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Showing posts with label Physician Assisted Death. Show all posts
Showing posts with label Physician Assisted Death. Show all posts

Thursday, July 26, 2018

Number of Canadians choosing medically assisted death jumps 30%

Kathleen Harris
www.cbc.ca
Originally posted June 21, 2018

There were 1,523 medically assisted deaths in Canada in the last six-month reporting period — a nearly 30 per cent increase over the previous six months.

Cancer was the most common underlying medical condition in reported assisted death cases, cited in about 65 per cent of all medically assisted deaths, according to the report from Health Canada.

Using data from Statistics Canada, the report shows medically assisted deaths accounted for 1.07 per cent of all deaths in the country over those six months. That is consistent with reports from other countries that have assisted death regimes, where the figure ranges from 0.3 to four per cent.

The information is here.

Monday, November 27, 2017

Suicide Is Not The Same As "Physician Aid In Dying"

American Association of Suicidology
Suicide Is Not The Same As "Physician Aid In Dying"
Approved October 30, 2017

Executive summary 

The American Association of Suicidology recognizes that the practice of physician aid in dying, also called physician assisted suicide, Death with Dignity, and medical aid in dying, is distinct from the behavior that has been traditionally and ordinarily described as “suicide,” the tragic event our organization works so hard to prevent. Although there may be overlap between the two categories, legal physician assisted deaths should not be considered to be cases of suicide and are therefore a matter outside the central focus of the AAS.

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Conclusion 

In general, suicide and physician aid in dying are conceptually, medically, and legally different phenomena, with an undetermined amount of overlap between these two categories. The American Association of Suicidology is dedicated to preventing suicide, but this has no bearing on the reflective, anticipated death a physician may legally help a dying patient facilitate, whether called physician-assisted suicide, Death with Dignity, physician assisted dying, or medical aid in dying. In fact, we believe that the term “physician-assisted suicide” in itself constitutes a critical reason why these distinct death categories are so often conflated, and should be deleted from use. Such deaths should not be considered to be cases of suicide and are therefore a matter outside the central focus of the AAS.

The full document is here.

Wednesday, September 27, 2017

New York’s Highest Court Rules Against Physician-Assisted Suicide

Jacob Gershman
The Wall Street Journal
Originally posted September 7, 2017

New York’s highest court on Thursday ruled that physician-assisted suicide isn’t a fundamental right, rejecting a legal effort by terminally ill patients to decriminalize doctor-assisted suicide through the courts.

The state Court of Appeals, though, said it wouldn’t stand in the way if New York’s legislature were to decide that assisted suicide could be “effectively regulated” and pass legislation allowing terminally ill and suffering patients to kill themselves.

Physician-assisted suicide is illegal in most of the country. But advocates who support loosening the laws have been making gains. Doctor-assisted dying has been legalized in several states, most recently in California and Colorado, the former by legislation and the latter by a ballot measure approved by voters in November. Oregon, Vermont and Washington have enacted similar “end-of-life” measures. Washington, D.C., also passed an “assisted-dying” law last year.

Montana’s highest court in 2009 ruled that physicians who provide “aid in dying” are shielded from liability.

No state court has recognized “aid in dying” as a fundamental right.

The article is here.

Sunday, July 2, 2017

Religious doctors who don’t want to refer patients for assisted dying have launched a hopeless court case

Derek Smith
Special to National Post 
Originally posted June 12, 2017

In a case being heard this week in an Ontario divisional court, a group of Christian doctors have launched a constitutional challenge against the College of Physicians and Surgeons of Ontario. The college requires religious doctors who refuse to offer medical assistance in dying (MAID) to give an “effective referral” so that the patient can receive the procedure from a willing doctor nearby.

The doctors say that the college has limited their religious freedom under the Charter of Rights and Freedoms unjustifiably. They argue that a referral endorses the procedure and helps kill, breaking God’s commandment. In their view, patients should have to find willing doctors themselves and “self-refer,” sparing religious objectors from sin and a guilty conscience.

The college should certainly accommodate religious objectors more than it currently does, but the lawsuit will likely fail. It deserves to fail.

Religious freedom sometimes has to yield to laws that prevent religious people from harming others. The Supreme Court of Canada has emphasized this in limiting religious freedom on a wide range of topics, including denials of blood transfusions, witnesses wearing niqabs in criminal trials, child custody disputes, accountability for unaccredited church schools and bans on Sunday shopping.

The article is here.

Sunday, June 18, 2017

Has Physician-Assisted Death Become the “Good Death?”

