By Michael Cook
Careful! A blog about end-of-life issues
Originally published April 13, 2014
Here is an excerpt:
The Society spells out its policy very carefully. It is not about grey areas like withdrawing burdensome or futile treatment or balancing pain relief against shortening a patient’s life. It clearly states that “shortening the dying process by administering sedatives beyond what is needed for patient comfort can be not only acceptable but in many cases desirable”.
“Shortening the dying process” is a euphemism for administering a lethal injection.
Most dying patients in intensive care have not made advance directives and “are usually not in a position to request euthanasia”. Therefore, “difficulty can arise when the purpose of the drugs used for comfort and pain relief in end-of-life management is misconstrued as deliberate use to speed the dying process.” The Society’s solution to this difficulty is to allow its members to kill the patients.
The entire story is here.
Thanks to Eric Affsprung for this information.
Showing posts with label Euthanasia. Show all posts
Showing posts with label Euthanasia. Show all posts
Thursday, May 1, 2014
Saturday, May 25, 2013
Vermont Legalizes Assisted Suicide
By Wilson Ring
The Associated Press
Originally published May 20, 2013
After years of debate, Vermont became the fourth state in the country Monday to allow doctors to prescribe lethal doses of medicine to terminally ill patients seeking to end their lives.
Gov. Peter Shumlin signed the bill into law at a Statehouse ceremony even as opponents vowed to push for its repeal.
The End of Life Choices law was effective immediately, although it could be weeks before the state Health Department develops regulations in accordance with the new measure.
Vermont Health Commissioner Dr. Harry Chen said he expects doctors to write between 10 and 20 lethal prescriptions a year, with a smaller number of patients actually using the drugs.
He based his figures on the experience in Oregon, the first state to legalize assisted suicide in 1997. Washington state and Montana followed later, with Montana's coming by way of a court order.
The entire story is here.
The Associated Press
Originally published May 20, 2013
After years of debate, Vermont became the fourth state in the country Monday to allow doctors to prescribe lethal doses of medicine to terminally ill patients seeking to end their lives.
Gov. Peter Shumlin signed the bill into law at a Statehouse ceremony even as opponents vowed to push for its repeal.
The End of Life Choices law was effective immediately, although it could be weeks before the state Health Department develops regulations in accordance with the new measure.
Vermont Health Commissioner Dr. Harry Chen said he expects doctors to write between 10 and 20 lethal prescriptions a year, with a smaller number of patients actually using the drugs.
He based his figures on the experience in Oregon, the first state to legalize assisted suicide in 1997. Washington state and Montana followed later, with Montana's coming by way of a court order.
The entire story is here.
Saturday, April 20, 2013
Physician-Assisted Suicide Program Wins Praise
By John Gever
Medscape News
Originally published April 10, 2013
Patients, their families, and physicians have been satisfied with a "death with dignity" physician-assisted suicide program made available to terminal cancer patients at a Seattle clinic, clinicians there reported.
Among 114 patients who asked about the program at the Seattle Cancer Care Alliance, the outpatient clinic for the city's major cancer treatment centers, 40 passed screening examinations and ultimately received lethal prescriptions for secobarbital, although only 24 actually took the drug, according to Elizabeth Trice Loggers, MD, PhD, and colleagues at the clinic and its affiliated centers.
"Patients, caregivers, and family members have frequently expressed gratitude after the patient obtained the prescription, regardless of whether it was ever filled or ingested, typically referencing an important sense of control in an uncertain situation," the authors wrote in the April 11 issue of the New England Journal of Medicine.
The entire story is here.
The primary source is here.
Medscape News
Originally published April 10, 2013
Patients, their families, and physicians have been satisfied with a "death with dignity" physician-assisted suicide program made available to terminal cancer patients at a Seattle clinic, clinicians there reported.
Among 114 patients who asked about the program at the Seattle Cancer Care Alliance, the outpatient clinic for the city's major cancer treatment centers, 40 passed screening examinations and ultimately received lethal prescriptions for secobarbital, although only 24 actually took the drug, according to Elizabeth Trice Loggers, MD, PhD, and colleagues at the clinic and its affiliated centers.
