Monthly Archives

February 2015

Assisted suicide increased by 44% in Oregon – 2014 report.

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Alex Schadenberg Blog 15 February 2015
The 2014 Oregon assisted suicide report indicates a 44% increase in assisted suicide deaths and a 28% increase in lethal prescriptions. In 2014, at least one person who died by assisted suicide obtained the lethal dose in 2012, (439 days before death) even though the law requires the person to be within 6 months of death.
The 2014 annual report is similar to prior years. The preamble implies that the deaths were voluntary (self-administered), but the information reported does not address that subject.
Oregon’s assisted suicide law allows the lethal dose to be administered without oversight. This creates the opportunity for an heir, or someone else who will benefit from the patient’s death, to administer the lethal dose to the patient without the patient’s consent. “Even if he struggled, who would know?”
In 2014, Assisted suicide’s in Oregon increased in numbers, conditions and demographics.

  • 105 assisted suicide deaths in 2014 up from 73 in 2013. (44% increase).
  • 155 prescriptions for suicide in 2014 up from 105 in 2013. (48% increase).
In previous years almost 80% of the deaths, were cancer related. In 2014, 68% had cancer with “other illnesses” increasing to 8.6% (9 deaths). Other illnesses includes diabetes.

She was already ‘at death’s door’ – so that makes it alright then?

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Hope 23 February 2015
If a young person tragically dies by suicide we are rightly upset. We feel immense compassion for the young person and for their grieving families. It is entirely natural to observe that part of the tragedy is that he or she had ‘their whole lives ahead of them’. And so, in our western society where youth suicide is tragically far too common, we invest significant time, effort and finances in suicide prevention – and rightly so.
But when our media reports a suicide of an older person, they and we often see it differently. Often, but not always, the story talks about someone who has had a wonderful life and simply wants to be gone. Reasons vary from the fear of deterioration or a difficult prognosis to simply not wanting to grow old. Wrapped up like a sugar-coated yet bitter pill, we’re encouraged to consider that such a suicide is understandable, perhaps even okay. It is not. We are encouraged to celebrate his or her ‘courage to choose’ without thought for the reality that to make such a suggestion at the suicide death of a young person would be deemed rightly as cruel and invariably wrong.
I cannot help but think that the easy acceptance of suicide amongst the elderly is somehow subtly tied up in our own fears about what we will face ourselves. The lack of suicide prevention campaigns aimed at our elders tends to support this thinking and the idea of euthanasia and assisted suicide as being for the aged and infirmed further compromises suicide prevention initiatives.
While it is again entirely natural to feel compassion for the older person’s circumstances we cannot apply the ‘whole life ahead of them’ commentary because it is less of a reality. That said person may yet have had many years to live is less clear than for our putative young person. Does the fact that we cannot find easily a point of reflection upon what is nevertheless a tragedy mean that we should not be just as concerned as we are at a younger person’s suicide? Should it mean that we fail to ask the hard and sometimes unanswerable questions?

