What Is Euthanasia and Physician-Assisted Suicide?

Euthanasia is the act of a physician or other third party ending a patient's life in response to severe, persistent and untreatable pain and suffering. It is sometimes referred to as assisted suicide, physician-assisted death, physician-assisted suicide, mercy killing, and other variations; however, assisted suicide and euthanasia have differences.

Assisted suicide is intentionally and knowingly providing the means for another to commit suicide. For example, providing a prescription medication to someone with the knowledge that they intend to use it for the purpose of suicide.

Euthanasia involves a person, such as a physician, knowingly acting to cause the death of a person suffering from severe and incurable pain. For example, a physician giving injections of drugs to induce coma and then stop the heart.

There are two primary classifications of euthanasia.

Voluntary euthanasia is not legal in most parts of the world. The Netherlands and Belgium are currently the only countries who allow the practice. Involuntary euthanasia is not legal anywhere.

Physician-assisted suicide is currently legal in the United States in several states, including Oregon and Washington, and in a handful of other countries.

Physician-assisted suicide is only done when a patient has a terminal diagnosis and is suffering, with little or no relief. In such cases, a patient may wish to control when and how they die. A key part of physician-assisted suicide involves how the suicide is enacted: The patient must be the one to take the medication. It is illegal for a friend, family member, physician or anyone else to administer the medication; to do so crosses the legal line into the definition of euthanasia.

Sometimes called terminal sedation, palliative sedation is the progressive use of sedatives to achieve a desirable level of comfortpatients who are terminally ill and experiencing unrelievedsuffering.Death usually follows shortly after a patient becomes sedated.

Palliative sedation is neither euthanasia nor is itphysician-assisted suicide as the intent is not to cause death. Though death may occur, it is often unclear whether the death occurred because of the sedation or the terminal illness itself.

Palliative sedation requires the consent of the patient. If a patient is unable to make decisions for himself or herself, the decision falls to the patient's designated health care decision maker. The patient is unable to deliver the correct dosage of a palliative sedative, which is usually given as a suppository or an infusion. Because the sedation is fast-acting, the sedatives can be only given by a physician, nurse or another of the patient's primary caregivers.

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What Is Euthanasia and Physician-Assisted Suicide?

Euthanasia Program | The Holocaust Encyclopedia

Nazi Germany's First Program of Mass Murder

The Euthanasia Program was Nazi Germany's first program of mass murder. It predated the genocide of European Jewry (the Holocaust) by approximately two years. The program was one of many radical eugenic measures which aimed to restore the racial "integrity" of the German nation. It aimed to eliminate what eugenicists and their supporters considered "life unworthy of life": those individuals whothey believedbecause of severe psychiatric, neurological, or physical disabilities represented both a genetic and a financial burden on German society and the state.

In the spring and summer months of 1939, a number of planners began to organize a secret killing operation targeting disabled children. They were led by Philipp Bouhler, the director of Hitler's private chancellery, and Karl Brandt, Hitler's attending physician.

On August 18, 1939, the Reich Ministry of the Interior circulated a decree requiring all physicians, nurses, and midwives to report newborn infants and children under the age of three who showed signs of severe mental or physical disability.

Beginning in October 1939, public health authorities began to encourage parents of children with disabilities to admit their young children to one of a number of specially designated pediatric clinics throughout Germany and Austria. In reality, the clinics were children's killing wards. There, specially recruited medical staff murdered their young charges by lethal overdoses of medication or by starvation.

At first, medical professionals and clinic administrators included only infants and toddlers in the operation. As the scope of the measure widened, they included youths up to 17 years of age. Conservative estimates suggest that at least 5,000 physically and mentally disabled German children perished as a result of the child "euthanasia" program during the war years.

Euthanasia planners quickly envisioned extending the killing program to adult disabled patients living in institutional settings. In the autumn of 1939, Adolf Hitler signed a secret authorization in order to protect participating physicians, medical staff, and administrators from prosecution. This authorization was backdated to September 1, 1939, to suggest that the effort was related to wartime measures.

The Fhrer Chancellery was compact and separate from state, government, or Nazi Party apparatuses. For these reasons, Hitler chose it to serve as the engine for the "euthanasia" campaign. The program's functionaries called their secret enterprise "T4." This code-name came from the street address of the program's coordinating office in Berlin: Tiergartenstrasse 4.

According to Hitler's directive, Fhrer Chancellery director Phillip Bouhler and physician Karl Brandt led the killing operation. Under their leadership, T4 operatives established six gassing installations for adults as part of the "euthanasia" action. These were:

Euthanasia Program Using a practice developed for the child "euthanasia" program, in the autumn of 1939 T4 planners began to distribute carefully formulated questionnaires to all public health officials, public and private hospitals, mental institutions, and nursing homes for the chronically ill and aged. The limited space and wording on the forms, as well as the instructions in the accompanying cover letter, combined to give the impression that the survey was intended simply to gather statistical data.

The form's sinister purpose was suggested only by the emphasis placed upon the patient's capacity to work and by the categories of patients which the inquiry required health authorities to identify. The categories of patients were:

Secretly recruited "medical experts," physiciansmany of them of significant reputationworked in teams of three to evaluate the forms. On the basis of their decisions beginning in January 1940, T4 functionaries began to remove patients selected for the "euthanasia" program from their home institutions. The patients were transported by bus or by rail to one of the central gassing installations for killing.

Within hours of their arrival at such centers, the victims perished in gas chambers. The gas chambers, disguised as shower facilities, used pure carbon monoxide gas. T4 functionaries burned the bodies in crematoria attached to the gassing facilities. Other workers took the ashes of cremated victims from a common pile and placed them in urns to send to the relatives of the victims. The families or guardians of the victims received such an urn, along with a death certificate and other documentation, listing a fictive cause and date of death.

Because the program was secret, T-4 planners and functionaries took elaborate measures to conceal its deadly designs. Even though physicians and institutional administrators falsified official records in every case to indicate that the victims died of natural causes, the "euthanasia" program quickly become an open secret. There was widespread public knowledge of the measure. Private and public protests concerning the killings took place, especially from members of the German clergy. Among these clergy was the bishop of Mnster, Clemens August Count von Galen. He protested the T-4 killings in a sermon August 13, 1941. In light of the widespread public knowledge and the public and private protests,Hitler ordered a halt to the euthanasia program in late August 1941.

According to T4's own internal calculations, the euthanasia effort claimed the lives of 70,273 institutionalized mentally and physically disabled persons at the six gassing facilities between January 1940 and August 1941.

Hitler's call for a halt to the T4 action did not mean an end to the euthanasia killing operation. Child euthanasia continued as before. Moreover, in August 1942, German medical professionals and healthcare workers resumed the killings, although in a more carefully concealed manner than before. More decentralized than the initial gassing phase, the renewed effort relied closely upon regional exigencies, with local authorities determining the pace of the killing.

Using drug overdose and lethal injectionalready successfully used in child euthanasiain this second phase as a more covert means of killing, the euthanasia campaign resumed at a broad range of institutions throughout the Reich. Many of these institutions also systematically starved adult and child victims.

TheEuthanasia Programcontinued until the last days of World War II, expanding to include an ever wider range of victims, including geriatric patients, bombing victims, and foreign forced laborers. Historians estimate that the Euthanasia Program, in all its phases, claimed the lives of 250,000 individuals.

Persons with disabilities also fell victim to German violence in the German-occupied east. The Germans confined the Euthanasia Program, which began as a racial hygiene measure, to the Reich properthat is, to Germany and to the annexed territories of Austria, Alsace-Lorraine, the Protectorate of Bohemia and Moravia, and the Warthegau in former Poland. However, the Nazi ideological conviction which labeled these persons "life unworthy of life" also made institutionalized patients the targets of shooting actions in Poland and the Soviet Union. There, the killings of disabled patients were the work of SS and police forces, not of the physicians, caretakers, and T4 administrators who implemented the Euthanasia Program itself.

In areas of Pomerania, West Prussia, and occupied Poland, SS and police units murdered some 30,000 patients by the autumn of 1941 in order to accommodate ethnic German settlers (Volksdeutsche) transferred there from the Baltic countries and other areas.

SS and police units also murdered disabled patients in mass shootings and gas vans in occupied Soviet territories. Thousands more died, murdered in their beds and wards by SS and auxiliary police units in Poland and the Soviet Union. These murders lacked the ideological component attributed to the centralized Euthanasia Program. The SS was apparently motivated primarily by economic and material concerns in killing institutionalized patients in occupied Poland and the Soviet Union.

The SS and the Wehrmacht quickly made use of the hospitals emptied in these killing operations as barracks, reserve hospitals, and munitions storage depots. In rare cases, the SS used the empty facilities as a formal T4 killing site. An example is the euthanasia facility Tiegenhof, near Gnesen (today Gniezno, in west-central Poland).

The EuthanasiavProgram represented in many ways a rehearsal for Nazi Germany's subsequent genocidal policies. The Nazi leadership extended the ideological justification conceived by medical perpetrators for the destruction of the "unfit" to other categories of perceived biological enemies, most notably to Jews and Roma (Gypsies).

Planners of the "Final Solution" later borrowed the gas chamber and accompanying crematoria, specifically designed for the T4 campaign, to murder Jews in German-occupied Europe. T4 personnel who had shown themselves reliable in this first mass murder program figured prominently among the German staff stationed at the Operation Reinhard killing centers of Belzec, Sobibor, and Treblinka.

Like those who planned the physical annihilation of the European Jews, the planners of the Euthanasia Program imagined a racially pure and productive society. They embraced radical strategies to eliminate those who did not fit within their vision.

Propaganda for the Euthanasia Program

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Euthanasia Program | The Holocaust Encyclopedia

Aktion T4 – Wikipedia

Aktion T4 (German, pronounced [aktsion te fi]) was a postwar name for mass murder through involuntary euthanasia in Nazi Germany.[4][b] The name T4 is an abbreviation of Tiergartenstrae 4, a street address of the Chancellery department set up in the spring of 1940, in the Berlin borough of Tiergarten, which recruited and paid personnel associated withT4.[c] Certain German physicians were authorized to select patients "deemed incurably sick, after most critical medical examination" and then administer to them a "mercy death" (Gnadentod). In October 1939 Adolf Hitler signed a "euthanasia note" backdated to 1 September 1939 which authorized his physician Karl Brandt and Reichsleiter Philipp Bouhler to implement the programme.

The killings took place from September 1939 until the end of the war in 1945; from 275,000 to 300,000[a] people were killed at extermination centres in psychiatric hospitals in Germany and Austria, occupied Poland and the Protectorate of Bohemia and Moravia (now the Czech Republic). The number of victims was originally recorded as 70,273 but this number has been increased by the discovery of victims listed in the archives of former East Germany.[1][12][d] About half of those killed were taken from church-run asylums, often with the approval of the Protestant or Catholic authorities of the institutions. The Holy See announced on 2 December 1940 that the policy was contrary to the natural and positive Divine law and that "the direct killing of an innocent person because of mental or physical defects is not allowed" but the declaration was not upheld by some Catholic authorities in Germany. In the summer of 1941, protests were led in Germany by Bishop von Galen, whose intervention led to "the strongest, most explicit and most widespread protest movement against any policy since the beginning of the Third Reich", according to Richard J. Evans.

Several reasons have been suggested for the programme, including eugenics, compassion, reducing suffering, racial hygiene, economy and pressure on the welfare budget. Physicians in German and Austrian asylums continued many of the practices of Aktion T4 until the defeat of Germany in 1945, in spite of its official cessation. The informal continuation of the policy led to 93,521 "beds emptied" by the end of 1941.[e][f] Technology developed under Aktion T4 was taken over by the medical division of the Reich Interior Ministry, particularly the use of lethal gas to kill large numbers of people, along with the personnel who had participated in the development of the technology and later participated in Operation Reinhard.

The technology and personnel developed were instrumental in implementing the Holocaust. The programme was authorized by Hitler but the killings have since come to be viewed as murders in Germany. The number of people killed was about 200,000 in Germany and Austria, with about 100,000 victims in other European countries.[d][12][24][25]

At the beginning of the twentieth century, the sterilisation of people carrying what were considered to be hereditary defects and in some cases those exhibiting what was thought to be hereditary "antisocial" behaviour, was a respectable field of medicine. Canada, Denmark, Switzerland and the US had passed laws enabling coerced sterilisation. Studies conducted in the 1920s ranked Germany as a country that was unusually reluctant to introduce sterilisation legislation. In his book Mein Kampf (1924), Hitler wrote that one day racial hygiene "will appear as a deed greater than the most victorious wars of our present bourgeois era".[when?]

In July 1933 "Law for the Prevention of Hereditarily Diseased Offspring" prescribed compulsory sterilisation for people with conditions thought to be hereditary, such as schizophrenia, epilepsy, Huntington's chorea and "imbecility". Sterilisation was also legalised for chronic alcoholism and other forms of social deviance. The law was administered by the Interior Ministry under Wilhelm Frick through special Hereditary Health Courts (Erbgesundheitsgerichte), which examined the inmates of nursing homes, asylums, prisons, aged-care homes and special schools, to select those to be sterilised. It is estimated that 360,000 people were sterilised under this law between 1933 and 1939.[30]

The policy and research agenda of racial hygiene and eugenics were promoted by Emil Kraepelin. The eugenic sterilization of persons diagnosed with (and viewed as predisposed to) schizophrenia was advocated by Eugen Bleuler, who presumed racial deterioration because of mental and physical cripples in his Textbook of Psychiatry,

The more severely burdened should not propagate themselves If we do nothing but make mental and physical cripples capable of propagating themselves, and the healthy stocks have to limit the number of their children because so much has to be done for the maintenance of others, if natural selection is generally suppressed, then unless we will get new measures our race must rapidly deteriorate.

Within the Nazi administration, the idea of including in the program people with physical disabilities had to be expressed carefully, given that one of the most powerful figures of the regime, Joseph Goebbels, had a deformed right leg.[g] After 1937 the acute shortage of labour in Germany arising from rearmament, meant that anyone capable of work was deemed to be "useful" and thus exempted from the law and the rate of sterilisation declined. The term "Aktion T4" is a post-war coining; contemporary German terms included Euthanasie (euthanasia) and Gnadentod (merciful death). The T4 programme stemmed from the Nazi Party policy of "racial hygiene", a belief that the German people needed to be cleansed of racial enemies, which included anyone confined to a mental health facility and people with simple physical disabilities.

Karl Brandt, personal doctor to Hitler and Hans Lammers, the head of the Reich Chancellery, testified after the war that Hitler had told them as early as 1933when the sterilisation law was passedthat he favoured the killing of the incurably ill but recognised that public opinion would not accept this. In 1935, Hitler told the Leader of Reich Doctors, Gerhard Wagner, that the question could not be taken up in peacetime, "Such a problem could be more smoothly and easily carried out in war". He wrote that he intended to "radically solve" the problem of the mental asylums in such an event. Aktion T4 began with a "trial" case in late 1938. Hitler instructed Brandt to evaluate a family's petition for the "mercy killing" of their son who was blind, had physical and developmental disabilities.[h] The child, born near Leipzig and eventually identified as Gerhard Kretschmar, was killed in July 1939. Hitler instructed Brandt to proceed in the same manner in all similar cases.