"Patients, caregivers, and family members have frequently expressed gratitude after the patient obtained the prescription, regardless of whether it was ever filled or ingested, typically referencing an important sense of control in an uncertain situation," the authors wrote in the April 11 issue of the New England Journal of Medicine.
The entire story is here.
The primary source is here.
Physician-Assisted Suicide Program Rarely Used, Study Finds
By Serena Gordon
HealthDay Reporter
Originally published April 10, 2013
Physician-assisted suicide laws can raise controversy and concern with their passage, but a new study from Washington state suggests many of those fears may be unfounded.
Washington's Death With Dignity Act hasn't lead to scores of terminally ill people seeking lethal prescriptions, the researchers report: Almost three years after the law was enacted, just 255 people had obtained a lethal prescription from a physician.
Of those 255 prescriptions, 40 were written for terminal cancer patients at the Seattle Cancer Care Alliance. And, in the new study, doctors there found that only 60 percent (24 people) of their patients chose to use their prescription to hasten their death.
"Most Americans say that they want to die at home with family members around, not in pain and with their mental faculties as in tact as possible. But, not everyone is achieving that kind of good death. For the rare number of people using the Death With Dignity program, we are reassured by the high numbers of people who use palliative or hospice care and who talk with their families about this decision," said study author Dr. Elizabeth Trice Loggers, medical director of palliative care at the Seattle Cancer Care Alliance.
The entire story is here.
Thursday, February 21, 2013
Vermont Senate approves amended death with dignity bill
By Dave Gram
The Associated Press
Originally published February 13, 2013
The Vermont Senate on Wednesday gave preliminary approval to an amended bill allowing doctors to prescribe a lethal dose of medication to terminally ill patients.
But even some backers of the measure, which passed 21-9, called the amended version a travesty. And other long-time backers of what they call ‘‘death with dignity’’ or ‘‘end-of-life choices,’’ along with opponents of physician-assisted suicide, were so angry about the amendment that they voted against it.
‘‘I will be voting yes for this bill, as much as I detest it,’’ said Sen. Claire Ayer, D-Addison and chairwoman of the Senate Health and Welfare Committee.
She said she hoped much of the original language — which mirrored Oregon’s first-in-the-nation Death With Dignity Act — would be restored when the measure moves to the House.
‘‘I want to be on that conference committee,’’ Ayer said, referring to the six-member panel of lawmakers who work out the differences between the House and Senate bills after they have cleared both chambers.
The entire story is here.
The Associated Press
Originally published February 13, 2013
The Vermont Senate on Wednesday gave preliminary approval to an amended bill allowing doctors to prescribe a lethal dose of medication to terminally ill patients.
But even some backers of the measure, which passed 21-9, called the amended version a travesty. And other long-time backers of what they call ‘‘death with dignity’’ or ‘‘end-of-life choices,’’ along with opponents of physician-assisted suicide, were so angry about the amendment that they voted against it.
‘‘I will be voting yes for this bill, as much as I detest it,’’ said Sen. Claire Ayer, D-Addison and chairwoman of the Senate Health and Welfare Committee.
She said she hoped much of the original language — which mirrored Oregon’s first-in-the-nation Death With Dignity Act — would be restored when the measure moves to the House.
‘‘I want to be on that conference committee,’’ Ayer said, referring to the six-member panel of lawmakers who work out the differences between the House and Senate bills after they have cleared both chambers.
The entire story is here.
Tuesday, January 22, 2013
There is more to end-of-life practices than euthanasia — Authors' reply
The Lancet
Volume 381, Issue 9862, Pages 202-203
Bregje Onwuteaka-Philipsen, Arianne Brinkman-Stoppelenburg, Hans van Delden, Anges van der Heide
We agree with Jan Schildmann and Eva Schildmann that the debate on end-of-life practices should not be limited to euthanasia. We also agree that increased attention to palliative care does not necessarily result in good quality end-of-life care. Our study gives an insight into end-of-life decision making and end-of-life acts, but not into the quality of end-of-life care. Additionally, what good quality end-of-life care consists of is not that straightforward. This is certainly true for palliative sedation. Although there is an increasing body of published studies on this subject, there are controversies on terminology and ethical acceptability of the practice. Guidelines are a way to try to overcome this and to improve quality of care. Yet there are many different guidelines—eg, at the institutional level and in different countries—and the premises of national guidelines can be the subject of debate. In our opinion, the role of empirical studies such as ours is to underpin the ongoing debate with information about what occurs in practice.