Nearly half of GPs back euthanasia – survey

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3News 20 February 2015
Nearly half of Kiwi doctors are in favour of euthanasia, or physician-assisted dying (PAD), according to a survey covered in the New Zealand Medical Journal today.
This lags well behind public support for PAD, which was measured at 82 percent in January by researchers at the University of Auckland.
But the survey’s validity is being questioned by the NZMJ’s editors, who say it does “relatively little to further our knowledge”.
According to a letter to the NZMJ from Voluntary Euthanasia Society chairman Dr Jack Havill, 200 GPs in the Waikato District Health Board area were sent letters presenting three different scenarios concerning PAD. The survey’s results were based on 78 responses.
The first question asked: “Given adequate safeguards against abuse, do you support the passing of a law to allow a medical practitioner to give assistance to die, on request from a competent patient, 18 years and older, where the patient has end stage terminal disease (eg cancer), or is suffering from irreversible unbearable suffering (eg motor neurone disease, end stage respiratory failure)?”
Thirty-seven GPs (47.3 percent) said they support PAD in this situation. An equal number oppose it, and four are unsure.
The second question posed a similar scenario, except this time the patient – while still able to do so –writes a directive authorising PAD in the event they become incompetent.
The same number of GPs – 47.3 percent backed PAD in this circumstance, with fewer opposed (43.6 percent) and more unsure (9 percent).
The third question asked doctors if they would support PAD in the following scenario, provided the patient had given approval while still competent: “If I develop severe dementia resulting from Alzheimer’s disease, or degenerative brain disease due to arterial disease or other agency, where my mental competence has deteriorated to the extent that I am no longer able to recognise close relatives or friends, and am totally dependent on others for basic physical needs e.g. eating food and drinking fluids, spoon feeding, toileting for incontinence, dressing, I would request that I be given medical assistance to die.”
Only 31 of the 78 doctors said they’d support PAD in this case (39.5 percent), with half opposed and the rest unsure.
Dr Havill says the results show nearly half of GPs “support or would probably support” euthanasia in certain circumstances, and that it is “reasonably certain” that New Zealand will adopt some form of PAD law in the next few years.
“Hopefully our professional medical and nursing bodies can take part in the framing of the law and regulations as this happens.”
But the study’s methodology has been questioned by editors of the NZMJ, who say the survey’s response rate was “poor”, and it is likely that “only those GPs with firm views, supportive or otherwise, who bothered to reply”.
“But nonetheless, that about 40 Waikato GPs would be willing to hasten the deaths of their patients, even if they are mentally incompetent, is noteworthy,” writes Assoc Prof Sandy Macleod of the Health Sciences Centre at the University of Canterbury.
“We certainly need to manage the dying better. We need good research, wise expert opinion and fair legislation. We lack these. Dying is not invariably easy, and clumsy medicine can aggravate it.
“But is it best to give up and terminate life by the violence of non-physiological pharmacology?”—survey-2015021913#axzz3S7VtQB6a

New voice launched for disabled people opposed to euthanasia

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Yahoo News 19 February 2015
Not Dead Yet Aotearoa, (NDYA) a new voice for disabled people in euthanasia and assisted suicide issues, has launched today. The organisation opposes euthanasia and assisted suicide laws and policies in New Zealand and advocates for the equal value of disabled lives.
This launch is very timely, says NDYA convener, Wendi Wicks. We want to be a key voice in the debates that are so important to us. Our community’s concerns about the consequences of such legislation haven’t been well heard to this point.
Disabled people want to have a good life. But too many of us lack the basic choices that our human dignity demands. That means many of us don’t feel at all secure and valued equally. But, ironically, society will happily provide us with the choice to die!
We’re seen too much in medical and deficit terms, with an undue emphasis on the unbearable pain and suffering associated with disability, says NDYA member Huhana Hickey. We’re seen as costly too, a drain on scarce public resources.
Our lives are already at greater risk when people think we don’t need to live, and put “do not resuscitate” notices in our medical files without our consent. In these kinds of situations, free and informed consent is a travesty – and in our key relationships with health professionals and service providers, we are too often at their mercy because of their power over our lives. So we find ourselves on the back foot, in an incredibly difficult place.
If people get to hear only one view on this issue, Wendi Wicks says, they won’t get to realise how much laws enabling assistance for individual choices to die can put the human rights of a whole community like ours at risk. Because our society holds such negative views about disabled lives, and because there are so many risks to our disabled community from euthanasia legislation, it’s vital to hear NDYA’s perspectives too.