On 18 August 1939, three weeks after the killing of the boy, the Reich Committee for the Scientific Registering of Hereditary and Congenital Illnesses was established. It was to register sick children or newborns identified as defective. The secret killing of infants began in 1939 and increased after the war started; by 1941 more than 5,000 children had been killed. Hitler was in favour of killing those whom he judged to be lebensunwertes Leben (Life unworthy of life). In a 1939 conference with Leonardo Conti, Reich Health Leader and state secretary for health in the Interior Ministry and Hans Lammers, Chief of the Reich Chancellerya few months before the "euthanasia" decreeHitler gave as examples the mentally ill who he said could only be "bedded on sawdust or sand" because they "perpetually dirtied themselves" and "put their own excrement into their mouths". This issue, according to the Nazi regime, assumed new urgency in wartime.

After the invasion of Poland, Hermann Pfannmller said

Fr mich ist die Vorstellung untragbar, dass beste, blhende Jugend an der Front ihr Leben lassen muss, damit verblichene Asoziale und unverantwortliche Antisoziale ein gesichertes Dasein haben. (It is unbearable to me that the flower of our youth must lose their lives at the front, while that feeble-minded and asocial element can have a secure existence in the asylum.)

Pfannmller advocated killing by a gradual decrease of food, which he believed was more merciful than poison injections.

The German eugenics movement had an extreme wing even before the Nazis came to power. As early as 1920, Alfred Hoche and Karl Binding advocated killing people whose lives were "unworthy of life" (lebensunwertes Leben). Darwinism was interpreted by them as justification of the demand for "beneficial" genes and eradication of the "harmful" ones. Robert Lifton wrote, "The argument went that the best young men died in war, causing a loss to the Volk of the best available genes. The genes of those who did not fight (the worst genes) then proliferated freely, accelerating biological and cultural degeneration". The advocacy of eugenics in Germany gained ground after 1930, when the Depression was used to excuse cuts in funding to state mental hospitals, creating squalor and overcrowding.

Many German eugenicists were nationalists and antisemites, who embraced the Nazi regime with enthusiasm. Many were appointed to positions in the Health Ministry and German research institutes. Their ideas were gradually adopted by the majority of the German medical profession, from which Jewish and communist doctors were soon purged. During the 1930s the Nazi Party had carried out a campaign of propaganda in favour of euthanasia. The National Socialist Racial and Political Office (NSRPA) produced leaflets, posters and short films to be shown in cinemas, pointing out to Germans the cost of maintaining asylums for the incurably ill and insane. These films included The Inheritance (Das Erbe, 1935), The Victim of the Past (Opfer der Vergangenheit, 1937), which was given a major premire in Berlin and was shown in all German cinemas, and I Accuse (Ich klage an, 1941), which was based on a novel by Hellmuth Unger, a consultant for "child euthanasia".

In mid-1939 Hitler authorized the creation of the Reich Committee for the Scientific Registering of Serious Hereditary and Congenital Illnesses (Reichsausschuss zur wissenschaftlichen Erfassung erb- und anlagebedingter schwerer Leiden), headed by Dr. Karl Brandt, his physician, and administered by Herbert Linden of the Interior Ministry as well as SS-Oberfhrer Viktor Brack. Brandt and Bouhler were authorized to approve applications to kill children in relevant circumstances, though Bouhler left the details to subordinates such as Brack and SA-Oberfhrer Werner Blankenburg.

Extermination centres were established at six existing psychiatric hospitals: Bernburg, Brandenburg, Grafeneck, Hadamar, Hartheim, and Sonnenstein. One thousand children under the age of 17 were killed at the institutions Am Spiegelgrund and Gugging in Austria. They played a crucial role in developments leading to the Holocaust. As a related aspect of the "medical" and scientific basis of this programme, the Nazi doctors took thousands of brains from 'euthanasia' victims for research.

From August 1939, the Interior Ministry registered children with disabilities, requiring doctors and midwives to report all cases of newborns with severe disabilities; the 'guardian' consent element soon disappeared. Those to be killed were identified as "all children under three years of age in whom any of the following 'serious hereditary diseases' were 'suspected': idiocy and Down syndrome (especially when associated with blindness and deafness); microcephaly; hydrocephaly; malformations of all kinds, especially of limbs, head, and spinal column; and paralysis, including spastic conditions". The reports were assessed by a panel of medical experts, of whom three were required to give their approval before a child could be killed.[i]

The Ministry used deceit when dealing with parents or guardians, particularly in Catholic areas, where parents were generally uncooperative. Parents were told that their children were being sent to "Special Sections", where they would receive improved treatment. The children sent to these centres were kept for "assessment" for a few weeks and then killed by injection of toxic chemicals, typically phenol; their deaths were recorded as "pneumonia". Autopsies were usually performed and brain samples were taken to be used for "medical research". Post mortem examinations apparently helped to ease the consciences of many of those involved, giving them the feeling that there was a genuine medical purpose to the killings. The most notorious of these institutions in Austria was Am Spiegelgrund, where from 1940 to 1945, 789 children were killed by lethal injection, gas poisoning and physical abuse.[65] Children's brains were preserved in jars of formaldehyde and stored in the basement of the clinic and in the private collection of Heinrich Gross, one of the institution's directors, until 2001.

When the Second World War began in September 1939, less rigorous standards of assessment and a quicker approval process were adopted. Older children and adolescents were included and the conditions covered came to include

... various borderline or limited impairments in children of different ages, culminating in the killing of those designated as juvenile delinquents. Jewish children could be placed in the net primarily because they were Jewish; and at one of the institutions, a special department was set up for 'minor Jewish-Aryan half-breeds'.

More pressure was placed on parents to agree to their children being sent away. Many parents suspected what was happening, especially when it became apparent that institutions for children with disabilities were being systematically cleared of their charges and refused consent. The parents were warned that they could lose custody of all their children and if that did not suffice, the parents could be threatened with call-up for 'labour duty'. By 1941, more than 5,000 children had been killed.[j] The last child to be killed under Aktion T4 was Richard Jenne on 29 May 1945 in the children's ward of the Kaufbeuren-Irsee state hospital in Bavaria, Germany, more than three weeks after U.S. Army troops had occupied the town.[68]

Brandt and Bouhler developed plans to expand the programme of euthanasia to adults. In July 1939 they held a meeting attended by Conti and Professor Werner Heyde, head of the SS medical department. This meeting agreed to arrange a national register of all institutionalised people with mental illnesses or physical disabilities. The first adults with disabilities to be killed en masse by the Nazi regime were Poles. After the invasion on 1 September 1939, adults with disabilities were shot by the SS men of Einsatzkommando 16, Selbstschutz and EK-Einmann under the command of SS-Sturmbannfhrer Rudolf Trger, with overall command by Reinhard Heydrich, during the genocidal Operation Tannenberg.[k] All hospitals and mental asylums of the Wartheland were emptied. The region was incorporated into Germany and earmarked for resettlement by Volksdeutsche following the German conquest of Poland.[72] In the Danzig (now Gdask) area, some 7,000 Polish patients of various institutions were shot and 10,000 were killed in the Gdynia area. Similar measures were taken in other areas of Poland destined for incorporation into Germany. The first experiments with the gassing of patients were conducted in October 1939 at Fort VII in Posen (occupied Pozna), where hundreds of prisoners were killed by means of carbon monoxide poisoning, in an improvised gas chamber developed by Dr Albert Widmann, chief chemist of the German Criminal Police (Kripo). In December 1939, Reichsfhrer-SS Heinrich Himmler witnessed one of these gassings, ensuring that this invention would later be put to much wider uses.

The idea of killing adult mental patients soon spread from occupied Poland to adjoining areas of Germany, probably because Nazi Party and SS officers in these areas were most familiar with what was happening in Poland. These were also the areas where Germans wounded from the Polish campaign were expected to be accommodated, which created a demand for hospital space. The Gauleiter of Pomerania, Franz Schwede-Coburg, sent 1,400 patients from five Pomeranian hospitals to undisclosed locations in occupied Poland, where they were shot. The Gauleiter of East Prussia, Erich Koch, had 1,600 patients killed out of sight. More than 8,000 Germans were killed in this initial wave of killings carried out on the orders of local officials, although Himmler certainly knew and approved of them.

The legal basis for the programme was a 1939 letter from Hitler, not a formal "Fhrer's decree" with the force of law. Hitler bypassed Conti, the Health Minister and his department, who might have raised questions about the legality of the programme and entrusted it to Bouhler and Brandt.[l]

Reich Leader Bouhler and Dr. Brandt are entrusted with the responsibility of extending the authority of physicians, to be designated by name, so that patients who, after a most critical diagnosis, on the basis of human judgment [menschlichem Ermessen], are considered incurable, can be granted mercy death [Gnadentod].

The killings were administered by Viktor Brack and his staff from Tiergartenstrae 4, disguised as the "Charitable Foundation for Cure and Institutional Care" offices which served as the front and was supervised by Bouhler and Brandt. The officials in charge included Dr Herbert Linden, who had been involved in the child killing programme; Dr Ernst-Robert Grawitz, chief physician of the SS; and August Becker, an SS chemist. The officials selected the doctors who were to carry out the operational part of the programme; based on political reliability as long-term Nazis, professional reputation and sympathy for radical eugenics. The list included physicians who had proved their worth in the child-killing programme, such as Unger, Heinze and Hermann Pfannmller. The recruits were mostly psychiatrists, notably Professor Carl Schneider of Heidelberg, Professor Max de Crinis of Berlin and Professor Paul Nitsche from the Sonnenstein state institution. Heyde became the operational leader of the programme, succeeded later by Nitsche.

In early October, all hospitals, nursing homes, old-age homes and sanatoria were required to report all patients who had been institutionalised for five years or more, who had been committed as "criminally insane", who were of "non-Aryan race" or who had been diagnosed with any on a list of conditions. The conditions included schizophrenia, epilepsy, Huntington's chorea, advanced syphilis, senile dementia, paralysis, encephalitis and "terminal neurological conditions generally". Many doctors and administrators assumed that the reports were to identify inmates who were capable of being drafted for "labour service" and tended to overstate the degree of incapacity of their patients, to protect them from labour conscription. When some institutions refused to co-operate, teams of T4 doctors (or Nazi medical students) visited and compiled the lists, sometimes in a haphazard and ideologically motivated way. During 1940, all Jewish patients were removed from institutions and killed.[m]

As with child inmates, adults were assessed by a panel of experts, working at the Tiergartenstrae offices. The experts were required to make their judgements on the reports, not medical histories or examinations. Sometimes they dealt with hundreds of reports at a time. On each they marked a + (death), a - (life), or occasionally a ? meaning that they were unable to decide. Three "death" verdicts condemned the person and as with reviews of children, the process became less rigorous, the range of conditions considered "unsustainable" grew broader and zealous Nazis further down the chain of command increasingly made decisions on their own initiative.

The first gassings in Germany proper took place in January 1940 at the Brandenburg Euthanasia Centre. The operation was headed by Brack, who said "the needle belongs in the hand of the doctor." Bottled pure carbon monoxide gas was used. At trials, Brandt described the process as a "major advance in medical history". Once the efficacy of the method was confirmed, it became standardised, and instituted at a number of centres across Germany under the supervision of Widmann, Becker, and Christian Wirth a Kripo officer who later played a prominent role in the extermination of the Jews as commandant of newly built death camps in occupied Poland. In addition to Brandenburg, the killing centres included Grafeneck Castle in Baden-Wrttemberg (10,824 dead), Schloss Hartheim near Linz in Austria (over 18,000 dead), Sonnenstein Euthanasia Centre in Saxony (15,000 dead), Bernburg Euthanasia Centre in Saxony-Anhalt and Hadamar Euthanasia Centre in Hesse (14,494 dead). The same facilities were also used to kill mentally sound prisoners transferred from concentration camps in Germany, Austria and occupied parts of Poland.

Condemned patients were transferred from their institutions to newly built centres in the T4 Charitable Ambulance buses, called the Community Patients Transports Service. They were run by teams of SS men wearing white coats, to give it an air of medical care. To prevent the families and doctors of the patients from tracing them, the patients were often first sent to transit centres in major hospitals, where they were supposedly assessed. They were moved again to special treatment (Sonderbehandlung) centres. Families were sent letters explaining that owing to wartime regulations, it was not possible for them to visit relatives in these centres. Most of these patients were killed within 24 hours of arriving at the centres, and their bodies cremated. For every person killed, a death certificate was prepared, giving a false but plausible cause of death. This was sent to the family along with an urn of ashes (random ashes, since the victims were cremated en masse). The preparation of thousands of falsified death certificates took up most of the working day of the doctors who operated the centres.

During 1940, the centres at Brandenburg, Grafeneck and Hartheim killed nearly 10,000 people each, while another 6,000 were killed at Sonnenstein. In all, about 35,000 people were killed in T4 operations that year. Operations at Brandenburg and Grafeneck were wound up at the end of the year, partly because the areas they served had been cleared and partly because of public opposition. In 1941, however, the centres at Bernburg and Sonnenstein increased their operations, while Hartheim (where Wirth and Franz Stangl were successively commandants) continued as before. As a result, another 35,000 people were killed before August 1941, when the T4 programme was officially shut down by Hitler. Even after that date, however, the centres continued to be used to kill concentration camp inmates: eventually some 20,000 people in this category were killed.[n]

In 1971, Gitta Sereny conducted a series of interviews with Stangl, who was in prison in Dsseldorf after having been convicted of co-responsibility for killing 900,000 people as commandant of the Sobibor and Treblinka extermination camps in Poland. Stangl gave Sereny a detailed account of the operations of the T4 programme based on his time as commandant of the killing facility at the Hartheim institute. He described how the inmates of various asylums were removed and transported by bus to Hartheim. Some were in no mental state to know what was happening to them, but many were perfectly sane, and for them various forms of deception were used. They were told they were at a special clinic where they would receive improved treatment, and were given a brief medical examination on arrival. They were induced to enter what appeared to be a shower block, where they were gassed with carbon monoxide (the ruse was also used at extermination camps).

The SS functionaries and hospital staff associated with Aktion T4 in the German Reich were paid from the central office at Tiergartenstrasse 4 in Berlin from the spring of 1940. The SS and police from SS-Sonderkommando Lange responsible for murdering the majority of patients in the annexed territories of Poland since October 1939, took their salaries from the normal police fund, supervised by the administration of the newly formed Wartheland district; the programme in Germany and occupied Poland was overseen by Heinrich Himmler. Before 2013, it was believed that 70,000 persons were murdered in the euthanasia programme, but the German Federal Archives reported that research in the archives of former East Germany indicated that the number of victims in Germany and Austria from 1939 to 1945 was about 200,000 persons and that another 100,000 persons were victims in other European countries.[12][24][93] In the German T4 centres there was at least the semblance of legality in keeping records and writing letters. In Polish psychiatric hospitals no one was left behind. Killings were inflicted using gas-vans, sealed army bunkers and machine guns; families were not informed about the murdered relatives and the empty wards were handed over to the SS.

