Daily Archives: April 23, 2023

Ernst Kuipers, the Dutch health minister, recently announced that regulations were being modified to allow doctors to actively end the lives of children aged one to 12 years who were terminally ill and suffering unbearably.

Previously, assisted dying was an option in the Netherlands in rare cases in younger children (under one year) and in some older teenagers who requested voluntary euthanasia. Until now, Belgium was the only country in the world to allow assisted dying in children under 12.

Under the proposal, it will remain against the law for doctors in the Netherlands to actively end the life of a child under the age of 12. However, a force majeure clause gives prosecutors the discretion not to prosecute in exceptional circumstances.

In 2005, Dutch doctors and legal experts published guidelines (the so-called Groningen protocol) elaborating when these exceptional circumstances would apply for infants under the age of one year. That included certainty about diagnosis and prognosis, hopeless and unbearable suffering, the support of both parents and appropriateness confirmed by an independent doctor.

The new regulations would allow the same principles to apply to children between one and 12 years of age.

In a study commissioned by the Dutch health ministry and released in 2019, researchers investigated the deaths of a large number of children who had died four years earlier. They did not identify any cases where doctors had deliberately hastened death.

However, Dutch paediatricians and parents had reported that in a small number of cases, children and families were experiencing distressing suffering at the end of life despite being provided with palliative care.

That included, for example, children with untreatable brain tumours who developed relentless vomiting, screaming, and seizures in their dying phase. Or children with epilepsy resistant to all treatment with tens to hundreds of seizures a day.

The study recommended improvements in access to palliative care for children, as well as altering regulation to provide the option of assisted dying in these extreme cases.

It has been suggested that five to ten children a year might be eligible for this option in the Netherlands.

The Dutch proposal is different to the law in Belgium. In 2014, Belgium removed a lower age limit for accessing voluntary euthanasia.

This means that, in theory, Belgian children under the age of 12 years can request assisted dying in strictly limited circumstances, including that they have a terminal illness, have severe suffering that cannot be eased, can understand their circumstances, and their parents agree.

This would not apply to the children covered by the Dutch regulation who are too young or too unwell to make decisions for themselves. Since the Belgian law was passed, only four cases of assisted dying in minors (under the age of 18) have been reported.

The expansion of assisted dying to children in the Netherlands will probably be viewed, by those who are opposed to assisted dying, as further evidence of the so-called slippery slope. This is the argument that allowing assisted dying in initially limited cases will lead to progressive liberalisation and to much more problematic cases.

The Groningen protocol for young infants was also claimed to be a clear example of the slippery slope. However, reports from the Netherlands suggest that rather than leading to an increase, there has been a significant reduction over time.

According to the Dutch health minister, only two cases in children under one year have been reported since 2007.

The important ethical question is what our society wants doctors to do when faced with the thankfully rare but heartbreaking situation of a child suffering severely at the end of their life.

Should doctors try sedating the child heavily until they are unconscious and wait for the inevitable end? Should doctors do the best they can, but accept that suffering is not always avoidable? Or should they take steps to hasten the childs death?

In most countries, the last is not a lawful option even if both parents and doctors think that would be kindest for the child. However, in the Netherlands, it appears that this will be available as a last resort, once the new regulations have been approved. Hopefully, it will rarely be needed.

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Dutch government to expand euthanasia law to include children aged one to 12 an ethicist's view - The Conversation

Speaking with ACI Prensa, CNAs Spanish-language news partner, Ivette Laviada, who holds a masters degree in bioethics, said that the death with dignity initiative that is proposed for debate in the Chamber of Deputies is completely contrary to human rights.

In Mexico, euthanasia and assisted suicide are expressly prohibited in Article 166 of the General Health Law and in Article 312 of the Federal Penal Code [CPF], she added.

Laviada also pointed out that the disguise that they want to put on active euthanasia [considered as helping or inducing suicide] as an act of mercy at the request of the patient to avoid suffering from a terminal illness has many angles that must be considered.

It is not the same thing to regulate advance directives in which a terminally ill person can in the exercise of his freedom decide what means, therapies, or procedures he wants to receive or not during the course of his illness, as to request that medical personnel or even a family member procure his death to lighten his pain since as established by the CPF, whoever procures the death of another commits homicide, she stressed.

Laviada also stressed that a dignified death has more to do with accompanying the sick with quality care and attention without artificially prolonging life with disproportionate means and without hastening death.

When a doctor can no longer cure, he can accompany with palliative care, she said. Necessary nutrition, hygiene, and medicines that eliminate or reduce pain should not be withheld and the patient, if he so desires, should receive spiritual accompaniment.