Franklin G. Miller
The Hastings Center
Originally published May 30, 2017

“Death with dignity” for the past 40 years has meant, for many people, avoiding unwanted medical technology and dying in a hospital.  A “natural” death at home or in a hospice facility has been the goal.   During the last 20 years, physician-assisted suicide has been legalized for terminally ill patients in several states of the United States, and recently “medical assistance in dying,” which also includes active euthanasia, has become legal in Canada.  How should we think about what constitutes a good death now?

There are signs of a cultural shift, in which physician-assisted death is not just a permitted choice by which individuals can control the timing and circumstances of their death but is taken as a model of the good death.  A recent lengthy front page article in the New York Times recounts a case of physician-assisted death in Canada in a way that strongly suggests that a planned, orchestrated death is the ideal way to die.  While I have long supported a legal option of physician-assisted suicide for the terminally ill, I believe that this cultural shift deserves critical scrutiny.

The article is here.

Wednesday, April 19, 2017

Should Mental Disorders Be a Basis for Physician-Assisted Death?

Paul S. Appelbaum
Psychiatric Services
Volume 68, Issue 4, April 01, 2017, pp. 315-317

Abstract

Laws permitting physician-assisted death in the United States currently are limited to terminal conditions. Canada is considering whether to extend the practice to encompass intractable suffering caused by mental disorders, and the question inevitably will arise in the United States. Among the problems seen in countries that have legalized assisted death for mental disorders are difficulties in assessing the disorder’s intractability and the patient’s decisional competence, and the disproportionate involvement of patients with social isolation and personality disorders. Legitimate concern exists that assisted death could serve as a substitute for creating adequate systems of mental health treatment and social support.

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, December 19, 2016

Colorado Voters Approve Aid-In-Dying Measure

John Daley
National Public Radio
Originally published November 10, 2016

Colorado has joined the handful of states that allow terminally ill patients to end their lives with medicine prescribed by a doctor.

Voters passed Proposition 106 by a 65 percent to 35 percent margin.

The fight pitted those who think the terminally ill should have the choice to end their lives if they choose to do so against those who think it's morally wrong and that people might be pressured into ending their lives.

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Under the Colorado measure, two doctors must agree a terminally ill adult has six months or less to live and is mentally competent. The person would self-administer the drug.

The article is here.

Monday, November 7, 2016

Assisted-Suicide Fight Moves to Colorado

Dan French
The Wall Street Journal
Originally posted October 16, 2016

The latest front in the battle over doctor-assisted suicide is unfolding in Colorado, where voters will consider a ballot measure next month that would permit physicians to aid terminally ill patients in dying.

Proposition 106 would allow adults who have six months or less to live, and are mentally competent, to take medication prescribed by a doctor to end their lives.

If it passes, Colorado would be the fifth state to have a law that allows the practice, according to the National Conference of State Legislatures.

Oregon—which is the model for Colorado’s proposal— along with Vermont and Washington have enacted similar measures. California’s law permitting doctor-assisted suicide took effect in June after it passed the state legislature last year.

In a sixth state, Montana, the state supreme court ruled that doctors who provide “aid in dying” are allowed to use a terminally ill patient’s consent as a defense in court if they are charged with homicide.

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.

Tuesday, July 12, 2016

Canada Legalizes Physician-Assisted Dying

By Merrit Kennedy
NPR.org
Originally posted June 18, 2016

After weeks of debate, Canadian lawmakers have passed legislation to legalize physician-assisted death.

That makes Canada "one of the few nations where doctors can legally help sick people die," as Reuters reports.

The new law "limits the option to the incurably ill, requires medical approval and mandates a 15-day waiting period," as The Two-Way has reported.

The Canadian government introduced the bill in April and it passed a final Senate vote Friday. It includes strict criteria that patients must meet to obtain a doctor's help in dying.

The article is here.

Tuesday, June 28, 2016

California doctor opens end-of-life clinic

by Michael Cook
BioEdge.org
Originally published June 11, 2016

California’s right-to-die law was rolled out this week and at least one doctor immediately opened up a dedicated assisted suicide clinic in San Francisco.

At Bay Area End of Life Options, Dr Lonny Shavelson, a well-known advocate of assisted suicide, will advise people who are wondering whether they ought to end their lives.

Dr Shavelson denies that he will be operating a drive-in suicide service. He says that he wants to work with patients to explore all the legal and therapeutic options. "When somebody says to a physician that they want to talk about the End of Life Option Act and says, 'Can you give me a prescription that will end my life?' I want them to tell me why," he told the San Jose Mercury. "A major goal of physicians is to make this (prescription) not happen."