After the official end of the euthanasia programme in 1941, most of the personnel and high-ranking officials, as well as gassing technology and the techniques used to deceive victims, were transferred under the jurisdiction of the national medical division of the Reich Interior Ministry. Further gassing experiments with the use of mobile gas chambers (Einsatzwagen) were conducted at Soldau concentration camp by Herbert Lange following Operation Barbarossa. Lange was appointed commander of the Chemno extermination camp in December 1941. He was given three gas vans by the RSHA, converted by the Gaubschat GmbH in Berlin and before February 1942, killed 3,830 Polish Jews and around 4,000 Romani, under the guise of "resettlement". After the Wannsee conference, implementation of gassing technology was accelerated by Heydrich. Beginning in the spring of 1942, three killing factories were built secretly in east-central Poland. The SS officers responsible for the earlier Aktion T4, including Wirth, Stangl and Irmfried Eberl, had important roles in the implementation of the "Final Solution" for the next two years.[o] The first killing centre equipped with stationary gas chambers modelled on technology developed under Aktion T4 was established at Beec in the General Government territory of occupied Poland; the decision preceded the Wannsee Conference of January 1942 by three months.

In January 1939, Brack commissioned a paper from Professor of Moral Theology at the University of Paderborn, Joseph Mayer, on the likely reactions of the churches in the event of a state euthanasia programme being instituted. Mayer a longstanding euthanasia advocate reported that the churches would not oppose such a programme if it was seen to be in the national interest. Brack showed this paper to Hitler in July, and it may have increased his confidence that the "euthanasia" programme would be acceptable to German public opinion. Notably, when Sereny interviewed Mayer shortly before his death in 1967, he denied that he formally condoned the killing of people with disabilities but no copies of this paper are known to survive.

There were those who opposed the T4 programme within the bureaucracy. Lothar Kreyssig, a district judge and member of the Confessing Church, wrote to Grtner protesting that the action was illegal since no law or formal decree from Hitler had authorised it. Grtner replied, "If you cannot recognise the will of the Fhrer as a source of law, then you cannot remain a judge", and had Kreyssig dismissed. Hitler had a fixed policy of not issuing written instructions for policies relating to what could later be condemned by international community, but made an exception when he provided Bouhler and Brack with written authority for the T4 programme in his confidential letter of October 1939 in order to overcome opposition within the German state bureaucracy. Hitler told Bouhler that, "the Fhrer's Chancellery must under no circumstances be seen to be active in this matter." The Justice Minister, Franz Grtner, had to be shown Hitler's letter in August 1940 to gain his cooperation.

In the towns where the killing centres were located, many people saw the inmates arrive in buses, saw the smoke from the crematoria chimneys and noticed that the buses were returning empty. In Hadamar, ashes containing human hair rained down on the town. The T4 programme was no secret. Despite the strictest orders, some of the staff at the killing centres talked about what was going on. In some cases families could tell that the causes of death in certificates were false, e.g. when a patient was claimed to have died of appendicitis, even though his appendix had been surgically removed some years earlier. In other cases, several families in the same town would receive death certificates on the same day. In May 1941, the Frankfurt County Court wrote to Grtner describing scenes in Hadamar where children shouted in the streets that people were being taken away in buses to be gassed.

During 1940, rumours of what was taking place spread and many Germans withdrew their relatives from asylums and sanatoria to care for them at home, often with great expense and difficulty. In some places doctors and psychiatrists co-operated with families to have patients discharged or if the families could afford it, transferred them to private clinics beyond the reach of T4. Other doctors "re-diagnosed" patients so that they no longer met the T4 criteria, which risked exposure when Nazi zealots from Berlin conducted inspections. In Kiel, Professor Hans Gerhard Creutzfeldt managed to save nearly all of his patients. Lifton listed a handful of psychiatrists and administrators who opposed the killings; many doctors collaborated, either through ignorance, agreement with Nazi eugenicist policies or fear of the regime.

Protest letters were sent to the Reich Chancellery and the Ministry of Justice, some from Nazi Party members. The first open protest against the removal of people from asylums took place at Absberg in Franconia in February 1941 and others followed. The SD report on the incident at Absberg noted that "the removal of residents from the Ottilien Home has caused a great deal of unpleasantness" and described large crowds of Catholic townspeople, among them Party members, protesting against the action. Similar petitions and protests occurred throughout Austria as rumors spread of mass killings at the Hartheim Euthanasia Centre and of mysterious deaths at the children's clinic, Am Spiegelgrund in Vienna. Anna Wdl, a nurse and mother of child with a disability, vehemently petitioned to Hermann Linden at the Reich Ministry of the Interior in Berlin to prevent her son, Alfred, from being transferred from Gugging, where he lived and which also became a euthanasia center. Wdl failed and Alfred was sent to Am Spiegelgrund, where he was killed on 22 February 1941. His brain was preserved in formaldehyde for "research" and stored in the clinic for sixty years.

The Lutheran theologian Friedrich von Bodelschwingh (director of the Bethel Institution for Epilepsy at Bielefeld) and Pastor Paul-Gerhard Braune (director of the Hoffnungstal Institution near Berlin) protested. Bodelschwingh negotiated directly with Brandt and indirectly with Hermann Gring, whose cousin was a prominent psychiatrist. Braune had meetings with Justice Minister Grtner, who was always dubious about the legality of the programme. Grtner later wrote a strongly worded letter to Hitler protesting against it; Hitler did not read it but was told about it by Lammers. Bishop Theophil Wurm, presiding the Evangelical-Lutheran Church in Wrttemberg, wrote to Interior Minister Frick in March 1940 and the same month a confidential report from the Sicherheitsdienst (SD) in Austria, warned that the killing programme must be implemented with stealth "in order to avoid a probable backlash of public opinion during the war". On 4 December 1940, Reinhold Sautter, the Supreme Church Councillor of the Wrttemberg State Church, complained to the Nazi Ministerial Councillor Eugen Sthle for the murders in Grafeneck Castle. Stahle said "The fifth commandment Thou shalt not kill, is no commandment of God but a Jewish invention".

Bishop Heinrich Wienken of Berlin, a leading member of the Caritas Association, was selected by the Fulda episcopal synod to represent the views of the Catholic Church in meetings with T4 operatives. In 2008, Michael Burleigh wrote

Wienken seems to have gone partially native in the sense that he gradually abandoned an absolute stance based on the Fifth Commandment in favour of winning limited concessions regarding the restriction of killing to 'complete idiots', access to the sacraments and the exclusion of ill Roman Catholic priests from these policies.

Despite a decree issued by the Vatican on 2 December 1940 stating that the T4 policy was "against natural and positive Divine law" and that "The direct killing of an innocent person because of mental or physical defects is not allowed", the Catholic Church hierarchy in Germany decided to take no further action. Incensed by the Nazi appropriation of Church property in Mnster to accommodate people made homeless by an air raid, in July and August 1941 the Bishop of Mnster, August von Galen, gave four sermons criticizing the Nazis for arresting Jesuits, confiscating church property and for the euthanasia program. Galen sent the text to Hitler by telegram, calling on

... the Fhrer to defend the people against the Gestapo. It is a terrible, unjust and catastrophic thing when man opposes his will to the will of God... We are talking about men and women, our compatriots, our brothers and sisters. Poor unproductive people if you wish, but does this mean that they have lost their right to live?

Galen's sermons were not reported in the German press but were circulated illegally as leaflets. The text was dropped by the Royal Air Force over German troops. In 2009, Richard J. Evans wrote that "This was the strongest, most explicit and most widespread protest movement against any policy since the beginning of the Third Reich". Local Nazis asked for Galen to be arrested but Goebbels told Hitler that such action would provoke a revolt in Westphalia and Hitler decided to wait until after the war to take revenge.

In 1986, Lifton wrote, "Nazi leaders faced the prospect of either having to imprison prominent, highly admired clergymen and other protesters a course with consequences in terms of adverse public reaction they greatly feared or else end the programme". Evans considered it "at least possible, even indeed probable" that the T4 programme would have continued beyond Hitler's initial quota of 70,000 deaths but for the public reaction to Galen's sermon. Burleigh called assumptions that the sermon affected Hitler's decision to suspend the T4 program "wishful thinking" and noted that the various Church hierarchies did not complain after the transfer of T4 personnel to Aktion Reinhard. Henry Friedlander wrote that it was not the criticism from the Church but rather the loss of secrecy and "general popular disquiet about the way euthanasia was implemented" that caused the killing to be suspended.[118]

Galen had detailed knowledge of the euthanasia program by July 1940 but did not speak out until almost a year after Protestants had begun to protest. In 2002, Beth A. Griech-Polelle wrote that,

Worried lest they be classified as outsiders or internal enemies, they waited for Protestants, that is the "true Germans", to risk a confrontation with the government first. If the Protestants were able to be critical of a Nazi policy, then Catholics could function as "good" Germans and yet be critical too.

On 29 June 1943, Pope Pius XII issued the encyclical Mystici corporis Christi, in which he condemned the fact that "physically deformed people, mentally disturbed people and hereditarily ill people have at times been robbed of their lives" in Germany. Following this, in September 1943, a bold but ineffectual condemnation was read by bishops from pulpits across Germany, denouncing the killing of "the innocent and defenceless mentally handicapped and mentally ill, the incurably infirm and fatally wounded, innocent hostages and disarmed prisoners of war and criminal offenders, people of a foreign race or descent".

On 24 August 1941, Hitler ordered the suspension of the T4 killings. After the invasion of the Soviet Union in June, many T4 personnel were transferred to the east to begin work on the final solution to the Jewish question. The projected death total for the T4 program of 70,000 deaths had been reached by August 1941. The termination of the T4 programme did not end the killing of people with disabilities; from the end of 1941, the killing of adults and children continued less systematically to the end of the war on the local initiative of institute directors and party leaders. After the bombing of Hamburg in July 1943, occupants of old age homes were killed. In the post-war trial of Dr. Hilda Wernicke, Berlin, August, 1946, testimony was given that "500 old, broken women" who had survived the bombing of Stettin in June 1944 were euthanized at the Meseritz-Oberwalde Asylum. The Hartheim, Bernberg, Sonnenstein and Hardamar centres continued in use as "wild euthanasia" centres to kill people sent from all over Germany, until 1945. The methods were lethal injection or starvation, those employed before use of gas chambers. By the end of 1941, about 100,000 people had been killed in the T4 programme. From mid-1941, concentration camp prisoners too feeble or too much trouble to keep alive were murdered after a cursory psychiatric examination under Action 14f13.

After the war a series of trials was held in connection with the Nazi euthanasia programme at various places including: Dresden, Frankfurt, Graz, Nuremberg and Tbingen. In December 1946 an American military tribunal (commonly called the Doctors' trial) prosecuted 23 doctors and administrators for their roles in war crimes and crimes against humanity. These crimes included the systematic killing of those deemed "unworthy of life", including people with mental disabilities, the people who were institutionalized mentally ill, and people with physical impairments. After 140 days of proceedings, including the testimony of 85 witnesses and the submission of 1,500 documents, in August 1947 the court pronounced 16 of the defendants guilty. Seven were sentenced to death and executed on 2 June 1948, including Brandt and Brack.

The indictment read in part:

14. Between September 1939 and April 1945 the defendants Karl Brandt, Blome, Brack, and Hoven unlawfully, wilfully, and knowingly committed crimes against humanity, as defined by Article II of Control Council Law No. 10, in that they were principals in, accessories to, ordered, abetted, took a consenting part in, and were connected with plans and enterprises involving the execution of the so called "euthanasia" program of the German Reich, in the course of which the defendants herein murdered hundreds of thousands of human beings, including German civilians, as well as civilians of other nations. The particulars concerning such murders are set forth in paragraph 9 of count two of this indictment and are incorporated herein by reference.

Earlier, in 1945, American forces tried seven staff members of the Hadamar killing centre for the killing of Soviet and Polish nationals, which was within their jurisdiction under international law, as these were the citizens of wartime allies. (Hadamar was within the American Zone of Occupation in Germany. This was before the Allied resolution of December 1945, to prosecute individuals for "crimes against humanity" for such mass atrocities.) Alfons Klein, Karl Ruoff and Wilhelm Willig were sentenced to death and executed; the other four were given long prison sentences. In 1946, newly reconstructed German courts tried members of the Hadamar staff for the murders of nearly 15,000 German citizens at the facility. Adolf Wahlmann and Irmgard Huber, the chief physician and the head nurse, were convicted.

The Ministry for State Security of East Germany stored around 30,000 files of Aktion T4 in their archives. Those files became available to the public only after the German Reunification in 1990, leading to a new wave of research on these wartime crimes.

The German national memorial to the people with disabilities murdered by the Nazis was dedicated in 2014 in Berlin.[146][147] It is located in the pavement of a site next to the Tiergarten park, the location of the former villa at Tiergartenstrasse 4 in Berlin, where more than 60 Nazi bureaucrats and doctors worked in secret under the "T4" program to organize the mass murder of sanatorium and psychiatric hospital patients deemed unworthy to live.[147]

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Welcome to Home Pet Euthanasia of Southern California …

If you are visiting our website, chances are that you either have already made the decision that it is time to let go of your pet or the time is drawing near and you want to be prepared. You probably are looking for a way to make this transition easier for your pet, to lessen his suffering, make it painless and stress free. Above all, you are looking for a caring and compassionate person to be there for your baby and for your family in such a difficult time.

Your pet may have severe arthritis, cancer, kidney failure, some other debilitating disease or he or she is just very old. He or She has been part of your life for many years, may have helped you through tough times, has been a faithful companion. Now, you see it in your pet's eyes. The love is still there but you also see suffering.

There is a huge difference between saying goodbye in the privacy and comfort of your home versus taking your pet to the vet's for that last, dreaded trip.

In a few words: compassion, caring, in the safety of your home, relaxed, peaceful, stress-free, no cold, stainless steel, ... To read more about why you should choose a home euthanasia, click here.

You undoubtedly want your pet to be comfortable at home with you in his last moments. You want your pet to feel your reassuring touch. You want him to be on his soft, comfortable bed. You want these last moments to be stress-free, peaceful, at home, in familiar surroundings. No cold, stainless steel table, perhaps you want him lying next to you. You want this moment to be quiet, calm, and for your baby to be in gentle, caring, kind and loving hands.

What do you do when the time has come? How do you make it easier on your pet, on your family and on yourself? How do you know the time has come? Do you know what to expect? These are all questions that will be answered on this website.

We offer a compassionate, caring and gentle pet euthanasia service done in the comfort of your own home so that your beloved pet doesn't have to be put in a stressful situation, having to be lifted into the car, going into a noisy, busy veterinary hospital to spend the last few moments of his or her life on a cold stainless steel table.

We primarily service the areas of Orange County, Riverside County, Los Angeles County, part of San Diego County, part of Ventura County and part of San Bernardino County. But wherever you are in the world, the information on our website will help you through this difficult event of your life that is the passing of your pet. We will gently guide you through the difficult decisions you will have to make and ensure that you have full understanding of what is ahead.

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Euthanasia, Assisted Suicide & Health Care Decisions …

Euthanasia, Assisted Suicide & Health Care Decisions:Protecting Yourself & Your Family

Table of Contents |Part 1 |Part 2

byRita L. Marker

INTRODUCTION

The words euthanasia and assisted suicide are often used interchangeably. However, they are different and, in the law, they are treated differently. In this report, euthanasia is defined as intentionally, knowingly and directly acting to cause the death of another person (e.g., giving a lethal injection). Assisted suicide is defined as intentionally, knowingly and directly providing the means of death to another person so that the person can use that means to commit suicide (e.g., providing a prescription for a lethal dose of drugs).

Part I of this report discusses the reasons used by activists to promote changes in the law; the contradictions that the actual proposals have with those reasons; and the logical progression that occurs when euthanasia and assisted suicide are transformed into medical treatments. It explores the failure of so-called safeguards and outlines the impact that euthanasia and assisted suicide have on families and society in general.