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Thousands of signatures presented to Mexican Congress urging defeat of euthanasia bill - Catholic News Agency

The most unnerving thing about Plan 75, the debut feature from Japanese filmmaker Chie Hayakawa, is that the dystopian future it presents doesnt seem futuristic at all. This is as true for the films mise en scne as it is for its premise.

Theres no comfort to be taken, for instance, in city-states that have been reimagined as gleaming high-tech playlands or blighted urban hell-scapes. We are far removed from either Logans Run or Soylent Green, iconic 1970s movies that Plan 75 brings to mind. What the picture does share with these two schlock masterpieces is summed up in the title: an agenda and time.

In Logans Run, youll recall, an Edenic world is built upon a duplicitous conceit the mandatory murder of its citizens upon their reaching 30 years of age. Utopia, in distinct contrast, is unimaginable in Soylent Green, wherein New York City in the year 2022 yes, that particular sell-by date has passed is lacking in space and food. As a consequence, senior citizens can opt for a trip to the Thanatorium, an assisted suicide clinic run by the government.

The Japan we see in Plan 75 is rather ordinary, if considerably dour: Cinematographer Hideho Urata swathes almost the entirety of the movie in a steely gray. Overpopulation has become so dire that the government has instituted a voluntary program, Plan 75, that allows seniors to end their own lives for the greater good.

Current-day Japan does have one of the oldest populations in the world and the government, with an eye on trimming budgetary fat, has encouraged delayed retirement for its seniors. When Ms. Hayakawa was doing research for her film, she floated its premise to a group of elderly women from various social strata. To a person, each respondent said that if a Plan 75 did exist, they would submit to it in order not to be a burden to their families and to the culture at large.

Another unnerving aspect of Ms. Hayakawas film is the business-as-usual quality of the imagined bureaucracy that deals with government-sanctioned euthanasia. The advertising, the outreach, the incentives, and the amiable young people manning the front desks and working the phone lines the professionalization of death is given a benign face. There is nothing that cant be marketed in a positive light. A dour strain of satire wheedles its way through Plan 75.

At the center of the film is Michi (Chieko Baish), a 78-year-old woman who has lost her job, received notice that her home will soon be undergoing demolition, and whose best friend recently died. Having little in the way of savings and no family, Michi begins to waver on Plan 75, an option she has previously resisted entertaining. Alongside Michis travails, we follow two younger characters: Himoru (Hayato Isomura), a recruiting agent who begins to doubt the moral basis of government-sponsored euthanasia, and Maria (Stephanie Arianne), a young Filipino care-giver eager to make some extra income to take care of her sick daughter.

Over the run of Plan 75, Ms. Hayakawa proves adept at composition and eliciting nuanced performances from her cast, but is somewhat iffier as a storyteller. The shape of the film proves unwieldy, as the three separate plot lines are allowed to meander too long before they begin to hint at a common dramatic purpose. By the time we reach the denouement, the picture has fizzled in momentum.

An editor with a firmer hand mightve righted this ship. In the meantime, Plan 75 touches upon a bevy of home truths with enough deftness to make it worth your while.

Mr. Naves is an artist, teacher and critic based in New York City. His writing has appeared in City Arts, The New Criterion,The New York Observer, Slate, The Spectator World, The Wall Street Journal, and other publications.

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Is Government-Sanctioned Euthanasia Really That Far-Fetched? - The New York Sun

Photo: Unsplash

Last week, it was reported that chief executives of community health programs in Victoria were phoned by government bureaucrats to warn them that they should brace for funding cuts of up to 15 per cent.

Violet Platt, the CEO of Palliative Care Victoria, told 7News that in the next ten years, there will be a 50 per cent increase in the need for palliative care and that funds are needed now to grow the specialist workforce that they will need to cater to this need going forward. Instead of more money, they will likely receive less. Platt also said that Palliative Care Victoria has had a shortfall in funding year-on-year for at least the last five years.

Is it a coincidence that the states euthanasia and assisted suicide were passed five years ago? Is it just blind chance that the year-on-year shortfall in palliative care funding coincided with the passage of these deathly laws? Will the parliamentary review of the euthanasia and assisted suicide laws, due to begin in June, give us the answer?

I doubt it will. Instead, we can expect that those who are pushing the euthanasia and assisted suicide bandwagon will advocate for further loosening of the laws to allow even more people access to lethal drugs.

We are already hearing the list of demands from activists.

They want to remove the requirement that a specialist in a patients condition be one of the doctors who signs off on their death. Instead, they want to allow even those with no expertise in a patients illness to be able to give them a terminal diagnosis and prescribe the lethal medication.

