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Showing posts with label Euthanasia. Show all posts
Showing posts with label Euthanasia. Show all posts

Thursday, December 6, 2018

Survey Finds Widespread 'Moral Distress' Among Veterinarians

Carey Goldberg
NPR.org
Originally posted October 17, 2018

In some ways, it can be harder to be a doctor of animals than a doctor of humans.

"We are in the really unenviable, and really difficult, position of caring for patients maybe for their entire lives, developing our own relationships with those animals — and then being asked to kill them," says Dr. Lisa Moses, a veterinarian at the Massachusetts Society for the Prevention of Cruelty to Animals-Angell Animal Medical Center and a bioethicist at Harvard Medical School.

She's the lead author of a study published Monday in the Journal of Veterinary Internal Medicine about "moral distress" among veterinarians. The survey of more than 800 vets found that most feel ethical qualms — at least sometimes — about what pet owners ask them to do. And that takes a toll on their mental health.

Dr. Virginia Sinnott-Stutzman is all too familiar with the results. As a senior staff veterinarian in emergency and critical care at Angell, she sees a lot of very sick animals — and quite a few decisions by owners that trouble her.

Sometimes, owners elect to have their pets put to sleep because they can't or won't pay for treatment, she says. Or the opposite, "where we know in our heart of hearts that there is no hope to save the animal, or that the animal is suffering and the owners have a set of beliefs that make them want to keep going."

The info is here.

Wednesday, September 12, 2018

‘My death is not my own’: the limits of legal euthanasia

Henk Blanken
The Guardian
Originally posted August 10, 2018

Here is an excerpt:

Of the 10,000 Dutch patients with dementia who die each year, roughly half of them will have had an advance euthanasia directive. They believed a doctor would “help” them. After all, this was permitted by law, and it was their express wish. Their naive confidence is shared by four out of 10 Dutch adults, who are convinced that a doctor is bound by an advance directive. In fact, doctors are not obliged to do anything. Euthanasia may be legal, but it is not a right.

As doctors have a monopoly on merciful killing, their ethical standard, and not the law, ultimately determines whether a man like Joop can die. An advance directive is just one factor, among many, that a doctor will consider when deciding on a euthanasia case. And even though the law says it’s legal, almost no doctors are willing to perform euthanasia on patients with severe dementia, since such patients are no longer mentally capable of making a “well-considered request” to die.

This is the catch-22. If your dementia is at such an early stage that you are mentally fit enough to decide that you want to die, then it is probably “too early” to want to die. You still have good years left. And yet, by the time your dementia has deteriorated to the point at which you wished (when your mind was intact) to die, you will no longer be allowed to die, as you are not mentally fit to make that decision. It is now “too late” to die.

The info is here.

Monday, May 28, 2018

This Suicide Pod Dubbed 'the Tesla of Death' Lets You Kill Yourself Peacefully

Loukia Papadopoulos
Interesting Engineering
Originally posted April 27, 2018

A new controversial pod for ending one’s life is on the market and it is being dubbed the Tesla of death and its founder, the Elon Musk of suicide. The pod, developed by euthanasia campaigner Dr. Philip Nitschke, is called the Sarco and it seeks to revolutionize the way we die.

The Sarco's website features a thought-provoking question on its landing page. “What if we had more than mere dignity to look forward to on our last day on this planet?” reads the site.

A description of the pod goes on to explain that “the elegant design was intended to suggest a sense of occasion: of travel to a ‘new destination’, and to dispel the ‘yuk’ factor.” If this sounds like a macabre joke, rest assured it is not.

The article is here.

Wednesday, November 15, 2017

Catholic Hospital Group Grants Euthanasia to Mentally Ill, Defying Vatican

Francis X. Rocca
The Wall Street Journal
Originally posted October 27, 2017

A chain of Catholic psychiatric hospitals in Belgium is granting euthanasia to non-terminal patients, defying the Vatican and deepening a challenge to the church’s commitment to a constant moral code.

The board of the Brothers of Charity, Belgium’s largest single provider of psychiatric care, said the decision no longer belongs to Rome.

Truly Christian values, the board argued in September, should privilege a “person’s choice of conscience” over a “strict ethic of rules.”