Withholding and withdrawing medical treatment and care are not legally considered euthanasia or assisted suicide. Withholding or withdrawing food and fluids is considered acceptable removal of a medical treatment.

Part II of this report includes information about practical ways to protect oneself and loved ones during any time of incapacity and a discussion of some of the policies that have led to patients being denied care that they or their decision-makers have requested. It concludes with an examination of the ethical distinction between treatment and care.

PART I

EUTHANASIA & ASSISTED SUICIDE

MOVING THE BOUNDARIES

In 2002, the International Task Force report, Assisted Suicide: Not for Adults Only? (1) discussed euthanasia and assisted suicide for children and teens. At that time, such concerns were largely considered outside the realm of possibility.

Then, as now, assisted-suicide advocates claimed that they were only trying to offer compassionate options for competent, terminally ill adults who were suffering unbearably. By and large, their claims went unchallenged.

A crack in that carefully honed image appeared in 2004 when the Groningen Protocol elicited worldwide outrage. The primary purpose of that protocol formulated by doctors at the Groningen Academic Hospital in the Netherlands was to legally and professionally protect Dutch doctors who kill severely disabled newborns. (2)

While euthanasia for infants (infanticide) was not new, widespread discussion of it was. Dutch doctors were now explaining that it was a necessary part of pediatric care.

Also in 2004, Hollands most prestigious medical society (KNMG) urged the Health Ministry to set up a board to review euthanasia for people who had no free will, including children and individuals with mental retardation or severe brain damage following accidents. (3)

At first, it seemed that these revelations would be harmful to the euthanasia movement, but the opposite was true.

Why?

Awareness of infanticide and euthanasia deaths of other incompetent patients moved the boundaries.

Prior to the widespread realization that involuntary euthanasia was taking place, advocacy of assisted suicide for those who request it seemed to be on one end of the spectrum. Opposition to it was on the other end.

Now, the practice of involuntary euthanasia took its place as one extreme, opposition to it as the other extreme, and assisted suicide for terminally ill competent adults appeared to be in the moderate middle a very advantageous political position and expansion of the practice to others had entered the realm of respectable debate.

This repositioning has become a tool in the assisted-suicide arsenal. In May 2006, an assisted-suicide bill, patterned after Oregons law permitting assisted suicide, failed to gain approval in the British Parliament. The bills supporters immediately declared that they would reintroduce it during the next parliamentary session.

Within two weeks, Professor Len Doyal a former member of the British Medical Associations ethics committee who is considered one of Englands leading experts on medical ethics called for doctors to be able to end the lives of some patients swiftly, humanely and without guilt, even without the patients consent. (4) Doyals proposal was widely reported and, undoubtedly, when the next assisted-suicide bill is introduced in England, a measure that would permit assisted suicide only for consenting adults will appear less radical than it might have seemed prior to Doyals suggestion.

Currently, euthanasia is a medical treatment in the Netherlands and Belgium. Assisted suicide is a medical treatment in the Netherlands, Belgium and Oregon. Their advocates erroneously portray both practices as personal, private acts. However, legalization is not about the private and the personal. It is about public policy, and it affects ethics, medicine, law, families and children.

A FAMILY AFFAIR

In December 2005, ABC News World News Tonight reported, Anita and Frank go often to the burial place of their daughter Chanou. Chanou died when, with her parents consent, doctors gave her a lethal dose of morphine. Im convinced that if we meet again somewhere in heaven, her father said, shell tell us we reached the most perfect solution.'(5)

The report about the six-month-old Dutch childs death was introduced as a report on the debate over euthanizing infants. A Dutch legislator who agrees that doctors who intentionally end their tiny patients lives should not be prosecuted said, Im certainly pro-life. But Im also a human being. I think when there is extreme, unbearable suffering, then there can be extreme relief. (6)

Gone was the previous years outrage over the Groningen Protocols. Infanticide had entered the realm of respectable debate in the mainstream media. The message given to viewers was that loving parents, compassionate doctors and caring legislators favor infanticide. It left the impression that opposing such a death would be cold, unfeeling and, perhaps, intentionally cruel.

In Oregon, some assisted-suicide deaths have become family or social events.

Oregons law does not require family members to know that a loved one is planning to commit suicide with a doctors help. (7) Thus, the first knowledge of those plans could come when a family member finds the body. However, as two news features illustrate, some Oregonians who die from assisted suicide make it a teachable moment for children or a party event for friends and family.

According to the Mail Tribune (Medford, Oregon), on a sunny afternoon, Joan Lucas rode around looking at houses, then she sat in a park eating an ice cream cone. A few hours later, she committed suicide with a prescribed deadly drug overdose. Grandchildren were made to understand that Grandma Joan would be going away soon. Those who were old enough to understand were told what was happening. (8

Did these children learn from Grandma Joan that suicide is a good thing?

UCLAs student newspaper, the Daily Bruin, carried an article favoring assisted suicide. It described how Karen Janoch who committed suicide under the Oregon law, sent invitations for her suicide to about two dozen of her closest friends and family. The invitation read, You are invited to attend the actual ending of my life. (9) At the same time Californias legislature was considering an assisted-suicide bill that was virtually identical to Oregons law, UCLA students learned that suicide can be the occasion for a party.

In Oregon, assisted suicide has gone from the appalling to the appealing, from the tragic to the banal.

During the last half of 2005 and the first half of 2006, bills to legalize assisted suicide were under consideration in various states and countries including, but not limited to, Canada, Great Britain, California, Hawaii, Vermont, and Washington. All had met failure by the end of June 2006. But plans to reintroduce them with some cosmetic changes are currently underway. A brief examination of arguments used to promote them illustrates the small world nature of assisted-suicide advocacy.

TWO PILLARS OF ADVOCACY

Wherever an assisted-suicide measure is proposed, proponents arguments and strategies are similar. Invariably, promotion rests on two pillars: autonomy and the elimination of suffering.

Autonomy

Autonomy (independence and the right of self-determination) is certainly valued in modern society and patients do, and should, have the right to accept or reject medical treatment. However, those who favor assisted suicide claim that autonomy extends to the right of a patient to decide when, where, how and why to die as the following examples illustrate.

During debate over an assisted-suicide measure then pending before the British Parliament, proponents emphasized personal choice. The bill, titled The Assisted Dying for the Terminally Ill Bill, was introduced by Lord Joel Joffe. Dr. Margaret Branthwaite, a physician, barrister and former head of Englands Voluntary Euthanasia Society (recently renamed Dignity in Dying (10)), called for passage of the Joffe bill in an article in the British Medical Journal. As a matter of principle, she wrote, it reinforces current trends towards greater respect for personal autonomy. (11)

The focus on autonomy was also reflected in remarks about a plan to introduce an assisted-suicide initiative in Washington. Booth Gardner, former governor of Washington, said he plans to promote the initiative because it should be his decision when and how he dies. He told the Seattle Post-Intelligencer, When I go, I want to decide. (12)

The rationale is that when, where, why and how one dies should be a matter of self-determination, a matter of independent choice, and a matter of personal autonomy.

Elimination of suffering

The second pillar of assisted-suicide advocacy is elimination of suffering. During each and every attempt to permit euthanasia and assisted suicide, its advocates stress that ending suffering justifies legalization of the practices.

California Assemblywoman Patty Berg, the co-sponsor of Californias euphemistically named Compassionate Choices Act, (13) said the assisted-suicide measure was necessary so that people would have the comfort of knowing they could escape unbearable suffering if that were to occur. (14)

In an opinion piece supporting the failed 1998 assisted-suicide initiative in Michigan, a spokesperson for those favoring the measure wrote that the patients targeted by the proposal were those who were tortured by the unbearable suffering of a slow and agonizing death. (15)

In the United Kingdom, Lord Joffe said his bill would enable those who are suffering unbearably to get medical assistance to die. (16) Testimony before the British House of Lords Select Committee studying the bill noted that, where assisted dying has been legalized, it has done so as a response to patients who were suffering. (17)

The centerpiece of the 1994 Measure 16 campaign that resulted in Oregons assisted-suicide law was a television commercial featuring Patti Rosen. Describing her daughter who had cancer, Rosen said, The pain was so great that she couldnt bear to be touched. Measure 16 would have allowed my daughter to die with dignity. (18)

When an assisted-suicide proposal that later failed was being considered by the Hawaiian legislature in 2002, a public relations consultant who was working on behalf of the bill, e-mailed a template for use in written or oral testimony. The template suggested inclusion of the phrases agonizingly painful, pain was uncontrollable, and pain beyond my understanding. (19)

During consideration of an assisted-suicide bill in Vermont, the states former governor Philip Hoff said, The last thing I would want in this world is to be around and be in pain, and have no quality of life, and be a burden to my family and others. (20) Dick Walters, chairman of Death with Dignity Vermont, said the proposal would permit a person to peacefully end suffering and hasten death. (21)

Thus, the rationale given by euthanasia and assisted-suicide proponents for legalization always includes autonomy and/or elimination of suffering. However, the laws they propose actually contradict this rationale.

CONTRADICTIONS

When proposed, laws such as those now in existence in Oregon and similar measures introduced elsewhere include conditions or requirements limiting assisted suicide to certain groups of qualified patients. A patient qualified to receive the treatment of assisted suicide must be an adult who is capable of making decisions and must be diagnosed with a terminal condition.

If one accepts the premise that assisted suicide is a good medical treatment that should be permitted on the basis of personal autonomy or elimination of suffering, other questions must be raised.

If the reason for permitting assisted suicide is autonomy, why should assisted suicide be limited to the terminally ill?

Does ones autonomy depend upon a doctors diagnosis (or misdiagnosis) of a terminal illness? If a person is not terminally ill, but is suffering whether physically, psychologically or emotionally why isnt it up to that person to decide when, why and how to die? Does a person only have autonomy if he or she has a particular condition or illness? Is autonomy a basis for the law?

If assisted suicide is a good and acceptable medical treatment for the purpose of ending suffering, why should it be limited to adults who are capable of decision-making?

Isnt it both discriminatory and cruel to deny that good and acceptable medical treatment to a child or an incompetent adult? Why is a medical treatment that has been deemed appropriate to end suffering available to an 18-year-old, but not to a 16-year-old or 17-year-old? Why is a person only eligible to have his or her suffering ended if he or she has reached an arbitrary age?

And, what of the adult who never was, or no longer is, capable of decision-making? Should that person be denied medical treatment that ends suffering? Are euthanasia and assisted-suicide laws based on the need to eliminate suffering, or not?

Establishing arbitrary requirements that must be met prior to qualifying for the medical treatment of euthanasia or assisted suicide does, without doubt, contradict the two pillars on which justification for the practices is based.

The question then must be asked: Why are those arbitrary requirements included in Oregons law and other similar proposals? The answer is simple. After a series of defeats, euthanasia and assisted-suicide proponents learned that they had to propose laws that appeared palatable.

In April 2005, Lord Joffe, the British bills sponsor, acknowledged that his bill was intended to be only the first step. During hearings regarding the measure, he said that this is the first stage and went on to explain that one should go forward in incremental stages. I believe that this bill should initially be limited. (22)

He repeated his remarks a year later when discussing hearings about his bill. I can assure you that I would prefer that the [proposed] law did apply to patients who were younger and who were not terminally ill but who were suffering unbearable, he said and added, I believe that this bill should initially be limited. (23)

STEP-BY-STEP APPROACH

Proposals for euthanasia and assisted suicide have always emanated from advocacy groups, not from any grassroots desire. Those groups learned that attempting to go too far, too fast, leads to certain defeat.

After many failed attempts, most recently those in the early 90s in Washington and California when ballot initiatives that would have permitted both euthanasia by lethal injection and assisted suicide by lethal prescription were resoundingly defeated death with dignity activists changed their strategy. They decided to take a step-by-step approach, proposing an assisted-suicide-only bill which, when passed, would serve as a model for subsequent laws. Only after several such laws were passed, would they begin to expand them. That was the strategy that led to Oregons Measure 16, the Oregon Death with Dignity Act.

Those who were most involved in the successful Oregon strategy were not new to the scene.

Cheryl K. Smith, who wrote the first draft of Oregons law, had served as a special counsel to the political action group Oregon Right to Die (ORD). Smith had been the National Hemlock Societys legal advisor after her graduation from law school in 1989 and had been a top aide to Hemlocks co-founder, Derek Humphry. While a student at the University of Iowa College of Law, Smith helped draft a Model Aid-in-Dying Act that provided for childrens lives to be terminated either at their own request or, if under 6 years of age, by parental request. (24)

Barbara Coombs Lee was Measure 16s chief petitioner. At the time, she was a vice president for a large Oregon managed care program. After the laws passage, she took over the leadership of Compassion in Dying. (25) [Note: In early 2005, Compassion in Dying merged with the Hemlock Society. The combined organization is now called Compassion and Choices.]

Coombs Lees promotion of assisted suicide and euthanasia began prior to her involvement with the Death with Dignity Act. As a legislative aide to Oregon Senator Frank Roberts in 1991, she worked on Senate Bill 114 that would have permitted euthanasia on request of a patient and, if the patient was not competent, a designated representative would have been authorized to request the patients death. (26)

Upon passage of the Oregon law in 1994, many assisted-suicide supporters were certain that other states would immediately fall in line. However, that did not occur. Between 1994 and mid-2006, assisted-suicide measures were introduced in state after state.(27) Each and every proposal failed. All of the proposals were assisted-suicide-only bills and, with one exception, (28) every one was virtually identical to the Oregon law.

Among supporters of assisted suicide and euthanasia, though, the Oregon law is seen as the model for success and is referred to in debates about assisted suicide throughout the world. For that reason, a careful examination of the Oregon experience is vital to understanding the problems with legalized assisted suicide.

OREGON

Under Oregons law permitting physician-assisted suicide, the Oregon Department of Human Services (DHS) previously called the Oregon Health Division (OHD) is required to collect information, review a sample of cases and publish a yearly statistical report. (29)

However, due to major flaws in the law and the states reporting system, there is no way to know for sure how many or under what circumstances patients have died from physician-assisted suicide. Statistics from official reports are particularly questionable and have left some observers skeptical about their validity.

For example, when a similar proposal was under consideration in the British Parliament, members of a House of Lords Committee traveled to Oregon seeking information regarding Oregons law for use in their deliberations. The public and press were not present during the closed-door hearings. However, the House of Lords published the committees proceedings in three lengthy volumes, which included the exact wording of questions and answers.

After hearing witnesses claim that there have been no complications associated with more than 200 assisted-suicide deaths, committee member Lord McColl of Dulwich, a surgeon, said, If any surgeon or physician had told me that he did 200 procedures without any complications, I knew that he possibly needed counseling and had no insight. We come here and I am told there are no complications. There is something strange going on. (30)

The following includes statistical data from official reports and other published information dealing with troubling aspects of the practice of assisted suicide in Oregon. Statements from the 744-page second volume of the House of Lords committee proceedings are also included. None of the included statements from the committee hearings were made by opponents of Oregons law.