They also want to let these doctors be able to do it all by telehealth, so that they dont ever need to meet or physically examine a patient before approving their access to lethal meds. They want doctors to be able to suggest euthanasia to patients, ignoring the power imbalance between doctor and patient, and they want to scrap the idea that a patient should only have 6 months to live before being able to take their own lives, replacing it with any time after they receive a terminal diagnosis (even if they could live for years.)

Any one of these changes would guarantee that more people would be eligible for euthanasia and assisted suicide. All of them together would see the number killed each year expand significantly. The troubling thing is, though, that the program is already expanding at an exponential rate.

More than 600 people died in the first three years of the laws being in operation, which is more than double the number of deaths Victorian Premier Daniel Andrews anticipated would have occurred by now.

The small amount of information available shows the death rates are increasing. There were 131 euthanasia and assisted suicide deaths in the first year the laws came into effect and 269 deaths in its third year, an increase of more than 100 per cent in just three short years.

To put these numbers in perspective, the 269 euthanasia and assisted suicide deaths that occurred in Victoria in the 2021-2022 financial year is higher than the number of deaths that have occurred in any single year in Oregon, where assisted suicide has been legal since 1997. Victoria is already on track to double Oregons average annual number of deaths, despite the whole process being relatively new.

Rather than question why the number of deaths is already so high, I am certain that the review will make all the recommendations above and more ensuring that the death rate rises even higher.

It would be wonderful if we could trust that the parliamentary inquiry would take its focus off the activists and instead ask serious questions about palliative care availability and funding, and how a lack in each of these removes end-of-life choice for the terminally ill, but I am not that nave.

The horrible truth is that euthanasia and assisted suicide are budget-saving measures. Health care is expensive and health care at the end of life is the most expensive of all. Expanding the categories of eligibility not only appeases the death on demand activists, it saves money while being couched in language of compassion.

A good test for compassion, though, is whether it costs anything. A person (or a government) that claims to be acting out of compassion while saving themselves time, money and the need to strengthen the medical and palliative care workforce probably has a different motivation.

Compassion costs. Euthanasia doesnt.

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Victoria's rising euthanasia rate shows governments won't bear the ... - The Catholic Weekly

Ailing elephant increases her food intake, says zoo officials Four Paws team due to arrive next week

KARACHI: Although ailing elephant Noor Jehan has increased her food intake over the past two days, her worsening health complications have forced experts to look into the option of putting her down, it emerged on Wednesday.

Sources said the 17-year-old African elephant had developed skin lesions, apparently due to the cranes belts and ropes used to change her position twice a day.

The poor animal had been lying on the ground since her collapse in her enclosure after she was lifted out of the pond in which she reportedly fell a week back.

Her skin lesions are being treated while a team is preparing a soft harness best suited to her needs, an official told Dawn.

Noor Jehan, he said, had been showing positive signals over the past two days.

We had lost all hopes but her positive response in the last two days has once again raised our hopes. She has increased her food intake from around 12kg and 15kg to 40 kg in a day and is passing out stool and urine, he said, adding that she also moved her legs when lifted for changing her position.

Noor Jehan underwent complex diagnostic procedure early this month and was found to have a large haematoma in her abdomen and ruptured pelvic membrane. She collapsed days later and has since lain stricken on its side.

Currently, the zoo administration is anxiously waiting for the arrival of Four Paws, the international animal welfare group supervising the elephants treatment process.

The team is due to arrive on Monday morning.

Noor Jehans condition is getting complicated every passing day. The team on site doesnt have the experience and equipment to handle this extraordinary situation, said Dr Amir Khalil representing the animal welfare group.

He regretted that its not possible for the team to reach early as it had prior commitments and was currently engaged, attending to the needs of animals suffering in different parts of the world.

All experts including the on-site team have already given Noor Jehan a chance and her recovery chances were high following diagnosis and treatment a few weeks back. Its sad that she seems to be losing the opportunity after that accident [her fall in the pond].

The sources said the nine-member team recently set up by Karachi Metropolitan Corporation would weigh in all options including that of euthanasia.

We will fight till the end for her recovery, and the rest is in the hands of Allah. We are diligently following Four Paws instructions for treatment. She is still eating despite being on her side, pin-pricked by drips and regularly doused with water to cool her down, Karachi Zoo director Kanwar Ayub said when asked about euthanizing Noor Jehan.

It might be recalled that Noor Jehan had been in pain and misery for over four months and the KMC sought assistance from the NGO after her plight was highlighted in the media.

In August last year, the foreign experts performed major tusk surgeries on Noor Jehan and Madhubala, the other female elephant. This step followed intervention of the Sindh High Court, which was approached by the Pakistan Animal Welfare Society (Paws) and activists worried over animal plight.