The policy change is highly symbolic, said Didier Pollefeyt, a theologian and vice rector of the Catholic University of Leuven.

“The Brothers of Charity have been seen as a beacon of hope and resistance” to euthanasia, he said. “Now that the most Catholic institution gives up resistance, it looks like the most normal thing in the world.”

Belgium legalized euthanasia in 2002, the first country with a majority Catholic population to do so. Belgian bishops opposed the legislation, in line with the church’s catechism, which states that causing the death of the handicapped, sick or dying to eliminate their suffering is murder.

The article is here.

Wednesday, February 1, 2017

New American Psychiatric Association Policy Prohibits Participation in Euthanasia of Non-Terminally Ill

Mark Moran
Psychiatric News
Published online: January 03, 2017

A psychiatrist should not prescribe or administer any intervention to a non-terminally ill person to cause death, according to a position statement passed by the APA Assembly at its meeting in Washington, D.C., this past November. The statement was approved one month later by the APA Board of Trustees by unanimous consent.

The precise wording of the Position Statement on Medical Euthanasia is as follows: “The American Psychiatric Association, in concert with the American Medical Association’s position on medical euthanasia, holds that a psychiatrist should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.”

(Policies and position statements approved by the Assembly are not official APA policy until they are approved by the Board. For a complete report on Board actions at its meeting this past December, see the next issue of Psychiatric News.)

In an interview with Psychiatric News, Mark S. Komrad M.D., an Assembly representative from the Southern Psychiatric Association who cosponsored the position statement in the Assembly, said it was crafted in response to reports from Belgium, the Netherlands, and elsewhere in Europe that physician involvement in “assisted suicide” had evolved from assisting terminally ill patients to die to actively helping non-terminally ill patients—including mentally ill individuals—die. Annette Hanson, M.D., was co-sponsor of the statement in the Assembly.

The article is here.

Wednesday, January 4, 2017

Four Reasons Why Assisted Dying Should Not Be Offered for Depression

Blikshavn T, Husum TL, Magelssen M
Journal of Bioethical Inquiry. 2016 Dec 8. p 1-7.
doi: 10.1007/s11673-016-9759-4

Abstract

Recently, several authors have argued that assisted dying may be ethically appropriate when requested by a person who suffers from serious depression unresponsive to treatment. We here present four arguments to the contrary. First, the arguments made by proponents of assisted dying rely on notions of "treatment-resistant depression" that are problematic. Second, an individual patient suffering from depression may not be justified in believing that chances of recovery are minimal. Third, the therapeutic significance of hope must be acknowledged; when mental healthcare opens up the door to admitting hopelessness, there is a danger of a self-fulfilling prophecy. Finally, proponents of assisted dying in mental healthcare overlook the dangers posed to mental-health services by the institutionalization of assisted dying.

The article is here.

Monday, October 24, 2016

Should doctors have the legal right to refuse care?

By Lisa Rapaport
Reuters Health
Originally published October 5, 2016

Physicians shouldn’t have the legal right to act as conscientious objectors and refuse to provide services like abortion or assisted suicide even when these things conflict with their personal values, some doctors argue.

That’s because access to care should take priority, and conscientious objectors may make it more difficult for patients to get treatment they need, Dr. Julian Savulescu of the University of Oxford in the U.K. and Udo Schuklenk of Queens University in Ontario, Canada, argue in an article in the journal Bioethics.

They make their case as a growing number of countries worldwide are grappling with how much autonomy to give patients and doctors to make decisions about care at the very beginning and end of life, particularly in an era when new technology and social media keep pushing the boundaries of long-held personal and religious beliefs.

The article is here.

Wednesday, August 24, 2016

The Controversial Issue of Euthanasia in Patients With Psychiatric Illness

Emilie Olie & Philippe Courtet
JAMA. 2016;316(6):656-657

A main objective of legalization of euthanasia or physician-assisted suicide (EAS) is to ease suffering (ie, physical pain and loss of autonomy elicited by an irreversible serious disease), when a terminally ill patient's pain is overwhelming despite palliative care. It implies that there is no reasonable alternative in the patient's situation, with no prospect of improvement of a painful condition or global functioning. Because mental disorders are among the most disabling illnesses, requests for EAS based on unbearable mental suffering caused by severe psychiatric disease may possibly increase. EAS may be differentiated from suicide because EAS results in death without self-inflicted behavior, yet both are driven by a desire to end life. This raises the question: Should the management of patients with psychiatric disorders requesting EAS be considered for suicide prevention?