Assisted suicide debate masks disability prejudice

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The Chronicle Herald 14 October 2014
Today (Oct. 15), the Supreme Court of Canada will hear argument in an appeal which seeks to strike down Canada’s Criminal Code prohibition against assisting suicide.
The appeal is mobilized by the B.C. Civil Liberties Association and supported by Death with Dignity advocates across the country, many of whom will take to the streets to urge Canadians to “stand on the side of history for assisted dying.”
But to whose history do they refer? We share most of a demographic profile — I’m a 60-plus boomer, white, middle-class, secular and accustomed to calling the shots in the domains of my daily life.
We also share an unwavering desire to see the very best of palliative care services realized under the Canada Health Act, for it is to our collective shame that, according to the Canadian Institute for Health Information, only 16 per cent to 30 per cent of Canadians currently have access to appropriate palliative and end-of-life care.
Further, we share a conviction that the debate about euthanasia and assisted suicide is of critical importance to the people of Canada, for the outcome of this debate will define us, shaping the nature and extent of our compassion toward fellow citizens who are frail and suffering.

What’s At Stake in Friday’s Supreme Court Decision on Assisted Suicide

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Media Release: Council of Canadians with Disabilities 4 February 2015
Whatever decision the Supreme Court of Canada makes in the Carter vs. Canada ruling to be released on Friday – to hold the line against assisted suicide in the Criminal Code, or to strike it down – the public standards of what it means to live a dignified life are at stake. At the core is a question about what it means to live a meaningful life until the end – and in our Canadian society, a decision from the court cannot reflect the complexity of these choices in anyone’s individual life.
If the Court strikes down the prohibition against assisted suicide, the fears of some will be assuaged by the knowledge that, at a time of their choosing, they may seek state-sanctioned intervention to cause their death. But for a growing group of Canadians whose daily lives fundamentally depend on the personal care and support of others, their fears are only heightened by such an outcome.
What is the basis for this fear? For those who receive care, for those who provide care, and for those who advocate for equality and inclusion alongside a wide variety of Canadians, the risk is palpable. Dependence upon others will come to be seen as a suffering too great to bear. The risk is that in private conversations, in policy choices and in adjudicated determinations, dependence will come to be equated with indignity when actually it is an essential part of living. And the larger fear is that the shape of such a life will become a good reason to seek its termination.
The risk of this cultural slide may well present the biggest challenge to Canadian values in our generation, the underlying value of an individual life.

Questions and Answers

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Focus on the Family (USA)

Q: What is physician-assisted suicide?

A: Physician-assisted suicide (PAS) is much different than refusing treatment. PAS involves a medical doctor who gives a terminally ill patient the means to commit suicide, usually by an overdose of prescription medication.

Q: Is physician-assisted suicide legal?

A: Physician-assisted suicide is illegal and a crime in most states.  It’s only legal in Oregon, Washington State and Vermont. The law is less clear in Montana. The issue is the topic of an ongoing court case in New Mexico.

Q: Can patients refuse to have treatment and decide they want to die?

A: Yes, mentally competent adults can refuse or stop treatment at any time. The medical decision-maker for a non-competent adult can also make that decision. So fears that technology will keep you alive past the time of natural death are generally unwarranted.  It’s also important to recognize that today’s health- care climate lends itself more to under treatment than overtreatment.
It’s one thing to say, “I don’t want any more treatment. I want to allow the natural dying process to take its course.”  It’s something quite different to ask a physician to violate the Hippocratic Oath of “Do No Harm” by prescribing drugs for suicide (physician-assisted suicide). That crosses a bright moral line that protects patients, especially when they are vulnerable due to a terminal diagnosis.

Q: Why do people commit suicide using drugs from a physician?

A: You might think most people want to commit suicide to avoid pain at the end of life. However, the most common concern cited in Oregon and Washington State is the loss of autonomy, followed by being less able to engage in enjoyable activities and loss of dignity.  While these concerns are important, the premature death of the patient by suicide is not the only way to address these needs.

Q: What about someone who doesn’t want to be a burden to his family and friends?