OFFICIAL REPORTS

Assisted-suicide deaths reported during the first eight years

Official Reports: 246Actual Number: Unknown

The latest annual report indicates that reported assisted-suicide deaths have increased by more than 230% since the first year of legal assisted suicide in Oregon. (31) The numbers, however, could be far greater. From the time the law went into effect, Oregon officials in charge of formulating annual reports have conceded theres no way to know if additional deaths went unreported because Oregon DHS has no regulatory authority or resources to ensure compliance with the law. (32)

The DHS has to rely on the word of doctors who prescribe the lethal drugs. (33) Referring to physicians reports, the reporting division admitted: For that matter the entire account [received from a prescribing doctor] could have been a cock-and-bull story. We assume, however, that physicians were their usual careful and accurate selves. (34)

The Death with Dignity law contains no penalties for doctors who do not report prescribing lethal doses for the purpose of suicide.

Complications occurring during assisted suicide

Official Reports: 13 (12 instances of vomiting & one patient who did not die fromlethal dose.)

Actual number: Unknown

Prescribing doctors may not know about all complications since, over the course of eight years, physicians who prescribed the lethal drugs for assisted suicide were present at only 19.5% of reported deaths. (35) Information they provide might come from secondhand accounts of those present at the deaths (36) or may be based on guesswork.

When asked if there is any systematic way of finding out and recording complications, Dr. Katrina Hedberg who was a lead author of most of Oregons official reports said, Not other than asking physicians. (37) She acknowledged that after they write the prescription, the physician may not keep track of the patient. (38) Dr. Melvin Kohn, a lead author of the eighth annual report, noted that, in every case that they hear about, it is the self-report, if you will, of the physician involved. (39)

Complications contained in news reports are not included in official reports

Patrick Matheny received his lethal prescription from Oregon Health Science University via Federal Express. He had difficulty when he tried to take the drugs four months later. His brother-in-law, Joe Hayes, said he had to help Matheny die. According to Hayes, It doesnt go smoothly for everyone. For Pat it was a huge problem. It would have not worked without help. (40) The annual report did not make note of this situation.

Speaking at Portland Community College, pro-assisted-suicide attorney Cynthia Barrett described a botched assisted suicide. The man was at home. There was no doctor there, she said. After he took it [the lethal dose], he began to have some physical symptoms. The symptoms were hard for his wife to handle. Well, she called 911. The guy ended up being taken by 911 to a local Portland hospital. Revived. In the middle of it. And taken to a local nursing facility. I dont know if he went back home. He died shortly someperiod of time after that. (41)

Overdoses of barbiturates are known to cause vomiting as a person begins to lose consciousness. The patient then inhales the vomit. In other cases, panic, feelings of terror and assaultive behavior can occur from the drug-induced confusion. (42) But Barrett would not say exactly which symptoms had taken place in this instance. She has refused any further discussion of the case.

Complications are not investigated

David Prueitt took the prescribed lethal dose in the presence of his family and members of Compassion & Choices. After being unconscious for 65 hours, he awoke. It was only after his family told the media about the botched assisted suicide that Compassion & Choices publicly acknowledged the case. (43) DHS issued a release saying it has no authority to investigate individual Death with Dignity cases. (44)

Referring to DHSs ability to look into complications, Dr. Hedberg explained that we are not given the resources to investigate and not only do we not have the resources to do it, but we do not have any legal authority to insert ourselves. (45)

David Hopkins, Data Analyst for the Eighth Annual Report, said, We do not report to the Board of Medical Examiners if complications occur; no, it is not required by law and it is not part of our duty. (46)

Jim Kronenberg, the Oregon Medical Associations (OMA) Chief Operating Officer, explained that the way the law is set up there is really no way to determine that [complications occurred] unless there is some kind of disaster. [P]ersonally I have never had a report where there was a true disaster, he said. Certainly that does not mean that you should infer there has not been, I just do not know. (47)

In the Netherlands, assisted-suicide complications and problems are not uncommon. One Dutch study found that, because of problems or complications, doctors in the Netherlands felt compelled to intervene (by giving a lethal injection) in 18% of cases.(48)

This led Dr. Sherwin Nuland of Yale University School of Medicine to question the credibility of Oregons lack of reported complications. Nuland, who favors physician-assisted suicide, noted that the Dutch have had years of practice to learn ways to overcome complications, yet complications are still reported. The Dutch findings seem more credible [than the Oregon reports], he wrote. (49)

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Euthanasia and Physician Assisted Suicide: All sides to …

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A root cause for the desire to commit suicide is often depression. This can often be controlled with medication. If you are depressed, I strongly recommend that you seek medical help to see if your depression can be lifted.

Another cause of suicidal ideation is often intolerable levels of pain associated with a terminal illness, like cancer. Many physicians are reluctant to prescribe high levels of some pain killers out of fear that the person will become addicted to them. If you are suffering from pain in spite of medication, try insisting on better levels or types of pain killers. Recruit friends and family to intercede with your physician if you can.

If you feel overwhelmed and lack an effective support system of friends and family, consider tapping into the services of a crisis hotline. These are called by various names: distress centers, crisis centers, suicide prevention centers, etc. Their telephone numbers can often be found in the first page(s) of your telephone directory. If you cannot find a number for a center in your area, try phoning directory assistance at 4-1-1.

In the United States, you can call 1-800-273-TALK. See: http://www.suicidepreventionlifeline.org/ They will direct you to a crisis center in your area.

U.S. Crisis Center map

Crisis centers/distress centers/ etc are often confidential services that you can phone up at any time of the day or night for support. You can usually remain anonymous.

Wikipedia lists suicide crisis lines for many countries from Australia to the United States at: https://en.wikipedia.org/ Although these lines are often called "suicide prevention lines" or "crisis lines." most of the people calling are not suicidal, not in crisis, but are in distress. So, don't be reluctant to call them because you are not suicidal or in crisis.

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Throughout North America, committing suicide or attempting to commit suicide is no longer a criminal offense. However, helping another person commit suicide is generally considered a criminal act. A few exceptions are:

There were four failed ballot initiatives between 1991 and 2000:

Between 1994 and 2016, there have been in excess of 75 legislative bills to legalize PAS in at least 21 states. Almost all failed to become law. 4

The author of this section is approaching his 80th birthday and is in good health. To him, end of life issues have taken on a personal aspect. Being an Agnostic, he doubts the existence of an afterlife. He does not fear death. He does not fear being dead. However, he has considerable fear about the process of dying, For many people in North America is an agonizingly painful and lengthy process during which time one's enjoyment of life often drops to zero and becomes negative without any hope that it will return to positive territory. Fortunately for him, he lives in Canada which -- like all other developed countries except for the U.S. -- has universal health care. So he will receive competent medical attention. Unfortunately, pain management is often as poorly managed in Canada as it is in the U.S. He regards suicide as a civil right and would prefer that he have access to a means of suicide if life becomes unbearable. He thus strongly supports legalizing physician assisted suicide.

He is critical of PAS laws that have been passed to date because they generally give access to assisted dying only to terminally ill people who are expected to die in the near future of natural causes. They do not do anything for people who experience chronic, overwhelming pain with no hope of relief for years.

He has attempted to remain impartial, objective and fair while writing these essays.

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Welcome to Home Pet Euthanasia of Southern California

If you are visiting our website, chances are that you either have already made the decision that it is time to let go of your pet or the time is drawing near and you want to be prepared. You probably are looking for a way to make this transition easier for your pet, to lessen his suffering, make it painless and stress free. Above all, you are looking for a caring and compassionate person to be there for your baby and for your family in such a difficult time.

Your pet may have severe arthritis, cancer, kidney failure, some other debilitating disease or he or she is just very old. He or She has been part of your life for many years, may have helped you through tough times, has been a faithful companion. Now, you see it in your pet's eyes. The love is still there but you also see suffering.

There is a huge difference between saying goodbye in the privacy and comfort of your home versus taking your pet to the vet's for that last, dreaded trip.

In a few words: compassion, caring, in the safety of your home, relaxed, peaceful, stress-free, no cold, stainless steel, ... To read more about why you should choose a home euthanasia, click here.

You undoubtedly want your pet to be comfortable at home with you in his last moments. You want your pet to feel your reassuring touch. You want him to be on his soft, comfortable bed. You want these last moments to be stress-free, peaceful, at home, in familiar surroundings. No cold, stainless steel table, perhaps you want him lying next to you. You want this moment to be quiet, calm, and for your baby to be in gentle, caring, kind and loving hands.

What do you do when the time has come? How do you make it easier on your pet, on your family and on yourself? How do you know the time has come? Do you know what to expect? These are all questions that will be answered on this website.

We offer a compassionate, caring and gentle pet euthanasia service done in the comfort of your own home so that your beloved pet doesn't have to be put in a stressful situation, having to be lifted into the car, going into a noisy, busy veterinary hospital to spend the last few moments of his or her life on a cold stainless steel table.

We primarily service the areas of Orange County, Riverside County, Los Angeles County, part of San Diego County, part of Ventura County and part of San Bernardino County. But wherever you are in the world, the information on our website will help you through this difficult event of your life that is the passing of your pet. We will gently guide you through the difficult decisions you will have to make and ensure that you have full understanding of what is ahead.

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Welcome to Home Pet Euthanasia of Southern California

Euthanasia – Learn | American Life League

When we talk about euthanasia, what exactly do we mean? Today, we usually hear about euthanasia in the health care context. For our purposes, euthanasia amounts to doing, or not doing, something to intentionally bring about a patients death. Because theres so much confusion surrounding the term, lets make sure we understand what euthanasia is not.

It is not euthanasia to administer medication needed to control painthats called good medical care. It is not euthanasia to stop treatment that is gravely burdensome to a patientthats called letting the patient exercise the moral option to refuse extraordinary medical means. It is not euthanasia to stop tube-feeding a patient whose diseased or injured body can no longer assimilate food and waterthats called simply accepting death.

In these circumstances, pain control, refusing extraordinary means, and stopping feeding may all allow death. Butand this is crucial to our understandingunlike euthanasia, their purpose and intent is not to bring about death.

Actually, euthanasia could be called a form of suicide, assisted suicide, or even murder, depending on the patients level of involvement and consent. To define euthanasia this way, though, seems to diminish its threat. After all, arent there laws or, at the very least, strong social taboos against suicide, assisted suicide, and murder?

Unfortunately, when it comes to the sick and disabled, this is no longer entirely true. And, the rationale and cultural forces behind the movement that brought this about threaten even more to tear down the legal and social barriers to killing.

Most of us know about Jack Kevorkian and his efforts to help ailing people commit suicide. Many of us may not realize, though, that Kevorkians maverick image masks a serious crusade that is building on emerging legal and cultural trends. Our society is poised to accept euthanasia on demandand worse. What we dont know about that could kill us.

In sum, it is vitally important to understand that everyones most basic rightthe right to lifeis in jeopardy when our law and collective morality no longer view all persons as equally worthy of life, solely on the basis of our common humanity. Not only is it the right thing to do, it is also in our own best interests to protect and cherish weak and vulnerable members of our human family.

In order to do that, we must educate ourselves and others about the growing threat of euthanasia, vigorously oppose its legalization, and pray for the wisdom and compassion to properly comfort, care for and dissuade those considering suicide.

The information on euthanasia is a PowerPoint Presentation (2007) prepared for American Life League by Julie Grimstad, Executive Director of Life is Worth Living, Inc.

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Euthanasia - Learn | American Life League

Euthanasia – New World Encyclopedia

Euthanasia (from Greek: -, eu, "good," , thanatos, "death") is the practice of terminating the life of a human being or animal with an incurable disease, intolerable suffering, or a possibly undignified death in a painless or minimally painful way, for the purpose of limiting suffering. It is a form of homicide; the question is whether it should be considered justifiable or criminal.

Euthanasia refers both to the situation when a substance is administered to a person with intent to kill that person or, with basically the same intent, when removing someone from life support. There may be a legal divide between making someone die and letting someone die. In some instances, the first is (in some societies) defined as murder, the other is simply allowing nature to take its course. Consequently, laws around the world vary greatly with regard to euthanasia and are constantly subject to change as cultural values shift and better palliative care or treatments become available. Thus, while euthanasia is legal in some nations, in others it is criminalized.

Of related note is the fact that suicide, or attempted suicide, is no longer a criminal offense in most states. This demonstrates that there is consent among the states to self determination, however, the majority of the states argue that assisting in suicide is illegal and punishable even when there is written consent from the individual. The problem with written consent is that it is still not sufficient to show self-determination, as it could be coerced; if active euthanasia were to become legal, a process would have to be in place to assure that the patient's consent is fully voluntary.

Euthanasia has been used with several meanings:

The term euthanasia is used only in senses (6) and (7) in this article. When other people debate about euthanasia, they could well be using it in senses (1) through (5), or with some other definition. To make this distinction clearer, two other definitions of euthanasia follow:

There can be passive, non-aggressive, and aggressive euthanasia.

James Rachels has challenged both the use and moral significance of that distinction for several reasons:

To begin with a familiar type of situation, a patient who is dying of incurable cancer of the throat is in terrible pain, which can no longer be satisfactorily alleviated. He is certain to die within a few days, even if present treatment is continued, but he does not want to go on living for those days since the pain is unbearable. So he asks the doctor for an end to it, and his family joins in this request. Suppose the doctor agrees to withhold treatment. The justification for his doing so is that the patient is in terrible agony, and since he is going to die anyway, it would be wrong to prolong his suffering needlessly. But now notice this. If one simply withholds treatment, it may take the patient longer to die, and so he may suffer more than he would if more direct action were taken and a lethal injection given. This fact provides strong reason for thinking that, once the initial decision not to prolong his agony has been made, active euthanasia is actually preferable to passive euthanasia, rather than the reverse (Rachels 1975 and 1986).

There is also involuntary, non-voluntary, and voluntary euthanasia.

Mercy killing refers to killing someone to put them out of their suffering. The killer may or may not have the informed consent of the person killed. We shall use the term mercy killing only when there is no consent. Legally, mercy killing without consent is usually treated as murder.

Murder is intentionally killing someone in an unlawful way. There are two kinds of murder:

In most parts of the world, types (1) and (2) murder are treated identically. In other parts, type (1) murder is excusable under certain special circumstances, in which case it ceases to be considered murder. Murder is, by definition, unlawful. It is a legal term, not a moral one. Whether euthanasia is murder or not is a simple question for lawyers"Will you go to jail for doing it or won't you?"

Whether euthanasia should be considered murder or not is a matter for legislators. Whether euthanasia is good or bad is a deep question for the individual citizen. A right to die and a pro life proponent could both agree "euthanasia is murder," meaning one will go to jail if he were caught doing it, but the right to die proponent would add, "but under certain circumstances, it should not be, just as it is not considered murder now in the Netherlands."

The term "euthanasia" comes from the Greek words eu and thanatos, which combined means good death. Hippocrates mentions euthanasia in the Hippocratic Oath, which was written between 400 and 300 B.C.E. The original Oath states: To please no one will I prescribe a deadly drug nor give advice which may cause his death."

Despite this, the ancient Greeks and Romans generally did not believe that life needed to be preserved at any cost and were, in consequence, tolerant of suicide in cases where no relief could be offered to the dying or, in the case of the Stoics and Epicureans, where a person no longer cared for his life.

The English Common Law from the 1300s until today also disapproved of both suicide and assisting suicide. It distinguished a suicide, who was by definition of unsound mind, from a felo-de-se or "evildoer against himself," who had coolly decided to end it all and, thereby, perpetrated an infamous crime. Such a person forfeited his entire estate to the crown. Furthermore his corpse was subjected to public indignities, such as being dragged through the streets and hung from the gallows, and was finally consigned to "ignominious burial," and, as the legal scholars put it, the favored method was beneath a crossroads with a stake driven through the body.