We declare that we have no conflicts of interest.
doi:10.1016/S0140-6736(13)60087-2
Volume 381, Issue 9862, Pages 202-203
Bregje Onwuteaka-Philipsen, Arianne Brinkman-Stoppelenburg, Hans van Delden, Anges van der Heide
We agree with Jan Schildmann and Eva Schildmann that the debate on end-of-life practices should not be limited to euthanasia. We also agree that increased attention to palliative care does not necessarily result in good quality end-of-life care. Our study gives an insight into end-of-life decision making and end-of-life acts, but not into the quality of end-of-life care. Additionally, what good quality end-of-life care consists of is not that straightforward. This is certainly true for palliative sedation. Although there is an increasing body of published studies on this subject, there are controversies on terminology and ethical acceptability of the practice. Guidelines are a way to try to overcome this and to improve quality of care. Yet there are many different guidelines—eg, at the institutional level and in different countries—and the premises of national guidelines can be the subject of debate. In our opinion, the role of empirical studies such as ours is to underpin the ongoing debate with information about what occurs in practice.
We declare that we have no conflicts of interest.
doi:10.1016/S0140-6736(13)60087-2
Tuesday, November 6, 2012
Suicide by Choice? Not So Fast
By Ben Mattlin
The New York Times - Opinion Pages
Originally published October 31, 2012
NEXT week, voters in Massachusetts will decide whether to adopt an assisted-suicide law. As a good pro-choice liberal, I ought to support the effort. But as a lifelong disabled person, I cannot.
There are solid arguments in favor. No one will be coerced into taking a poison pill, supporters insist. The “right to die” will apply only to those with six months to live or less. Doctors will take into account the possibility of depression. There is no slippery slope.
Fair enough, but I remain skeptical. There’s been scant evidence of abuse so far in Oregon, Washington and Montana, the three states where physician-assisted death is already legal, but abuse — whether spousal, child or elder — is notoriously underreported, and evidence is difficult to come by. What’s more, Massachusetts registered nearly 20,000 cases of elder abuse in 2010 alone.
The entire article is here.
The New York Times - Opinion Pages
Originally published October 31, 2012
NEXT week, voters in Massachusetts will decide whether to adopt an assisted-suicide law. As a good pro-choice liberal, I ought to support the effort. But as a lifelong disabled person, I cannot.
There are solid arguments in favor. No one will be coerced into taking a poison pill, supporters insist. The “right to die” will apply only to those with six months to live or less. Doctors will take into account the possibility of depression. There is no slippery slope.
Fair enough, but I remain skeptical. There’s been scant evidence of abuse so far in Oregon, Washington and Montana, the three states where physician-assisted death is already legal, but abuse — whether spousal, child or elder — is notoriously underreported, and evidence is difficult to come by. What’s more, Massachusetts registered nearly 20,000 cases of elder abuse in 2010 alone.
The entire article is here.
Friday, October 12, 2012
May Doctors Help You to Die?
By Marcia Angell
The New York Review of Books
Published on October 11, 2012
On November 6, Massachusetts voters will decide whether a physician may provide a dying patient with medication to bring about a faster, easier death if the patient chooses. On the ballot will be a Death with Dignity Act that reads:
If this ballot initiative passes, it will be binding, and Massachusetts will join Oregon, which implemented a virtually identical statute in 1998, and Washington, which did the same in 2009, as the only states where voters approved this form of physician-assisted dying, sometimes called aid-in-dying. (These terms are favored by proponents over the older term, physician-assisted suicide, because they distinguish it from the typical suicide in which someone with a normal life expectancy chooses death over life. Here the patient is near death from natural causes anyway, and chooses the timing and manner of an inevitable death.) Montana, through a 2009 decision by its Supreme Court, not a voter referendum, also permits physician-assisted dying.