A: The notion of being a burden is most often the perspective of the person who is receiving care, not the one providing the support. A parent doesn’t think twice about caring for a newborn or toddler that needs help. The same holds true for most family members when it comes to their loved ones: It’s not a burden to care for those we love!
Our culture prides itself on being independent and having autonomy. Some people may think, “I’d rather be dead than dependent.” This speaks volumes to how we value independence, even above the value of human life. The attitude that, “I’d rather die than be dependent on someone else” sends a larger message that life only has value if it’s independent of others. It’s a message that is heard often loud and clear by the elderly, infirm and disabled who need and deserve our care, and do not want assisted suicide.  Physician-assisted suicide sends the message that some lives are not worth living.

Q: What’s wrong with a patient committing suicide if they are dying anyway and don’t want to suffer?

A: The desire for death by suicide (physician-involved or otherwise) speaks to larger issues for the patient, and for society.
Suicide is a moral issue: Do we have moral authority to end our own life?  Western civilization has long considered suicide morally wrong based on the belief that human life is a gift from God — regardless of its circumstances. Life itself has purpose and value.
Patients facing a terminal illness often experience a wide range of emotions, including hopelessness, depression and fear. The desire for suicide before a natural death likely indicates the patient is afraid of what is to come or doesn’t view his life as having value.
Every human being is terminal; at some point all of us will die. Suicide eliminates the “what if” possibilities that may occur: The discovery of a new treatment or cure, the realization of an incorrect diagnosis, or the opportunity to have one last kiss or touch from a loved one.
It may seem ironic but laws, such as in Oregon, encouraging physician-assisted suicide actually work to deny terminally ill patients death with dignity. That’s because human dignity comes from God and is affirmed by those around us, especially when others care for us in our last days. There are incredible life-giving experiences that happen in this difficult journey for both the patient and their loved ones, but physician-assisted suicide piles sorrow upon sorrow.

Q: What about expensive medical bills for treating disease?

A: Remember patients can decide how much or how little treatment they want. By the time a patient is in hospice care (with a diagnosis of six months to live), the care is focused on making the patient comfortable, not treatment.
Suicide is much less expensive than treatment and care and that fact raises red flags for many in light of today’s demands to “manage” health care costs— even by rationing care for patients whose lives are deemed less valuable. In a dollar driven health care environment, the inexpensive cost of assisted suicide is a great concern, as it can be used as a way to reduce the amount of health-care dollars spent per patient.
Do we want patients being pressured to end their lives with suicide as a “duty” to die in order to save money?

Q: What about pain and other physical symptoms at the end of life?

A: Pain- and symptom-management has improved greatly in recent years, thanks in part to the expansion of hospice (palliative) care.  For most patients, pain can be controlled along with other physical symptoms of disease and the dying process.  Palliative care addresses the physical, psychological, emotional and spiritual needs of the patient and the patient’s family.
As mentioned previously, fear of not controlling pain is not a primary reason for physician-prescribed death.

Q: Can doctors be wrong about the diagnosis and prognosis?

A: Yes, there are many stories of incorrect diagnoses and predictions, as well as numerous cases where people have lived far beyond their doctor’s predictions, and some people who have been cured from their terminal disease.
People living with terminal illness deserve more than the offer of a physician to facilitate their death. They merit true compassion and that’s not found in a bottle of pills.  True compassion is when people come along side you in this journey.

Supreme Court of Canada strikes down existing protections against assisted suicide