Since the nineteenth century, euthanasia has sparked intermittent debates and activism in North America and Europe. According to medical historian Ezekiel Emanuel, it was the availability of anesthesia that ushered in the modern era of euthanasia. In 1828, the first known anti-euthanasia law in the United States was passed in the state of New York, with many other localities and states following suit over a period of several years.

Euthanasia societies were formed in England, in 1935, and in the U.S., in 1938, to promote aggressive euthanasia. Although euthanasia legislation did not pass in the U.S. or England, in 1937, doctor-assisted euthanasia was declared legal in Switzerland as long as the person ending the life has nothing to gain. During this period, euthanasia proposals were sometimes mixed with eugenics.

While some proponents focused on voluntary euthanasia for the terminally ill, others expressed interest in involuntary euthanasia for certain eugenic motivations (targeting those such as the mentally "defective"). Meanwhile, during this same era, U.S. court trials tackled cases involving critically ill people who requested physician assistance in dying as well as mercy killings, such as by parents of their severely disabled children (Kamisar 1977).

Prior to World War II, the Nazis carried out a controversial and now-condemned euthanasia program. In 1939, Nazis, in what was code named Action T4, involuntarily euthanized children under three who exhibited mental retardation, physical deformity, or other debilitating problems whom they considered "unworthy of life. This program was later extended to include older children and adults.

Leo Alexander, a judge at the Nuremberg trials after World War II, employed a "slippery slope" argument to suggest that any act of mercy killing inevitably will lead to the mass killings of unwanted persons:

The beginnings at first were a subtle shifting in the basic attitude of the physicians. It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually, the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans.

Critics of this position point to the fact that there is no relation at all between the Nazi "euthanasia" program and modern debates about euthanasia. The Nazis, after all, used the word "euthanasia" to camouflage mass murder. All victims died involuntarily, and no documented case exists where a terminal patient was voluntarily killed. The program was carried out in the closest of secrecy and under a dictatorship. One of the lessons that we should learn from this experience is that secrecy is not in the public interest.

However, due to outrage over Nazi euthanasia crimes, in the 1940s and 1950s, there was very little public support for euthanasia, especially for any involuntary, eugenics-based proposals. Catholic church leaders, among others, began speaking against euthanasia as a violation of the sanctity of life.

Nevertheless, owing to its principle of double effect, Catholic moral theology did leave room for shortening life with pain-killers and what would could be characterized as passive euthanasia (Papal statements 1956-1957). On the other hand, judges were often lenient in mercy-killing cases (Humphrey and Wickett, 1991, ch.4).

During this period, prominent proponents of euthanasia included Glanville Williams (The Sanctity of Life and the Criminal Law) and clergyman Joseph Fletcher ("Morals and medicine"). By the 1960s, advocacy for a right-to-die approach to voluntary euthanasia increased.

A key turning point in the debate over voluntary euthanasia (and physician-assisted dying), at least in the United States, was the public furor over the case of Karen Ann Quinlan. In 1975, Karen Ann Quinlan, for reasons still unknown, ceased breathing for several minutes. Failing to respond to mouth-to mouth resuscitation by friends she was taken by ambulance to a hospital in New Jersey. Physicians who examined her described her as being in "a chronic, persistent, vegetative state," and later it was judged that no form of treatment could restore her to cognitive life. Her father asked to be appointed her legal guardian with the expressed purpose of discontinuing the respirator which kept Karen alive. After some delay, the Supreme Court of New Jersey granted the request. The respirator was turned off. Karen Ann Quinlan remained alive but comatose until June 11, 1985, when she died at the age of 31.

In 1990, Jack Kevorkian, a Michigan physician, became infamous for encouraging and assisting people in committing suicide which resulted in a Michigan law against the practice in 1992. Kevorkian was later tried and convicted in 1999, for a murder displayed on television. Meanwhile in 1990, the Supreme Court approved the use of non-aggressive euthanasia.

Suicide or attempted suicide, in most states, is no longer a criminal offense. This demonstrates that there is consent among the states to self determination, however, the majority of the states postulate that assisting in suicide is illegal and punishable even when there is written consent from the individual. Let us now see how individual religions regard the complex subject of euthanasia.

In Catholic medical ethics, official pronouncements tend to strongly oppose active euthanasia, whether voluntary or not. Nevertheless, Catholic moral theology does allow dying to proceed without medical interventions that would be considered "extraordinary" or "disproportionate." The most important official Catholic statement is the Declaration on Euthanasia (Sacred Congregation, Vatican 1980).

The Catholic policy rests on several core principles of Catholic medical ethics, including the sanctity of human life, the dignity of the human person, concomitant human rights, and due proportionality in casuistic remedies (Ibid.).

Protestant denominations vary widely on their approach to euthanasia and physician assisted death. Since the 1970s, Evangelical churches have worked with Roman Catholics on a sanctity of life approach, though the Evangelicals may be adopting a more exceptionless opposition. While liberal Protestant denominations have largely eschewed euthanasia, many individual advocates (such as Joseph Fletcher) and euthanasia society activists have been Protestant clergy and laity. As physician assisted dying has obtained greater legal support, some liberal Protestant denominations have offered religious arguments and support for limited forms of euthanasia.

Not unlike the trend among Protestants, Jewish movements have become divided over euthanasia since the 1970s. Generally, Orthodox Jewish thinkers oppose voluntary euthanasia, often vigorously, though there is some backing for voluntary passive euthanasia in limited circumstances (Daniel Sinclair, Moshe Tendler, Shlomo Zalman Auerbach, Moshe Feinstein). Likewise, within the Conservative Judaism movement, there has been increasing support for passive euthanasia. In Reform Judaism responsa, the preponderance of anti-euthanasia sentiment has shifted in recent years to increasing support for certain passive euthanasia.

In Theravada Buddhism, a monk can be expelled for praising the advantages of death, even if they simply describe the miseries of life or the bliss of the afterlife in a way that might inspire a person to commit suicide or pine away to death. In caring for the terminally ill, one is forbidden to treat a patient so as to bring on death faster than would occur if the disease were allowed to run its natural course (Buddhist Monastic Code I: Chapter 4).

In Hinduism, the Law of Karma states that any bad action happening in one lifetime will be reflected in the next. Euthanasia could be seen as murder, and releasing the Atman before its time. However, when a body is in a vegetative state, and with no quality of life, it could be seen that the Atman has already left. When avatars come down to earth they normally do so to help out humankind. Since they have already attained Moksha they choose when they want to leave.

Muslims are against euthanasia. They believe that all human life is sacred because it is given by Allah, and that Allah chooses how long each person will live. Human beings should not interfere in this. Euthanasia and suicide are not included among the reasons allowed for killing in Islam.

"Do not take life, which Allah made sacred, other than in the course of justice" (Qur'an 17:33).

"If anyone kills a personunless it be for murder or spreading mischief in the landit would be as if he killed the whole people" (Qur'an 5:32).

The Prophet said: "Amongst the nations before you there was a man who got a wound, and growing impatient (with its pain), he took a knife and cut his hand with it and the blood did not stop till he died. Allah said, 'My Slave hurried to bring death upon himself so I have forbidden him (to enter) Paradise'" (Sahih Bukhari 4.56.669).

The debate in the ethics literature on euthanasia is just as divided as the debate on physician-assisted suicide, perhaps more so. "Slippery-slope" arguments are often made, supported by claims about abuse of voluntary euthanasia in the Netherlands.

Arguments against it are based on the integrity of medicine as a profession. In response, autonomy and quality-of-life-base arguments are made in support of euthanasia, underscored by claims that when the only way to relieve a dying patient's pain or suffering is terminal sedation with loss of consciousness, death is a preferable alternativean argument also made in support of physician-assisted suicide.

To summarize, there may be some circumstances when euthanasia is the morally correct action, however, one should also understand that there are real concerns about legalizing euthanasia because of fear of misuse and/or overuse and the fear of the slippery slope leading to a loss of respect for the value of life. What is needed are improvements in research, the best palliative care available, and above all, people should, perhaps, at this time begin modifying homicide laws to include motivational factors as a legitimate defense.

Just as homicide is acceptable in cases of self-defense, it could be considered acceptable if the motive is mercy. Obviously, strict parameters would have to be established that would include patients' request and approval, or, in the case of incompetent patients, advance directives in the form of a living will or family and court approval.

Mirroring this attitude, there are countries and/or statessuch as Albania (in 1999), Australia (1995), Belgium (2002), The Netherlands (2002), the U.S. state of Oregon, and Switzerland (1942)that, in one way or other, have legalized euthanasia; in the case of Switzerland, a long time ago.

In others, such as UK and U.S., discussion has moved toward ending its illegality. On November 5, 2006, Britain's Royal College of Obstetricians and Gynecologists submitted a proposal to the Nuffield Council on Bioethics calling for consideration of permitting the euthanasia of disabled newborns. The report did not address the current illegality of euthanasia in the United Kingdom, but rather calls for reconsideration of its viability as a legitimate medical practice.

In the U.S., recent Gallup Poll surveys showed that more than 60 percent of Americans supported euthanasia (Carroll 2006; Moore 2005) and attempts to legalize euthanasia and assisted suicide resulted in ballot initiatives and legislation bills within the United States in the last 20 years. For example, Washington voters saw Ballot Initiative 119 in 1991, California placed Proposition 161 on the ballot in 1992, Michigan included Proposal B in their ballot in 1998, and Oregon passed the Death with Dignity Act. The United States Supreme Court has ruled on the constitutionality of assisted suicide, in 2000, recognizing individual interests and deciding how, rather than whether they will die.

Perhaps a fitting conclusion of the subject could be the Japanese suggestion of the Law governing euthanasia:

All links retrieved August 10, 2017.

Autopsy Brain death Clinical death Euthanasia Persistent vegetative state Terminal illness

Immortality Infant mortality Legal death Maternal death Mortality rate

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Euthanasia - New World Encyclopedia

Euthanasia Wisconsin Right to Life – wrtl.org

It has been said that if a fence is built around something, one should learn why the fence is there before dismantling it. For thousands of years, in virtually every culture, a legal fence has prohibited euthanasia and treated it as homicide.

Current trends indicate a willingness to dismantle this protective fence, picket by picket, fueled by the desire for patient self-determination, death with dignity, and the right to control the time of death.

The first picket for which removal is advocated is to allow someone to voluntarily choose death and have someone else administer it. What harm would there be, the argument goes, if the choice is freely made, strictly regulated, and achieves a good end namely, relief from suffering or choosing ones own time?

Perhaps you are persuaded by this reasoning. It is important for you to understand why this rationale is flawed and puts many vulnerable people at risk.

Shouldnt euthanasia be legal if a patient freely requests death?This argument might seem reasonable to you. Supporters of euthanasia argue that the right of a competent patient to make medical treatment decisions should include the right to request and receive death by lethal injection.

There are dangers, however, even when patients are allowed to freely request euthanasia:

Could we just legalize voluntary euthanasia and stop there?The answer is clearly NO for legal, moral and practical reasons.

Legal:Courts all over the United States have already moved from recognizing the right of competent patients to refuse medical treatment to granting that benefit to those unable or unwilling to make the decision for themselves. The same legal principles would apply if voluntary euthanasia were available. For example, if a person not in pain can request and receive a lethal injection, then how can a request be denied to a person with mental retardation perceived to be suffering? The law will not allow such an inequity to stand.

Moral:If killing a person because he or she is suffering is morally justifiable, then it is equally moral for someone else to make the decision for a person who is incapacitated and unable to do so.

Practical:Did you know that doctors in Nazi Germany killed up to 250,000 people who were deemed unfit? These doctors added more and more people into the unfit category, including those with mental retardation, mental illness, epilepsy, and bed wetters. The experience in the Netherlands has been the same. This country initially approved only voluntary euthanasia and assisted suicide which rapidly developed to include family members making death decisions for those who are incapacitated. The Netherlands recently adopted guidelines allowing parents to consent to direct killing of newborn infants with disabilities.

Shouldnt euthanasia be available for people who are in pain?No one wants to be in pain or see their loved ones in pain. This is a very real fear you may have. Fortunately, we live in a time when medicine has made great strides to manage pain. It is important to have a medical team who understands how to relieve pain.

The Wisconsin Cancer Pain Initiative has been working for many years to teach medical professionals how to relieve pain. Please clickhttp://aspi.wisc.edu/wpi/to visit their web site.

The Alliance of State Pain Initiatives (ASPI) has an excellent booklet with information for patients on how to discuss pain symptoms with their doctor. The booklet can be found atwww.aspi.wisc.edu/CPCBR.htm.

In Oregon, where assisted suicide is legal, the most important reasons people report for requesting suicide is not pain but loss of autonomy and fear of incapacity. We hope after reviewing this information that you will not use pain as a reason to support euthanasia.

What other reasons are promoted for using euthanasia? Make no mistake: while proponents of euthanasia sell the act by talking about people who are in severe pain, they have no intention of stopping at pain or even terminal illness.

A professor from Brown University, Jacob M. Appel, wrote in the May-June 2007 issue of the Hastings Center Report that assisted suicide should be available to people who suffer from repeated bouts of severe depression. This concept is finding support among mainstream commentators who favor assisted suicide, calling it rational suicide. They reason that mental suffering can be just as great as physical suffering so people should be able to avail themselves of death to relieve an unbearable life of mental suffering. These same arguments can be applied to euthanasia.

This rationale is known as the slippery slope. Once you open the door for killing of patients for one reason, it is nearly impossible to limit the right to that one circumstance. Jack Kevorkian, a Michigan doctor who assisted in the deaths of over 130 people, helped people to kill themselves even if they were not dying. In the Netherlands, legalized euthanasia for terminal illness has been followed by recognition that it is needed for mental illness. The Netherlands has also extended the euthanasia right to newborn infants with disabilities.

How would people be affected if euthanasia is legalized?You and your loved ones will certainly be affected. The practice of medicine would change because healing and killing would become equally valid goals of the medical profession. If death becomes a legal right, doctors will feel obligated to offer death as an option to all of their patients.

Those at risk of being killed without consent or against their own wishes would become fearful of seeing a physician, being hospitalized, or entering a nursing home. You would view medical professionals and even your own family members with suspicion, fearing that they will choose death by lethal injection without your consent or even against your wishes.

Who opposes legalization of assisted suicide and euthanasia?The driving force in opposition to legalization of euthanasia and assisted suicide has been medical and disability rights groups. The American Medical Association has an official position in opposition to legalization. Disability rights groups are opposed because they recognize that people with disabilities are potential victims of these practices.

In California, state and national Latino organizations worked with a coalition to defeat the proposed assisted suicide law there.

Right-to-life groups and major church denominations also worked to defeat these measures.

For more information on euthanasia, please visitwww.nightingalealliance.org.

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Euthanasia Wisconsin Right to Life - wrtl.org

Whitfield animal shelter allowing public into kennel area, changing method of euthanasia – The Daily Citizen

The covering on the fence has been taken down. Animal rescue groups and other members of the public can once again go into the kennel area.

It has been less than two weeks since Whitfield County Animal Control director Don Allen Garrett's last day at the shelter and some of the controversial policies implemented in his final months have been reversed or significantly modified.