The entire review is here.
The New York Review of Books
Published on October 11, 2012
On November 6, Massachusetts voters will decide whether a physician may provide a dying patient with medication to bring about a faster, easier death if the patient chooses. On the ballot will be a Death with Dignity Act that reads:
It is hereby declared that the public welfare requires a defined and safeguarded process by which an adult Massachusetts resident who has the capacity to make health care decisions and who has been determined by his or her attending and consulting physicians to be suffering from a terminal disease that will cause death within six months may obtain medication that the patient may self administer to end his or her life in a humane and dignified manner. It is further declared that the public welfare requires that such a process be entirely voluntary on the part of all participants, including the patient, his or her physicians, and any other health care provider or facility providing services or care to the patient.
If this ballot initiative passes, it will be binding, and Massachusetts will join Oregon, which implemented a virtually identical statute in 1998, and Washington, which did the same in 2009, as the only states where voters approved this form of physician-assisted dying, sometimes called aid-in-dying. (These terms are favored by proponents over the older term, physician-assisted suicide, because they distinguish it from the typical suicide in which someone with a normal life expectancy chooses death over life. Here the patient is near death from natural causes anyway, and chooses the timing and manner of an inevitable death.) Montana, through a 2009 decision by its Supreme Court, not a voter referendum, also permits physician-assisted dying.
The entire review is here.
Merciful Assistance or Physician-Assisted Killing?
By Ronald Pies, M.D.
psychcentral.com blog
Here are some excerpts:
From the standpoint of medical ethics, I see no fundamental moral difference in a doctor’s assisting a patient to jump off a bridge — without, of course, pushing him off — and a doctor’s prescribing a lethal dose of medication to “assist” in the patient’s suicide. The main difference is that, whereas anybody can assist a suicidal patient in climbing over a bridge railing, only physicians and a few other health care professionals are authorized by law to prescribe medication — and, in Oregon and Washington state, to prescribe lethal medication for “physician-assisted suicide” (PAS).
Of course, there are important procedural differences between my bridge scenario and the way PAS is handled in these states. There are numerous procedural safeguards in place to ensure that dying patients are thoroughly evaluated, and not pressured or coerced into requesting lethal medication — though the evidence is mixed as to how effective these safeguards have been. One study of physician-assisted suicide in Oregon and the Netherlands found no evidence that disadvantaged groups (such as the elderly or disabled) are being disproportionately affected by the laws (Battin et al). On the other hand, another study (Finlay and George) concluded that, “…there is reason to believe that some terminally ill patients in Oregon are taking their own lives with lethal drugs supplied by doctors despite having had depression at the time when they were assessed and cleared for PAS.”
From a strictly ethical perspective, I believe physicians have no more business helping patients kill themselves with lethal drugs than they do helping patients jump off bridges — regardless of how “voluntary” the patient’s decision may be. Clearly, neither action is compatible with the traditional role of the physician as healer. Indeed, psychiatrist and ethicist Dr. Thomas Szasz has argued that “physician-assisted suicide” is merely a euphemism for “medical killing.” For these reasons, I am opposed to the November ballot initiative in Massachusetts for a measure that would allow terminally ill patients to be prescribed lethal drugs.
The entire blog post is here.
psychcentral.com blog
Here are some excerpts:
From the standpoint of medical ethics, I see no fundamental moral difference in a doctor’s assisting a patient to jump off a bridge — without, of course, pushing him off — and a doctor’s prescribing a lethal dose of medication to “assist” in the patient’s suicide. The main difference is that, whereas anybody can assist a suicidal patient in climbing over a bridge railing, only physicians and a few other health care professionals are authorized by law to prescribe medication — and, in Oregon and Washington state, to prescribe lethal medication for “physician-assisted suicide” (PAS).