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IMFCanada 6 February 2015
Today the Supreme Court of Canada has struck down Canada’s existing laws against assisted suicide which protected all Canadians including the elderly, the vulnerable and the disabled.
The Institute of Marriage and Family Canada has researched the effects of legalization in four jurisdictions that have legalized euthanasia/assisted suicide. These are Belgium (2002), the Netherlands (2002), Oregon (1997) and Washington State (2009).
Some of our findings include:
Belgium: A study published in the Canadian Medical Association Journal found that 32 percent of euthanasia deaths in Belgium happened without the express request of the patient. These patients were predominantly 80 years or older who were mostly in a coma or had dementia. Between 2002 and 2009, only five percent of euthanasia requests were denied.
Oregon: Since 2005, the number of deaths by assisted suicide has doubled. Prescriptions to kill patients grew by 76 percent, whereas the population grew by only seven percent.
Washington: Between 2009 and 2012, the number of deaths by assisted suicide grew by 130 percent while Washington’s population grew only 18 percent. Their law, which states that to qualify a person must be 18, competent and have a diagnosed incurable and irreversible disease with six months to live, has been deemed too restrictive. The push is on to make assisted suicide available to those who judge their suffering unbearable but are not terminally ill, as well as those who are not competent but have previously asked for assisted suicide in an advanced directive.
The Netherlands: The number of deaths by euthanasia doubled between 2008 and 2013. Under the Groningen Protocol, the right to assisted suicide has expanded to include babies. This protocol regulates the process of killing infants with life threatening illness and/or the prospect of great suffering.
The Institute of Marriage and Family Canada sees no evidence to believe “suicide creep” won’t also happen in Canada.
Furthermore, this decision will harm families, as we have noted in the past. What has been promoted as an individual right will have profound family and community effects.
Suffering can be alleviated through excellent palliative care, an area where Canadians are leaders in the field. Most Canadians currently do not have access to palliative care.
For further reading and for sources for the above data points, please check No second chances, What can the Dutch experience with euthanasia teach Canada and The illusion of limiting legalized euthanasia.

Colorado rejects right-to-die legislation proposal

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OneNews 7 February 2015
Colorado lawmakers rejected a proposal to give dying patients the option to seek doctors’ help ending their lives, concluding a long day of emotional testimony from more than 100 people.
For one lawmaker who voted no, the issue was personal. Tearfully telling her colleagues she was a cancer survivor, Democratic Republican Dianne Primavera recalled how a doctor told her she wouldn’t live more than five years.
But she found a doctor who gave her a different opinion.
“And he took me in his care, and I am here today 28 years later,” she said.
Doctors who opposed the measure told lawmakers earlier that allowing dying patients to seek life-ending medications from a physician closed off the possibility of a recovery when a prognosis can sometimes be wrong.
A House committee considering the bill voted 8-5 against it after dozens of people with serious illnesses and others who have seen relatives suffer packed the Colorado legislative hearing.

Media Release: Supreme Court Decision Relied on Biased Reports

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Euthanasia-Free NZ 8 February 2015
Euthanasia-Free NZ deplores the Supreme Court of Canada’s decision to lift the ban on assisted suicide and euthanasia.
The Supreme Court falsely concluded that “a properly administered regulatory regime is capable of protecting the vulnerable from abuse or error”. Nowhere in the world has that been achieved.
The Court based its conclusion on the reports by the Royal Society of Canada and The Quebec National Assembly’s Select Committee on Dying with Dignity.
Both reports ignored the findings of five peer-reviewed studies on euthanasia and assisted suicide in Belgium and The Netherlands. These studies found that a significant percentage of Belgian and Dutch assisted deaths are not reported, flaunt legal safeguards and are performed without the patient’s consent.
A 2012 Lancet study found that 272 Dutch people were euthanised in 2010 without their consent. In half of cases the doctor made the decision without consulting a colleague and in a quarter of cases the doctor didn’t discuss it with either the patient, the patient’s relatives or a colleague. In 6% of cases with the patient’s consent, only one doctor was involved in the decision. About 23% of assisted deaths were not reported.
Three 2010 studies focused on Flanders, where 82% of Belgian assisted deaths occur:
A 2010 BMJ study concluded that 48% of euthanasia deaths were not reported. Legal requirements were met in only 73% of reported assisted deaths and in only 12% of unreported cases.
2010 CMAJ study found that 32% of assisted deaths occurred without the patient’s explicit request. More than 90% of victims were older than 80 – a vulnerable demographic group that was also confirmed by a 2009 NEJM study.
Another 2010 CMAJ study reported that Belgian nurses administer lethal injections in 12 % of cases, which is illegal, and 45% of these cases were without request.