Former Murray County Animal Shelter director Diane Franklin, who also worked for several years at the Whitfield shelter, was brought in as interim director and has made a number of changes. For one, the public can now go back into the kennel area.

"I want to do what we can do to get these animals adopted in a positive way, and I think letting the rescue groups get back in there and see the dogs will help us do that," said Franklin.

In May, the shelter barred the animal rescue groups, and the public, from going back into the kennels. Previously, dog owners and members of rescue groups could go back into the kennel area to look at the animals. County officials said that move was prompted by safety and liability concerns about having people so close to the dogs.

Franklin says there are still some safety concerns.

"That's why we will require anyone going into the back to be accompanied by a staff member," she said. "And we are working on some liability waivers they will have to sign."

Board of Commissioners Chairman Lynn Laughter describes the new policy as a "modification" of the policy of not allowing people into the back, not a reversal.

"They can go in the back, but they have to be accompanied by a staff member. Previously, we were allowing them to go into the back unescorted. This strikes a good balance," she said.

Jan Eaton of Tri State Pet Rescue in Blue Ridge had criticized the policy of not allowing rescue groups into the back, saying it made their work more difficult. She said she welcomed the new policy.

"I can only speak for myself. But I would prefer to have a staff member with me when I go into the back, so I can ask questions about the dogs," she said.

The new policy seems to be similar to those in surrounding counties. Officials with animal shelters in Gordon County, Murray County and Walker County say they do allow members of rescue groups and pet owners back into the kennel areas but only when supervised by staff.

"I do have some concerns about people other than the staff being in the back," said Commissioner Roger Crossen. "There is the possibility they can be bit. But I feel better that they are escorted by a staff member. I'm one of those people who thinks we should let our department heads do their jobs, and if she thinks this is a workable policy, I think we should let her implement it."

Franklin has also taken down the covering that was placed on the shelter fence in July.

"I moved that to a pen that I am using," she said. "If you want to come out here and adopt a dog you need to be able to interact with that dog. By putting the screen around that pen, we let the dog devote his attention to the person thinking about adopting it. But it is no longer blocking public view."

Earlier this month, because of questions about training, the Georgia Department of Agriculture blocked shelter staff from euthanizing animals. County Administrator Mark Gibson says he expects the department to certify a staff member to perform euthanasia soon.

Gibson says that going forward the staff will only euthanize animals by giving them an intravenous (IV) injection. State law permits three methods to euthanize animals, in order of preference: IV, intraperitoneal injection (into the body cavity) and intercardial injection. In the past, animal welfare groups have criticized the shelter for over-reliance on intercardial injections, sometimes called the heart stick, the least preferred method.

"I am so glad to hear they are only going to use IV," said Eaton. "We don't want to see any animal euthanized. But if it has to be done, we want them to use the preferred method."

Laughter says the shelter did not violate the law by using intercardial injections and it was done humanely.

"I have witnessed them doing it. The animal was asleep when it was done. It did not suffer," she said.

But she added that if IV is what the state prefers that is what the shelter will use going forward.

Garrett retired earlier this month after some 25 years as animal control director. His last official day is Sept. 30, but officials say his last day actually at the shelter was Aug. 14. Gibson says Garrett is using unused paid time off until his official separation date. His retirement came less than two weeks after the state pulled the shelter's ability to euthanize. But officials say he was not forced out.

Garrett could not be reached for comment, and he did not file a resignation letter. His personnel file shows he routinely received solid performance reviews from county administrators over the years. But it also shows that in 2014, Garrett was suspended for five days without pay after a dog at the shelter was mistakenly euthanized before the 10-day hold on the animal was up. And in May 2015, Garrett received a formal reprimand from Gibson for failing on several occasions to make weekly deposits of all funds received at the animal shelter as he had been instructed to do the previous August.

"In addition, although not reprimanded for this particular aspect of your job, you should post either animals eligible for adoption or animals that have been adopted on social media, namely Facebook, as well as on a section of our county website which is conspicuous as possible as determined by IT with my approval," the reprimand states.

In the file, there is an August 2014 memo from Gibson to Garrett directing him to charge the same amount to everyone who picks up an animal at the shelter, develop a uniform fee schedule for services, to record all payments and to bring all receipts to the county finance department each week. There is also an April 2015 memo from Assistant Finance Director Melva Andrews to Finance Director Alicia Vaughn showing the dates that Garrett actually did make such deposits. It shows that he would sometimes go up to five weeks without delivering receipts.

Gibson says Franklin will serve as interim director until a permanent director is hired but says he does not know when that will be.

"As to a search for a permanent director, the board (of commissioners) will take up that issue as soon as we are able, but the immediate plan is to stabilize operations to provide the best service for taxpayers. When the board decides when the search begins, I don't believe a time limit may be put on it at this time because we don't want to limit ourselves by time in order to find just anyone able to perform the requirements of the position," he said.

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Whitfield animal shelter allowing public into kennel area, changing method of euthanasia - The Daily Citizen

‘We’re all gonna die’: Senior citizens weigh in on euthanasia – Newshub

Euthanasia is a subject with no definitive ethical consensus.

Despite two attempts to pass legislation to legalise euthanasia, the practice is still illegal in New Zealand.

But for many nations across the globe the right to decide when you die has been instantiated into law.

Newshub spoke to advocates from New Zealand on both sides of the argument, before heading to Eden Village to ask the elderly how they feel.

We spoke to advocates from New Zealand on both sides of the argument

Chris O'Brien is President of the Right to Life organisation

"Right to Life opposes the decriminalisation of both Euthanasia and Physician Assisted suicide for the following reasons:

"We believe that it is a watershed issue. Once decriminalised for any category of person then it becomes a right, in fact a human right. Human rights by their very nature are universal.

"So no matter what safeguards may be inherent in any legislation we can be sure that those safeguards will over time be breached.

"This is particularly obvious in the case of the The Netherlands where Euthanasia was decriminalised in 2002. The Dutch started with legislation that allowed Euthanasia only for those patients who were considered to be suffering unbearable pain and with no hope of cure.

"Since then an ever increasing number of conditions have been added allowing for persons who are eligible for euthanasia.

"Until we arrive at the situation today where the Parliament of that country is now seriously considering Euthanasia as an option for those who are not terminally ill, and in fact simply believe they have completed their lives.

"Here lies the danger. In far less than two decades look what they are proposing? Is this what we want for New Zealand? We we can be certain that regardless of all the good intentions in the world, euthanasia once decriminalised will become un-manageable.

"Right to Life believes that Euthanasia must never be decriminalized, there no exceptions. To do so would put at risk those who are vulnerable, especially the elderly, the disabled and those who have dementia or are mentally ill.

"There are no safeguards that can effectively protect the vulnerable from coercion and exploitation.

"We already have a significant elder abuse problem and the decriminalising of Euthanasia and allowing for Physician Assisted Suicide is going to make the elderly even more vulnerable, especially given our rapidly ageing population and rising health care costs.

"Two adages. Firstly; hard cases make bad laws. Secondly; the law is a powerful educator of the public conscience. If New Zealand goes down this path then what we are saying is that suicide is a solution to a problem.

"How can we, on one hand advocate for suicide prevention, while on the other, advocate suicide and euthanasia as a solution?

"This is particularly troublesome given the very high rate of youth suicide in New Zealand.

"Doctors are healers not killers and the fact that the NZMA and other medical groups oppose euthanasia should be enough to put a stop to this proposal.

"Right to Life believes that those who are pushing for Euthanasia are well resourced, well educated and are people who are used to autonomy and being in control of their lives. They want to maintain that control right up to arranging their own deaths.

"We ask when does their 'right' to have a doctor kill them trump the right of the many thousands of vulnerable people whose lives will be increasingly at risk, if decriminalisation occurs?

"Right to Life believes that instead of proposing that doctors should be able to kill their patients, greater efforts should be being put into ensuring that our palliative care systems and delivery continues to be world class and to develop and be available to all."

David Barber represents the End of Life Choice organisation

"I have seen loved ones die in pain, with unbearable suffering and total loss of dignity, being reliant on carers to feed, wash, dress and toilet them.

"Waiting for a pain-racked death to end their suffering is I believe an intolerable situation no human should have to bear.

"Everyone should be able to end their lives painlessly and with dignity. We allow that for animals - why not humans?

"I would only stop campaigning for voluntary euthanasia or end-of-life choice if the law was changed to allow medical assistance to die for those who request it."

With all this in mind we decided to ask the elderly at Eden Village what they felt about the matter.

Watch the video.

Newshub.

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'We're all gonna die': Senior citizens weigh in on euthanasia - Newshub

Dutch Couple Chooses Euthanasia – Valley News – Valley News

Nic and Trees Elderhorst knew exactly how they wanted to die.

They were both 91 years old and in declining health. Nic Elderhorst suffered a stroke in 2012 and more recently, his wife, Trees Elderhorst, was diagnosed with dementia, according to the Dutch newspaper, De Gelderlander.

Neither wanted to live without the other, or leave this world alone.

So the two, who lived in Didam, a town in the eastern part of the Netherlands, and had been together 65 years, shared a last word, and a kiss, then died last month hand-in-hand in a double euthanasia allowed under Dutch law, according to De Gelderlander.

Dying together was their deepest wish, their daughters told the newspaper, according to an English translation.

The Netherlands became the first country to legalize euthanasia in 2002, allowing physicians to assist ailing patients in ending their lives without facing criminal prosecution.

Euthanasia, in which a physician terminates a patients life at his or her request, is legal in a few countries, including Belgium, Colombia and Luxembourg. Physician-assisted suicide, in which a doctor prescribes lethal drugs that a patient may take to end his or her life, is permitted in a few others, including in certain states in the United States, according to ProCon.org, a nonprofit organization that researches countries legislation on the issue.

We are pleased that we have in the Netherlands this humane and carefully executed legislation that allows the honorable wishes of these two people whose fate was painful and hopeless, Dick Bosscher, of the Dutch Association for a Voluntary End of Life (NVVE), said in a statement to The Washington Post. He said the Elderhorsts belonged to NVVE, a 165,000-member organization for euthanasia and assisted suicide in the Netherlands.

In recent years, apparent double-suicides and murder-suicides have been capturing worldwide attention amid an emotional right-to-die debate couples from Florida to Paris reportedly ending their lives together.

Assisted suicide has summoned up deep religious and ethical concerns among critics.

In the United States, the subject was widely debated in 2014, when a 29-year-old woman who had a fatal brain tumor moved from California to Oregon, where she could legally seek medical aid to end her life. California has since enacted its End of Life Option Act, joining a small number of states where it is legal.

Even in the Netherlands, according to Bosscher with NVVE, the Elderhorsts case is rare in that both of them were able to meet the criteria for euthanasia under the Dutch Termination of Life on Request and Assisted Suicide (Review Procedures) Act. Euthanasia and physician-assisted suicide can be carried out only when the patients request is voluntary and well thought-out, the patient is in lasting and unbearable suffering and there are no other solutions, among other things.

Research published this month in the New England Journal of Medicine revealed that euthanasia and physician-assisted suicides accounted for 4.5 percent of deaths in the Netherlands in 2015, up from 1.7 percent in 1990, before it was legal. The 25-year review found that most patients who received assistance had serious illnesses.

It looks like patients are now more willing to ask for euthanasia and physicians are more willing to grant it, lead author Agnes Van der Heide, of Erasmus University Medical Center in Rotterdam, told the Associated Press.

However, Bosscher said that there are more than 15,000 requests for euthanasia each year in the Netherlands and that only about 6,000 of them are granted.

The Elderhorsts discussed their options and submitted requests for euthanasia, a year-long process their daughters called an intense time, according to De Gelderlander.

The couple, who had even planned their own funerals, died July 4.

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Dutch Couple Chooses Euthanasia - Valley News - Valley News

Owner seeks lawyer as dog faces euthanasia – The Recorder

The Athol man whose dog was ordered by the Athol Selectboard to be euthanized said he is working on getting money to hire a Beverly-based law firm that defends dogs and their owners.

Eric F. Zewiey, 53, of 399 Unity Ave., said he wants to recruit the legal services of Jeremy Cohen of Boston Dog Lawyers, but there is a $5,750 fee required.

The Athol Selectboard voted last month to have Lillie, Zewieys pit bull, put down by a veterinarian, as allowed by state law, after the dog reportedly bit a woman on Feb. 11, 2016, and then a 15-year-old boy who was out jogging on June 12. The recommendation for euthanization came from Animal Control Officer Jennifer Arsenault, who said Lillie has also attacked several dogs.

The vote came three months after the Selectboard deemed the dog dangerous and ordered it to be restrained at all times.

Zewiey had until July 31 to file an appeal in Orange District Court. He insists he made the deadline, but Clerk Magistrate Joella E. Fortier disputes this. Clerks at the courthouse said there is no record of any appeal for a dog euthanization order. They add they found Zewieys check but didnt know what it was for and returned it by mail.

Zewiey said the court returned to him the $195 fee, but he didnt understand why. Fortier said it is because there is no appeal before the court.

Contending he filed the required paperwork with the check that was returned, Zewiey said the town and court have mishandled his situation.

This is a matter of life and death, he said, adding that courthouse employees have not been helpful. This isnt a (expletive) parking ticket.

Zewiey referred to Lillie as a family member.

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Owner seeks lawyer as dog faces euthanasia - The Recorder

Elderly couple got ‘deepest wish’ to die together in rare euthanasia case – Washington Post

Nic and Trees Elderhorstknew exactly how they wanted to die.

They were both 91 years old and in declining health. Nic Elderhorst suffered a stroke in 2012 and more recently, his wife,Trees Elderhorst, wasdiagnosed with dementia, according to the Dutch newspaper,De Gelderlander.

Neither wanted to live without the other, or leave this world alone.

So the two, wholived in Didam, a town in the eastern part of the Netherlands, and had been together 65 years, shared a last word, and a kiss, then died last month hand-in-hand in a double euthanasia allowed underDutch law, according to De Gelderlander.

Dying together was their deepest wish, their daughters told the newspaper,according to an English translation.

[A terminally ill woman had one rule at her end-of-life party: No crying]

The Netherlands became the first country to legalize euthanasia in 2002, allowing physiciansto assist ailing patients in ending their lives without facing criminal prosecution.

Euthanasia, in which a physician terminates a patient'slife at his or herrequest, is legal in a few countries, including Belgium, Colombiaand Luxembourg. Physician-assisted suicide, in which a doctor prescribes lethal drugs that a patient may take to end his or her life, is permitted in a fewothers, including in certain states in the United States, according toProCon.org, a nonprofit organization that researches countries' legislation on the issue.

We are pleased that we have in the Netherlands this humane and carefully executed legislation that allows the honorable wishes of these two people whose fate was painful and hopeless,Dick Bosscher, ofthe Dutch Association for a Voluntary End ofLife (NVVE), said in a statement to The Washington Post. He said theElderhorsts belonged toNVVE, a165,000-member organization foreuthanasia and assisted suicide in the Netherlands.

,,Ze gaven elkaar een dikke kus en rustig en zelfverzekerd zijn ze hand in hand ingeslapen.Via DG Liemers

Posted by De Gelderlander onThursday, August 10, 2017

In recent years, apparent double-suicides and murder-suicides have been capturing worldwide attention amid an emotional right-to-die debate couples from Florida toParisreportedlyending their lives together.

Assisted suicide has summoned up deep religious and ethical concerns among critics.