Of course, there are important procedural differences between my bridge scenario and the way PAS is handled in these states. There are numerous procedural safeguards in place to ensure that dying patients are thoroughly evaluated, and not pressured or coerced into requesting lethal medication — though the evidence is mixed as to how effective these safeguards have been. One study of physician-assisted suicide in Oregon and the Netherlands found no evidence that disadvantaged groups (such as the elderly or disabled) are being disproportionately affected by the laws (Battin et al). On the other hand, another study (Finlay and George) concluded that, “…there is reason to believe that some terminally ill patients in Oregon are taking their own lives with lethal drugs supplied by doctors despite having had depression at the time when they were assessed and cleared for PAS.”
From a strictly ethical perspective, I believe physicians have no more business helping patients kill themselves with lethal drugs than they do helping patients jump off bridges — regardless of how “voluntary” the patient’s decision may be. Clearly, neither action is compatible with the traditional role of the physician as healer. Indeed, psychiatrist and ethicist Dr. Thomas Szasz has argued that “physician-assisted suicide” is merely a euphemism for “medical killing.” For these reasons, I am opposed to the November ballot initiative in Massachusetts for a measure that would allow terminally ill patients to be prescribed lethal drugs.
The entire blog post is here.
Saturday, August 18, 2012
In Ill Doctor, a Surprise Reflection of Who Picks Assisted Suicide
by Katie Hafner
The New York Times
Originally published on August 11, 2012
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.
By far the most common reasons, Dr. Ganzini’s study found, were the desire to be in control, to remain autonomous and to die at home. “It turns out that for this group of people, dying is less about physical symptoms than personal values,” she said.
The New York Times
Originally published on August 11, 2012
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,” Dr. 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.”
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.
Dr. Wesley is emblematic of those who have taken advantage of the law. 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.
(cut)
Dr. Linda Ganzini, a professor of psychiatry at Oregon Health and Science University, published a study in 2009 of 56 Oregonians who were in the process of requesting physician-aided dying.
(cut)
Dr. Linda Ganzini, a professor of psychiatry at Oregon Health and Science University, published a study in 2009 of 56 Oregonians who were in the process of requesting physician-aided dying.
“Everybody thought this was going to be about pain,” Dr. Ganzini said. “It turns out pain is kind of irrelevant.”
By far the most common reasons, Dr. Ganzini’s study found, were the desire to be in control, to remain autonomous and to die at home. “It turns out that for this group of people, dying is less about physical symptoms than personal values,” she said.
Thursday, July 19, 2012
The Evolving State of Physician-Assisted Suicide
Massachusetts voters soon will decide whether to become the third state to legalize the contentious end-of-life care option for the terminally ill.
By Jaime Joyce
The Atlantic Monthly
Originally published July 16, 2012
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.
(cut)
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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Others posts about end of life issues and Death with Dignity can be found by using the "search" function on the right hand side of this blog.
Dutch Euthanasia Rates Unchanged After Legalization
By Robert Preidt
MedicineNet.com
Originally published July 10, 2012
The rates of euthanasia and assisted suicide in the Netherlands in 2010 were comparable to the rates before the practices became legal in 2002, a new study finds.
(cut)
Researchers analyzed the Netherlands' death-registry data and found that the total number of euthanasia and assisted-suicide deaths in 2010 was 4,050, slightly less than 3 percent of all deaths.
The rates of euthanasia and assisted suicide in the Netherlands decreased between 2002 and 2005, but increased between 2005 and 2010. The increase was due largely to a rise in the number of patients requesting to end their lives, the researchers said.
The entire story is here.
The research from The Lancet is here.
MedicineNet.com
Originally published July 10, 2012
The rates of euthanasia and assisted suicide in the Netherlands in 2010 were comparable to the rates before the practices became legal in 2002, a new study finds.
(cut)
Researchers analyzed the Netherlands' death-registry data and found that the total number of euthanasia and assisted-suicide deaths in 2010 was 4,050, slightly less than 3 percent of all deaths.
The rates of euthanasia and assisted suicide in the Netherlands decreased between 2002 and 2005, but increased between 2005 and 2010. The increase was due largely to a rise in the number of patients requesting to end their lives, the researchers said.
The entire story is here.
The research from The Lancet is here.
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