Published in Dawn, April 20th, 2023

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Experts looking into option of euthanasia for Noor Jehan - DAWN.com

Philadelphias only animal care and control provider, which also handles the intake of animals, said dozens of dogs are at risk of euthanasia as the facility struggles to manage the spread of canine flu and pneumovirus, a respiratory illness that has spread rapidly in shelters in recent months.

The shelter, ACCT Philly, said it has to create a second shelter to temporarily house dogs exposed to canine flu for up to a month in order to limit further spread. Shelter operators consulted with disease control experts and found the infected animals will need to be separated from incoming dogs for up to 30 days to lower risk.

However, with an average of 100 dogs entering the shelter weekly, ACCT Philly said it is not able to close its doors because no other organization is capable of absorbing the influx.

The nonprofit said it is housing 120 dogs, and with a temporary space only able to accommodate 50 dogs, at least 70 of them are at risk of being put down.

There is no good time to do something like this, but unfortunately with the number of dogs who are getting sick, we dont have a humane alternative, Sarah Barnett, ACCT Phills executive director, said in a release. We continue to be here for the animals most in need in Philadelphia, and while this will be very challenging to pull off, we hope that the community will support us and help make this successful.

Barnett said volunteers to adopt a dog or foster a large dog for a month are desperately needed. If not, she called on the community for donations.

We are the only organization open 365 days a year 24/7, helping almost 16,000 animals each year, and we can only do so with the communitys investment, Barnett said.

Individuals can sign up to foster or adopt a large dog.

All adoption fees are waived for dogs over 40 pounds until April 23, and people who can foster large dogs will receive a $400 Visa gift card at the end of the month.

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More than 70 dogs in PA at risk of euthanasia by next week amid canine flu outbreak - SILive.com

Various attempts have previously been made to implement legislation that would legalise doctor-led euthanasia; it is undeniable that such reform must be introduced in contemporary politics. At present, assisted dying in England and Wales is deemed illegal under the Suicide Act of 1961. The Parliamentary Assembly of the Council of Europe defines euthanasia as an act intended to end a patients life at his or her persistent, carefully considered and voluntary request in order to relieve unbearable suffering. Support for lifting the ban on euthanasia has never been more prominent; it stems not only from 88% of the general public, but additionally from judicial authorities, the Medical Council as well as the Parliament itself.

A governing argument for such reform is that of personal autonomy, which is often balanced against the sanctity of life; arguing that without autonomy, a persons morality diminishes. Additionally, many prominent individuals believe that the right to life, provided in Article 2 of the European Convention on Human Rights, extends to the right to die. Human Rights arguments are raised, claiming that reforms similar to those made in Canada, Switzerland and the USA are necessary. Alternatively, it can be argued that the legalisation of euthanasia violates the states obligation to preserve life. Furthermore, such modification would create a slippery slope effect that would lead to the acceptance of severely immoral medical practices.

Nonetheless, the principle of personal autonomy must prevail in future legal reforms. Advocates for autonomous decisions raise the argument that respect for personal autonomy is one of the fundamental principles of medicinal practice, a concept that enables a mentally competent individual to act independently. The contemporary concept of autonomy is predominantly characterised by the efforts of John Stewart Mill, who implied that autonomy must be viewed as a prudential value; something that benefits an individual and compliments their life. To overlook an individuals personal choices would be to violate their dignity, it is an unconditional value that ensures that a person maintains a good quality of life. Its ignorance could potentially lead to mental distress and severe physical discomfort, not only for the individual, but also for their relatives.

It is important to consider that it is still a widely held belief that the sanctity of life must be protected, however, the term is derived from ancient times, back when it was impossible for an individual to be sustained by life support machines. Additionally, the possibility of a slippery slope is problematic, however, it must be remembered that such a possibility comes hand in hand with every systematic development. Though this does not automatically mean that the advancements proceeding the development of euthanasia will be immoral.

Multiple attempts have been constructed to change the legal situation regarding assisted suicide in the United Kingdom, dating back to the year 1931, during which Killick Millard proposed a Voluntary Euthanasia Bill. The most recent bill aimed at proposing a legal framework to legalise euthanasia was rejected by the House of Lords in October 2021.

In conclusion, it is an alarming infringement of a persons right to experience a life of intolerable pain and mental distress whilst there are medical professionals who are willing to assist them with euthanasia. The fundamental rights of every natural person, namely, liberty and personal autonomy are violated by the current law surrounding euthanasia in the United Kingdom. It is now time for the Parliament to introduce a reform which, unlike the previous attempts, will withstand the opposition within the House of Lords.

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Death Upon Request: Euthanasia and Assisted-Suicide - The Speaker