Mental illness increases suicidal risk and requires treatment. Nevertheless, evidence-based medical and psychosocial treatments currently are not provided to the majority of patients with psychiatric diseases who would benefit. Even if these therapies were prescribed, about 30% of depressed patients are treatment resistant. Patients may have undergone treatments destined to fail or they may have refused potential effective therapeutics. Nevertheless, the probability of disease remission increases with number of different treatments attempted. Given these uncertainties and that there are no valid indicators to predict the response to treatment, there is no reliable mechanism to define incurable disease and determine medical futility for psychiatric care. Considering euthanasia for psychiatric patients may reinforce poor expectations of the medical community for mental illness treatment and contribute to a relative lack of progress in developing more effective therapeutic strategies.

The article is here.

Saturday, April 16, 2016

Legal and ethical aspects of organ donation after euthanasia in Belgium and the Netherlands

Jan Bollen, Rankie ten Hoopen, Dirk Ysebaert, Walther van Mook, & Ernst van Heurn
J Med Ethics doi:10.1136/medethics-2015-102898

Abstract

Organ donation after euthanasia has been performed more than 40 times in Belgium and the Netherlands together. Preliminary results of procedures that have been performed until now demonstrate that this leads to good medical results in the recipient of the organs. Several legal aspects could be changed to further facilitate the combination of organ donation and euthanasia. On the ethical side, several controversies remain, giving rise to an ongoing, but necessary and useful debate. Further experiences will clarify whether both procedures should be strictly separated and whether the dead donor rule should be strictly applied. Opinions still differ on whether the patient's physician should address the possibility of organ donation after euthanasia, which laws should be adapted and which preparatory acts should be performed. These and other procedural issues potentially conflict with the patient's request for organ donation or the circumstances in which euthanasia (without subsequent organ donation) traditionally occurs.

The article is here.

Wednesday, January 27, 2016

The History of the Euthanasia Movement

BY Anna Hiatt
JSTOR
Originally published January 6, 2016

The idea that death should be merciful is not new. When a person is gravely wounded or terminally ill, when death is inevitable, and the suffering is so great that living no longer brings any joy to the person, it is understandable that he or she may wish to die. In “Two Pioneers of Euthanasia Around 1800,” Michael Stolberg cites accounts of people pulling on the legs of those who had been hanged, but had not yet died, to hasten their deaths. He mentions also Apologie, the autobiography of a French surgeon named Ambroise Paré who happened upon three gravely wounded soldiers. An uninjured soldier asked the surgeon if they would live, to which he responded they would not. The uninjured soldier proceeded to slit their throats.

The invention and widespread use of morphine in the 19th century to treat, and then to kill, pain led to the belief that a less painful dying process was possible, Giza Lopes writes in her book Dying With Dignity: A Legal Approach to Assisted Death.

The article is here.

Sunday, January 24, 2016

Opponents fail to derail the state's right-to-die measure, but they may yet try again in court

By The Times Editorial Board
The Los Angeles Times
Originally posted January 7, 2016

Here is an excerpt:

The group behind the referendum attempt, known as Seniors Against Suicide, says it is now contemplating a lawsuit to stop the law's implementation. The law is set to go into effect 90 days after the state Legislature concludes the still-open special session on healthcare.

We respect the law's opponents, including the Roman Catholic Church and some disability-rights advocates; they waged a passionate battle — both moral and practical — against it. But we don't share their fears. There is no evidence that a law this narrow would lead uncaring health insurers or family members to coerce sick patients to kill themselves in order to save on medical costs.

To the contrary, two decades of experience with Oregon's landmark Death with Dignity Act suggests that it will be used sparingly. In the first 17 years, just 1,327 people in Oregon requested a life-ending prescription from a doctor. More than a third of them then chose not to use the prescription.

The article is here.