In the United States, the subject was widely debated in 2014, when a 29-year-oldwoman who had a fatal brain tumormoved from California to Oregon, where she could legally seek medical aid to end her life. Californiahas since enacted itsEnd of Life Option Act, joining a small number of states where it is legal.

Even in the Netherlands, according to Bosscher withNVVE, theElderhorsts' case is rarein that both of them were able to meet the criteria foreuthanasia under the DutchTermination of Life on Request and Assisted Suicide (Review Procedures) Act. Euthanasiaand physician-assisted suicide can be carried out only when the patient's request is voluntary and well thought-out, the patient is in lasting and unbearable suffering and there are no other solutions, among other things.

Researchpublished this monthin the New England Journal of Medicine revealed that euthanasia and physician-assistedsuicidesaccounted for 4.5 percent of deaths in the Netherlands in 2015, up from1.7 percent in 1990, before it was legal. The 25-year review found that most patients who received assistance had serious illnesses.

It looks like patients are now more willing to ask for euthanasia and physicians are more willing to grant it, lead author Agnes Van der Heide, of Erasmus University Medical Center in Rotterdam, told the Associated Press.

However, Bosscher said that there are more than 15,000 requests foreuthanasia each year in the Netherlands and that only about 6,000 of them are granted.

The Elderhorsts discussed their options and submitted requests for euthanasia a year-long process their daughters called an intense time, according to De Gelderlander.

The couple, who had even planned their own funerals,died July 4.

Read more:

How Brittany Maynard may change the right-to-die debate

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Elderly couple got 'deepest wish' to die together in rare euthanasia case - Washington Post

Stand-off with Catholic hospitals as euthanasia gains traction in Canada – BioEdge

As euthanasia rates increase in the Canadian province of Ontario, pressure is mounting on Catholic Healthcare providers to abandon their blanket opposition to Medical Assistance in Dying (MAiD).

Over 630 Ontarians have received MAiD since the procedure was legalised in Canada in 2015, according to data from the provincial coroner, yet none of these cases has taken place in a Catholic healthcare facility.

Lobby groups are now calling for sanctions on Catholic healthcare providers, particularly in light of the public funding these providers receive.

Dying With Dignity Canada CEO Shanaaz Gokool told CBA News that her organisation is considering a legal challenge of Catholic hospitals right to conscientiously object to participation in euthanasia.

Gokool says that the Catholic healthcare policy of transferring MAiD patients to secular facilities places an undue burden on patients. "It really depends on how precarious their physical medical condition is," she said. "And if they are in a precarious state physically, then that can cause them more trauma."

Ontario health minister Eric Hoskins said that access to MAiD was not currently a problem. "We're obviously monitoring it very, very closely and currently don't have those concerns in terms of access," he told CBA News. "And about half of medical assistance in dying happens at home.

MORE ON THESE TOPICS |

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Stand-off with Catholic hospitals as euthanasia gains traction in Canada - BioEdge

Monmouth County SPCA Joins Efforts To Save Dogs Slated For Euthanasia In Puerto Rico – Patch.com


Patch.com
Monmouth County SPCA Joins Efforts To Save Dogs Slated For Euthanasia In Puerto Rico
Patch.com
EATONTOWN, NJ - The Monmouth County SPCA has teamed up with other animal rescue organizations to fly and temporarily shelter dogs from Puerto Rico that were slated for eventual euthanasia. The rescued dogs are part of The Sato Project, which ...
Dogs rescued from euthanasia heading to NJ for adoptionNJ.com

all 3 news articles »

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Monmouth County SPCA Joins Efforts To Save Dogs Slated For Euthanasia In Puerto Rico - Patch.com

BioEdge: Dutch couple choose euthanasia together – BioEdge

The latest husband-and-wife euthanasia in the Netherlands took place on July 4. Nic and Trees Elderhorst, both 91, died in their home town of Didam, surrounded by family members. Neither was terminally ill, but both were in failing health. Nic, the husband, had a stroke five years ago, and Trees, the wife, was declining into dementia.

The couple had made advance directives in 2012 but they needed the euthanasia before Trees became unable to give her informed consent.

The couple applied to the Levenseindekliniek, a clinic which handles euthanasia requests when other doctors refuse. They gave each other a big kiss and passed away confidently holding hands, one of their daughters told a local newspaper, the Gelderlander.

Couple euthanasia is relatively common in the Netherlands, although some requests are refused because one of the partners does not fulfil the criteria. According to the Gelderlander, there are a few cases a year statistically negligible, but socially significant and no longer surprising.

Read more from the original source:

BioEdge: Dutch couple choose euthanasia together - BioEdge

When death comes calling: Top diseases leading to veterinary euthanasia – dvm360

Shutterstock.comPain and death. Death and pain. They often go hand in hand. But for Dani McVety, DVM, and her fellow veterinarians in the Lap of Love hospice and in-home euthanasia network, the goal is to minimize painand the anxiety that often accompanies itas much as possible before the end. Maybe even to prevent it altogether.

We as veterinarians are very comfortable with the concept of quality of life, she told her audience at a recent CVC. But I want to provide a good quality of death as well. That means no panicky trips to the ER in the middle of the night. Id rather have the family out on the dock with the pet at sunset, everyone saying a prayer before I push the plunger. Whatever it takes to give that family and that pet a peaceful experience.

A major part of creating that peaceful experience is educating and preparing clients for what to expect as their pet reaches end of life, along with helping them know when euthanasia is an appropriate choice. Here are the top six conditions Lap of Love veterinarians see in association with euthanasia (based on data collected by the company) and how Dr. McVety handles each one with clients.

1. Old age

Obviously old age isnt a disease, but it sure is a killer, Dr. McVety says. Its the No. 1 reason Lap of Love clients call to request euthanasia, and what it really means is that the pets medical condition is undiagnosed. That means anything can happen, so client and doctor alike should brace for the unexpected. Problems with cognition, along with stroke, seizures and organ failure, are all possibilities.

2. Osteoarthritis and mobility issues

This painful disease is the second-most-common reason Dr. McVety receives calls requesting consultation on euthanasia for pets. The pain increases with progression, and clients should be instructed to watch for signs of intensifying discomfort. Sundowners syndromeawakeness or awareness in the middle of the night, accompanied by panting, pacing, whining and cryingis very common with osteoarthritis (as well as a number of other end-of-life conditions).

While the pet should be on an osteoarthritis treatment protocol, clients may also need rescue drugs to get the pet through a pain crisis before the euthanasia takes place. Dr. McVety says she leaves rescue medications with clients if theyre not ready to euthanize yet or if theyre trying to make a deadline, such as getting through Christmas or waiting for Mom or Dad to get home to say goodbye.

Along with gabapentin, Dr. McVety uses tramadol for osteoarthritis patients as a rescue drug. Weve learned that tramadol is not necessarily fantastic for pain, but Ill tell you how I use it, she says. Tramadol is like a glass of winesometimes we need one glass of wine to get through the night; sometimes we need three or four. Of course, if were using three or four doses multiple nights in a row, we have a quality-of-life issue and we need to have a conversation about that.

Dr. Dani McVetyAs far as knowing the right time to euthanize, we have the curse and the luxury of time, Dr. McVety says. With osteoarthritis patients there is major variation in when a client and veterinarian can make the decision and have it be appropriate and ethical. Sometimes animals will eat through pain and wag their tail right up to the end, so cessation of these activities is not always a reliable indicator, Dr. McVety says. Tell clients this, and let them know its still OK to say goodbye if pain and anxiety are detracting from the patients life.

3. Renal failure

With chronic kidney disease, pain is variable depending on the patient: It can range from uncomfortable to very painful. Again, its best to educate clients on signs of pain and watch for progression in their pets. Rescue drugs can include buprenorphine, tramadol, fluids, anti-emetics and appetite stimulants.

When is it right to euthanize a kidney disease patient? Again, we have the curse and the luxury of time, Dr. McVety says. The goal for a high quality of death is to make it a peaceful experience and avoid a crisis that leads to an ER trip.

4. Heart failure

As with chronic kidney disease, pain associated with congestive heart failure (CHF) can range from uncomfortable to sufferable, Dr. McVety says. The main thing she tells her clients to watch for is change, particularly changes in eating. If a CHF patient comes in and is still eating, we can usually mitigate, says Dr. McVety, who worked in emergency practice before founding Lap of Love and has seen her share of heart failure. Not at the very end. If the pet stops eating, thats a huge red flag.

Rescue drugs for heart failure include high-dose furosemide, and Dr. McVety will even sometimes leave an oxygen machine with the family if theyre trying to delay euthanasia until a family member can be present.

When is the right time to euthanize? Much sooner than you want to if you want a peaceful end-of-life experience, Dr. McVety tells clients.

5. Hemangiosarcoma

Pain associated with hemangiosarcoma, the fifth-most-common condition leading to euthanasia requests, ranges from uncomfortable (in hypoxic patients) to sufferable (discomfort related to pulmonary metastases and pressure from ascites).

Hemangiosarcoma declines rapidly under most conditions in elderly patients. Thismakes the use ofrescuemedications (those that act rapidly to mitigate pain) not as applicable in these cases. But theyre still useful, if only for their placebo effect with both patient and pet parent, Dr. McVety says. Oxygen may also help certain patients.

A key factor with hemangiosarcoma patients is to educate their owners about what the end will look likeit might be a slow bleed and it might be a fast bleed. We need to let clients know what to expect so they dont freak out, Dr. McVety says. I told one lady about the possibility of a fast bleed, and she said later that because she knew what was happening, her dog died peacefully in her arms and she didnt panic. She gave me a huge hug and a thank you that she knew what to expect.

With hemangiosarcoma, its also important to tell clients that euthanasia sooner rather than later is better for a peaceful goodbye experience.

6. Osteosarcoma

Rounding out the top six end-of-life conditions from Dr. McVety, osteosarcoma ranges in painfulness from discomfort to sufferability. Awareness of progression is key for clients, and rescue drugs for controlling pain are very important. The answer to when should I euthanize? is, again, Sooner than you want to, Dr. McVety says.

Whether its one of these conditions or any other health problem that makes euthanasia a reasonable choice for client and patient, the bottom line is to let pet owners know what the dying process looks like in their pets disease context. This helps them stay calm and make good decisions, with your help, about their pets care. After all, death comes calling for all animals, whether veterinarians step in or not, so everyone involved can release judgment and guilt and focus on the petthe joy it has brought in life, and the peace and love it can experience with its family at the end.

Excerpt from:

When death comes calling: Top diseases leading to veterinary euthanasia - dvm360

Canadian bishops grapple with legal euthanasia and funerals … – America Magazine

Physician-assisted suicide is legal in five states and Washington, D.C., and supporters of the practice say they have plans to push for legalization in a dozen more states. The number of Americans who ask doctors to prescribe lethal doses of medication is relatively small, but support for the practice is growing. End-of-life issues have garnered attention north of the border, as well. Last year, Canadian lawmakers legalized euthanasia, a practice that differs slightly from physician-assisted suicide in that doctors administer the drugs rather than simply prescribe them. The law allows individuals whose deaths are reasonably foreseeable to request lethal doses of medication to end their lives early, though some lawmakers want to expand the law to include those who are suffering but who are not near death.

With Canadians now free to request euthanasia, some Catholic bishops there are grappling with a difficult question: Should those who end their lives with the assistance of medication be given a Catholic funeral?

Cardinal Grald Lacroix, the archbishop of Quebec, where euthanasia has been legal since 2014, told America that it is difficult to know why a patient chose to end his or her life early. As a result, the church should err on the side of mercy when it comes to funerals. He said that many elderly people are made to feel burdensome, are afraid to be alone in their final days or are nervous about experiencing pain. Increasingly, he said, society tells them that an early death is preferable.

Culturally, theyre bombarded with this [message] all the time, he said. So who are we to judge why they are like this? he asked, referring to patients who decide they want to take advantage of what proponents have dubbed medical aid in dying.

We do the best we can and leave the rest to the Lord. If the Lord accuses us of being too merciful, well, Ill take it, he said.

But not all bishops in Canada are on the same page when it comes to how the church should proceed for people who end their lives with the assistance of doctors.

Last fall, six bishops from western and northern Canada signed a statement that suggested some individuals who use euthanasia would not be eligible for a Catholic burial, especially if that person was a high-profile figure. The document notes that the church offers funerals for those who commit suicide, as pastors are not able to judge the reason the person has taken that decision or the disposition of their heart.

But when it comes to physician-assisted suicide, the bishops write, there are sometimes more clues about the intentions of the deceased. In such cases, it may not be possible to celebrate a Christian funeral, the statement reads. If the Church were to refuse a funeral to someone, it is not to punish the person but to recognize his or her decisiona decision that has brought him or her to an action that is contrary to the Christian faith, that is somehow notorious and public, and would do harm to the Christian community and the larger culture, it continues.

A few months later, bishops in Canadas eastern provincesreleased their own statement suggesting that the question of funerals was too complex for written guidelines and proposing that each case be dealt with individually.

Persons, and their families, who may be considering euthanasia or assisted suicide and who request the ministry of the church, need to be accompanied with dialogue and compassionate prayerful support, the statement reads. The fruit of such a pastoral encounter will shed light on complex pastoral situations and will indicate the most proper action to be taken including whether or not the celebration of sacraments is appropriate.

Cardinal Lacroix seems to come down somewhere in the middle, suggesting that people who opt for euthanasia could still be eligible for a Catholic funeral, so long as they and their loved ones are not promoting the practice or using the funeral to make a statement about the law.

Plus the family might not support a loved ones decision to end his or her life.

Do you think they need consolation? Of course, he said. We accompany everybody.

Still, he suggested that there are cases where a Catholic funeral would not be prudent.

The only time we will say noit hasnt happened yet but it could happen as far as Im concernedis if somebody says: Im getting euthanasia, and Im going to have a [Catholic] funeral. I deserve this, and at my funeral, those who are going to speak are going to say, Were promoting this, he said. No, no this isnt a show.

Cardinal Lacroix recalled two episodes in which pastors were asked to minister to patients considering euthanasia. In one, a frail woman dying of cancer had decided to end her life early. The hospital chaplain, a Catholic priest, asked her why, and she explained that she feared being a burden to her busy children, now with families of their own. He suggested that she talk to them about her concerns, and when she did, they were shocked and convinced her to change her mind. Accompaniment, he said. The priest didnt do it. But he helped her make the decision. He didnt tell her: What! You cant do that! Thats immoral! He helped her think.

In another instance, Cardinal Lacroix said, he visited a dying woman at the request of a friend. The woman had planned her death, which would include a final meal with her family before doctors administered the drugs. He recalled listening to the patient talk about her life and her family, but she was determined that she did not want to suffer at the end. She went through with the practice, and in her obituary, the cardinal said, the woman thanked lawmakers for legalizing euthanasia. In that case, had the woman asked for a Catholic funeral, he said it probably would have been inappropriate to grant her request.

We accompanied her, we accompanied her family, he said. Thats what we can do. We can harp and harp, and say, This is bad, this is bad, and it is and we do in some ways. But he prefers a more proactive approach, and to that end, he has supported a program that will train hundreds of volunteers to spend time with those in their final days, so that people are not alone when it is time to die.

Thats what we do. We accompany life, in real situations. We propose the best we can offer, which is what the church teaches, Cardinal Lacroix continued. The rest is not in our hands.

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Canadian bishops grapple with legal euthanasia and funerals ... - America Magazine