His fees will be US$200 for an initial consultation plus $1800 if the patient is qualified and wishes to continue.

The article is here.

Tuesday, June 21, 2016

Dignity, Politics, and Medical Assistance in Dying

by Harry Critchley
Impact Ethics
Originally published June 6, 2016

Here is an excerpt:

A common problem with both of these approaches to understanding dignity, however, is the underlying assumption that dignity is best understood from a theoretical perspective. Another, more fruitful approach might be to examine the meaning of dignity with reference to its use in public discourse. On this view, to determine what dignity is requires that we ask what appeals to dignity are intended to do. Dignity is not only, or even primarily, appealed to in the solitude of philosophical contemplation, but rather in the company of others. Regardless of whether we understand dignity as sanctity of life or as autonomy, its emergence and acknowledgement in the political arena is an achievement not wholly dependent on its theoretical grounding.

The article is here.

Monday, May 2, 2016

Panelists Debate Morality Of Assisted Suicide Bill

By Jenna Rudolfsky
The Cornell Daily Sun
Originally posted April 18, 2016

Panelists from the Cornell Law School hosted a discussion entitled “Death with Dignity” to debate the controversial issue of assisted suicide and pending New York state legislation last Thursday.

If the “Death with Dignity” bill passes, New York will become the sixth state to allow terminally ill patients to end their own lives with prescribed lethal medication, according to MSNBC.

Panelist Prof. Daryl Bem, psychology, whose wife committed assisted suicide, discussed her struggles with Alzheimer’s disease in explaining why he is in favor of assisted suicide.

The article is here.

Thursday, April 28, 2016

Canadian Prime Minister Seeks to Legalize Physician-Assisted Suicide

By Ian Austen
The New York Times
Originally posted April 14, 2016

The government of Prime Minister Justin Trudeau introduced legislation on Thursday to legalize physician-assisted suicide for Canadians with serious medical conditions.

The proposed law limits physician-assisted suicides to Canadians and residents, who are eligible to participate in the national health care system, preventing a surge in medical tourism among the dying from other countries. Assisted suicide is legal in only a few American states, including Oregon and Vermont.

Under Canada’s proposed law, people who want to die will be able to either commit suicide with medication provided by their doctors or have the doctors administer the dose. Family members will be allowed to assist patients with their death.

The article is here.

Friday, February 19, 2016

A Time to Fly and a Time to Die: Suicide Tourism and Assisted Dying in Australia Considered

Hadeel Al-Alosi
UNSW Law Research Paper No. 2016-04
January 8, 2016

Abstract:    

Recently, a series of high-profile court cases have led the Director of Public Prosecution in the United Kingdom to publish a policy clarifying the exercise of its discretion in assisted suicide. Importantly, the experience in the United Kingdom serves as a timely reminder that Australia too should formulate its own guideline that detail how prosecutorial discretion will be exercised in cases of assisted suicide. This is especially given the fact that many Australian citizens are travelling to jurisdictions where assistance in dying is legal. Any policy should not, however, distract from addressing law reform on voluntary euthanasia. Australian legislators should be consulting with the public in order to represent the opinion of the majority. Nevertheless, any future policy and law reform implemented should provide adequate safeguards and be guided by the principle of individual autonomy.

The paper 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.

Thursday, December 10, 2015

Who Should Have The Right To Die?

By Nerdwriter
Originally posted October 28, 2015

Doctor-assisted suicide continues to be hotly debated in the United States, but the ideas – and specifically the words – used to support it have evolved in fascinating ways. Over nearly a century, there has been a shift away from terms related to death towards a focus on autonomy and dignity, drawing in no small part on the ideas of the 19th-century English philosopher John Stuart Mill.


Monday, November 23, 2015

Treatment-resistant depression and physician-assisted death

By Franklin G Miller
J Med Ethics doi:10.1136/medethics-2015-103060

Abstract

In a recent article, Udo Schuklenk and Suzanne van de Vathorst argued in favour of a legal option of physician-assisted death for patients with ‘treatment-resistant’ depression. In this commentary, I contend that their argument neglects the important consideration of the professional integrity of physicians. In light of this consideration, coupled with uncertainty about whether additional interventions with the patient can improve quality of life and restore the will to live, it is not appropriate to include patients with ‘treatment-resistant’ depression within a legal option of physician-assisted death.

The entire article is here.