Monday, September 28, 2015

Your Right to Die Isn’t Enough

By Elizabeth Stoker Bruenig
The New Republic
Originally published July 15, 2015

Here is an excerpt:

Some opponents of assisted suicide legislation are concerned that, with assisted suicide on the table, exhausted doctors and cash-strapped families might coerce ill family members into taking this cheap, quick way out rather than suffering through further treatments and payments for terminal illness. Others worry that legal assisted suicide will transform culture in such a way that the option to die will eventually be interpreted as an obligation to do so after a certain point, creating a slippery slope from legal to de-facto compulsory. Still others fear that euthanasia advocates don’t appropriately take into account the possibility of spontaneous remission, and worry that readiness to end the lives of terminally ill patients would foreclose the possibility of recovery for those with the potential for it, however slim.

There is little evidence that legal euthanasia contributes to the coercion of the poor, and numbers on spontaneous remission can usually be adduced for any given terminal disease, which helps prevent the what-if objection from gaining much traction. Yet there is reason to worry about a slippery slope forming between the legal but rare option of euthanasia for the terminally ill and the haphazard elective suicide of persons with no real physical illness. At this moment, for example, a 24-year-old Belgian woman is awaiting assisted suicide for no reason other than her unhappiness. She won’t be the first: a friend of hers who also suffered from depression was euthanized for that condition less than two years ago, following in the footsteps of numerous people with sad life experiences or momentary shocks who, thanks to Belgian law, sought death instead of treatment.

The entire article is here.

Thursday, September 17, 2015

Child euthanasia: should we just not talk about it?

By Luc Bovens
J Med Ethics 2015;41:630-634
doi:10.1136/medethics-2014-102329

Abstract

Belgium has recently extended its euthanasia legislation to minors, making it the first legislation in the world that does not specify any age limit. I consider two strands in the opposition to this legislation. First, I identify five arguments in the public debate to the effect that euthanasia for minors is somehow worse than euthanasia for adults—viz, arguments from weightiness, capability of discernment, pressure, sensitivity and sufficient palliative care—and show that these arguments are wanting. Second, there is another position in the public debate that wishes to keep the current age restriction on the books and have ethics boards exercise discretion in euthanasia decisions for minors. I interpret this position on the background of Velleman's ‘Against the Right to Die’ and show that, although costs remain substantial, it actually can provide some qualified support against extending euthanasia legislation to minors.

The entire article is here.

Friday, September 11, 2015

Safeguarding choice at the end of life

By Dominic Wilkinson
J Med Ethics 2015;41:575-576
doi:10.1136/medethics-2015-102990

Across the world, in countries with permissive or restrictive existing legislation, debates about Euthanasia and Assisted Suicide (EAS) continue to grip politicians, ethicists, physicians and the wider public.

Early debates about EAS focused on whether it could ever be ethical for a physician to actively cause the death of a patient. However, most contemporary writers, including most of the contributors to this special double issue of the JME appear to accept that such actions could, in some circumstances, be ethical. Current debate is mostly focused instead on which actions are permissible, when they are permissible, and what safeguards are necessary to protect the vulnerable.

There are two separate justifications for EAS. The first of these is based on the autonomy of competent patients, on their right to make important decisions about their own lives. Arguably, a decision about continuing or not continuing your life in the face of severe suffering is the most important decision that you could make. Correspondingly, we have strong autonomy based reasons for permitting that choice. (While some Kantians might claim that a decision to die, and thereby to end one's autonomous agency could not be compatible with autonomy and dignity, Michael Cholbi points out (see page 607) that a sophisticated Kantian position on EAS is neither completely restrictive nor permissive). The second justification for EAS is based on the interests of a patient, and a concern that continued life for some individuals may be so extraordinarily and intensely unpleasant that it would be better for them to die.

The entire article is here.

Tuesday, July 21, 2015

Euthanasia cases more than double in northern Belgium

By Raf Casert
Associated Press
Originally published March 17, 2015

Almost one in 20 people in northern Belgium died using euthanasia in 2013, more than doubling the numbers in six years, a study released Tuesday showed.

The universities of Ghent and Brussels found that since euthanasia was legalized in 2002, the acceptance of ending a life at the patient’s request has greatly increased. While a 2007 survey showed only 1.9 percent of deaths from euthanasia in the region, the figure was 4.6 percent in 2013.

The entire article is here.

