a bill yesterday to eliminate criminal penalties to one who by “necessary actions or active cooperation, permits, brings about, or facilitates death with dignity and without pain of another person, with express, free, and unequivocal permission of the same, when they suffer from a serious illness that would have definitely caused his death.”

The legislation also would have given individuals the right to “understand at least the purpose and nature of each intervention and treatment, as well as the risks and consequences,” and to “refuse to consent to a treatment” if they so wished.

The proposal was roundly rejected by Spain’s two biggest parties, which are normally at loggerheads over human life and family issues.

Switzerland

Swiss law tolerates assisted suicide when patients commit the act themselves and helpers have no vested interest in their death. Assisted suicide has been allowed in the country since the 1940s.
 
Death is usually induced through a lethal dose of barbiturates that has been prescribed by a doctor. Ingestion of the poison, whether by drinking it or through the use of intravenous drips or stomach tubes, must be carried out by the person wanting to die.
 
A 2006 decision by the Swiss Federal Court ruled that all people of sound judgment, irrespective of whether they suffer from a mental illness, have the right to decide the manner of their death.
 
The government examined various options to regulate assisted suicide practises and decided not to seek legal changes but to boost suicide prevention and palliative care.
 
Switzerland has two main groups which cater to people who seek an assisted suicide, Exit and Dignitas.

Dr. Jerome Sobel, president of Exit (Switzerland) I think it’s their right, their choice, and their individual freedom. Currently if a patient in a home asks for assisted suicide, homes can refuse to give permission. New law would force old people’s’ homes to open their doors to assisted suicide providers.
He believes physicians should accompany their patients in their chosen death, respect their last wish.

Swiss voters overwhelmingly support assisted suicide  (5/16/11) – Voters in Zurich, Switzerland supported the legality of assisted suicide in two measures which sought to ban the practice.  The first would have banned assisted suicide, which has been legal in Switzerland since 1941, completely, while the other proposed limiting assisted suicide to Zurich residents only, in an attempt to curb the tide of foreigners who take advantage of Switzerland’s liberal policy and travel to Switzerland to die.  85% of voters rejected the overall ban, and 78% voted against the second proposal.

The results were a sweeping affirmation of Swiss support for assisted suicide, despite the fact that before the election, 66% of Swiss people were said to oppose “suicide tourism.”  Active suicide is illegal in Switzerland, so while patients can be prescribed deadly drugs, they must ingest them without any assistance from others.

Headlines:

Switzerland: Sharp Rise in Assisted Suicide Numbers
More People Die in Switzerland Via Assisted Suicide in 2011
Murder in the Netherlands
Assisted suicide booms in Switzerland
Swiss assisted suicide deaths continue to increase
Europe’s culture of death on upswing

Swiss assisted suicide up seven-fold in a decade

Some actual numbers – 68 more than last year, 164 over 13 years
Digitas (near Zurich) 144 people in 2011, up 35% – 2/3 women
Exit – 300 people, up from 257
Most suffering from cancer
Average age 76
Men more likely to commit suicide – 1050 annually

No Doc Will Help? Sue Government to Kill You by Michael Carl – Assisted suicide on trial after physicians refuse woman lethal drugs.

If Alda Gross gets her way, the Swiss government will give her the drugs needed to commit suicide.

Gross filed a lawsuit against the Swiss government when she couldn’t find a doctor to prescribe for her the suicide drug sodium pentobarbitol.

United Kingdom

Should we legalize assisted suicide? (Walesonline.com) – The case of Tony Nicklinson who has locked-in syndrome, has once again raised the issue of about whether we should legalize assisted suicide. The High Court last week decided it will hear Mr. Nicklinson’s case– he wants a doctor to be able to lawfully end his life, which he sums up as “dull, miserable, demeaning, undignified and intolerable.”
Baroness Ilora Finlay, a professor of palliative care at Cardiff University, speaks against legalizing assisted suicide. Dr. Jeremy Honeybun, a GP and member of Dignity in Dying and Healthcare Professionals for Assisted Dying, explains why he believes the UK should legalize assisted dying.

MP and doctor Dan Poulter’s expresses fears over right to die (The Telegraph by Laura Donnelly) – An MP who still works as a doctor is to use a Parliamentary debate to oppose any moves towards so-called “right to die” legislation, saying his experience has turned him against assisted suicide.

Dr Dan Poulter will warn that current prosecution guidelines on assisted dying must not be passed into law as he believes they have the potential to lead to patients being killed simply to benefit their relatives – a risk he has seen on the wards.

But he will also speak of the need for dignity and compassion for the dying and describe how his own resuscitation of a very ill woman left her spending her last three weeks alive in pain because the procedure broke her ribs.

Richard Ottoway MP hints at support for euthanasia law (The Telegraph by John Bingham) – Richard Ottoway, the MP behind the first full Commons debate on assisted suicide for almost 40 years, has hinted he would support further moves towards legalising euthanasia.

Mr Ottaway, a Tory backbencher, has secured parliamentary time for a full debate on new legal guidelines on whether those who help terminally ill love-ones travel to Switzerland to end their lives should be prosecuted.

He said that the debate, on Tuesday, would be the first time since 1974 that the Commons has discussed a substantive motion dealing directly with the issue of whether people should have a right to die.

In the intervening decades, a string of cases have tested the law on assisted suicide to the limit and a series of polls have pointed to growing public support for a change although it remains a criminal offence.

MP’s plea for law change after his father’s suicide (Sheffield Telegraph) – Central MP Paul Blomfield told this week how his father committed suicide after being diagnosed with lung cancer .

The Labour MP said his father took his own life last July at the age of 87, by filling his garage with exhaust fumes. His dad had watched many friends suffer for months before dying and did not want to suffer the indignity of being unable to look after himself.

Mr Blomfield said he was sure his father would not have killed himself if the law was changed so his relatives could have assisted his suicide, free from the fear of prosecution.

The assisted suicide debate will be interpreted in multiple ways by Steve Baker, MP) – This policy does not in any way “decriminalise” the offence of encouraging or assisting suicide. Nothing in this policy can be taken to amount to an assurance that a person will be immune from prosecution if he or she does an act that encourages or assists the suicide or the attempted suicide of another person.

Parliament does not want to normalise assisted suicide and, for most of us, our welcome of the DPP’s guidance reaffirms the view that life is precious and that assisting suicide  is a criminal offence, albeit one which it may not always be in the public interest to prosecute.

Attempt to relax laws on assisted suicide fails (The Christian Institute) – An attempt to undermine the law against assisted suicide has been unanimously rejected by the House of Commons.

In stark contrast the Commons gave unanimous backing to an amendment encouraging the development of specialist palliative care services.

Therese Coffey, a Conservative MP, said: “It was a mature debate but certainly clear that there was no appetite of the majority of the House to change the law as it stands today.”

Victory for compassion as MPs unanimously support non prosecution of compassionate amateur assistance to die. – Dignity in Dying has today welcomed MPs’ historic decision to back Director of Public Prosecutions (DPP) guidelines on assisted suicide, as well as MPs endorsement of further development of end-of-life care via an amendment to the motion.  The DPPs guidelines make clear that those who compassionately assist a loved one to die at their request are unlikely to be prosecuted, and that those who maliciously encourage the death of another will feel the full force of the law.