Wednesday, June 10, 2015

The Gray Areas Of Assisted Suicide

By April Dembosky
Kaiser Health News
Originally published May 21, 2015

Here is an excerpt:

People don’t talk about it, but it happens. Just over 3 percent of U.S. doctors said they have written a prescription for life-ending medication, according to an anonymous survey published in the New England Journal of Medicine in 1998. Almost 5 percent of doctors reported giving a patient a lethal injection.

Other studies suggest oncologists, and doctors on the West Coast, are more likely to be asked for life-ending medication, or euthanasia, in which the doctor administers the lethal dose.

“Those practices are undercover. They are covert,” says Barbara Coombs Lee, president of Compassion & Choices, an advocacy group. “To the degree that patients are part of the decision-making, it is by winks and nods.”

Coombs Lee’s organization helped tell the story of Brittany Maynard, a 29-year-old woman who moved from California to Oregon to be able to end her life legally after she was diagnosed with a brain tumor. Now the organization is backing legislation in California to make it legal for doctors to prescribe lethal medication to terminally ill patients who request it.

The entire article is here.

Thursday, April 16, 2015

Stigma Around Physician-Assisted Dying Lingers

By Clyde Haberman
The New York Times
Originally posted on March 22, 2015

Here is an excerpt:

Arguments, pro and con, have not changed much over the years. Assisted dying was and is anathema to many religious leaders, notably in the Roman Catholic Church. For the American Medical Association, it remains “fundamentally incompatible with the physician’s role as healer.”

Some opponents express slippery-slope concerns: that certain patients might feel they owe it to their overburdened families to call it quits. That the poor and the uninsured, disproportionately, will have their lives cut short. That medication might be prescribed for the mentally incompetent. That doctors might move too readily to bring an end to those in the throes of depression. “We should address what would give them purpose, not give them a handful of pills,” Dr. Ezekiel Emanuel, a prominent oncologist and medical ethicist, told Retro Report.

The entire article is here.

Tuesday, February 3, 2015

Elderly cousins undergo joint euthanasia for fear of being separated

By Lyndsey Telford
The Telegraph
Originally posted February 1, 2015

Two elderly Scottish cousins who relied on each other to get by have undergone joint euthanasia because they feared being put in separate care homes.

Stuart Henderson, 86, and Phyllis McConachie, 89, took their lives together in a Swiss clinic in November last year. Neither was terminally ill.

The pair had lived together for 40 years and managed to look after each other in a sheltered housing complex.

But, with Ms McConachie having injured her hip in a fall and with Mr Henderson’s onset dementia, the cousins worried they would be sent to different homes and separated.

Their joint deaths have sparked outrage among anti-euthanasia campaigners, who have described their case as “the ultimate abandonment” due to a lack of patient-centred care in the UK.

The entire article is here.

Monday, January 19, 2015

Belgian rapist Frank Van Den Bleeken 'to be euthanised' in prison this week

By Roisin O'Connor
The Independent
Originally posted January 5, 2015

A convicted murderer and rapist who won the right to end his life rather than endure 'unbearable suffering' in prison will be euthanised on 11 January.

Granted the right to die under Belgium’s liberal euthanasia laws in September, Frank Van Den Bleeken claimed he could not face the rest of his life in jail and argued that he would never be able to overcome his violent sexual impulses.

The entire article is here.

Tuesday, November 4, 2014

The Last Right: Why America Is Moving Slowly on Assisted Suicide

By Ross Douthat
The New York Times Sunday Review
Originally posted on October 11, 2014

Here is an excerpt:

The tragedy here is almost deep enough to drown the political debate. But that debate’s continued existence is still a striking fact. Why, in a society where individualism seems to be carrying the day, is the right that Maynard intends to exercise still confined to just a handful of states? Why has assisted suicide’s advance been slow, when on other social issues the landscape has shifted dramatically in a libertarian direction?

Twenty years ago, a much more rapid advance seemed likely. Some sort of right to suicide seemed like a potential extension of “the right to define one’s own concept of existence” that the Supreme Court had invoked while upholding a woman’s constitutional right to abortion. Polls in the 1990s consistently showed more support — majority support, depending on the framing — for physician-assisted suicide than for what then seemed like the eccentric cause of same-sex marriage.

The entire article is here.