Category Archives: Euthanasia

WITH Premier Annastacia Palaszczuk riding high in the popularity stakes, there's a strong belief - particularly in Labor circles - she is home and hosed at the October 31 poll.

It's a conclusion easily reached, because the perception is that the Premier has handled the coronavirus crisis well, protecting most Queenslanders from its deadly ravages.

But the jury is out on how voters will judge Labor's cautious approach to the economic recovery, after Ms Palaszczuk resisted attempts for weeks to open the borders, despite advice from Canberra that it was safe.

Ms Palaszczuk's likability and her "steady as she goes'' approach will stand Labor in good stead, although integrity scandals, high youth crime, poor economic performance - even before COVID-19 - and a child safety crisis will not help.

Before Labor strategists get too carried away and start stockpiling the Moet for the celebratory drinks on poll night, there are a couple of factors to consider before October 31.

Those closest to God go to church - and like those who fish, they vote.

Many were not happy when they saw thousands of people marching in the streets with no repercussions and they were stopped from going to Sunday Mass.

They are also upset with the Government's pro-abortion laws and the fact Labor has not ruled out voluntary assisted dying reforms, better known as euthanasia.

If you think the Christian vote doesn't influence the outcome of elections, take a look at the federal Brisbane seat of Longman.

Few people gave the Coalition any hope of winning the Brisbane seat of Longman at last year's federal poll.

Ten months before the May 2019 federal poll, the Labor Party had won the Longman by-election after incumbent Susan Lamb became embroiled in the so-called parliamentary eligibility crisis.

Lamb retained the seat after LNP candidate Trevor Ruthenberg was outed for claiming to have been the recipient of the Australian Service Medal, a distinction higher than what he had actually received, the Australian Defence Medal.

"If I screwed up then I screwed up and all I can do is apologise,'' he told The Courier-Mail's Steven Wardill, who broke the story.

And while the medal controversy did the LNP candidate no favours, there were other factors at play.

Premier Annastacia Palaszczuk yesterday. Picture: Attila Csaszar

The Longman by-election was a major test for then Labor leader Bill Shorten.

As such, the Labor Party threw everything at the election, spending hundreds of thousands of dollars on campaigning and advertising.

Had Labor lost, Shorten would have had to walk the plank.

Far-left agitators Get Up! doorknocked the electorate and honed in on a controversial healthcare policy of the then Turnbull government.

But there was another factor that is often underestimated in the Longman by-election post-mortem.

It was the Christian vote, more specifically the Catholic vote.

At the time, the Turnbull government was being attacked by the Catholic Church for its independent schools funding policy, which they said threatened the viability of their educational offerings.

On that Super Saturday of by-elections, Catholic and Anglican priests told parishioners to vote for any party other than the Coalition.

They did - in droves.

Mr Turnbull changed that education funding anomaly and after being dumped as leader, it was Prime Minister Scott Morrison who reaped the benefits of the Catholics returning to the conservative fold.

With Shorten's politics of envy, a terrible, complacent Labor campaign and Morrison fighting for his political life, the LNP's Terry Young won Longman at the general election. Labor strategists had put Longman in the column that said "certain win''. The arrogance and hubris that was the hallmark of the 2019 campaign had not factored in the Longman peculiarities.

The lesson from Longman was clear: Don't underestimate the Christian vote, because it votes as a bloc.

On October 31, they'll be voting for the LNP.

The pro-life movement - Cherish Life - is about to let Queensland voters know about Labor's strong pro-abortion stance.

It has drawn up a hit list of 14 Labor seats - and one held by the Greens - which they say are vulnerable on October 31.

They include Townsville, Whitsunday, Gaven, Mundingburra, Mansfield, Maiwar, Barron River, Redlands, Keppel, Cairns, Springwood, Redcliffe, Pine Rivers, Mount Ommaney and Thuringowa.

All seats are held by margins of up to 5 per cent.

Cherish Life will also mount campaigns to retain five LNP seats that it sees as crucial to an LNP win.

Cherish Life says, based on number-crunching from previous elections, it can influence a seat by anything up to 3.5 per cent.

It says many swinging voters are appalled that the new pro-abortion legislation, passed in State Parliament in 2018, allows babies to be aborted with the approval of two doctors right up to birth, or full term.

Women do not need any medical approval up to 22 weeks to have an abortion.

The Australian Family Association has opposed so-called voluntary-assisted-dying reforms.

It has written to a state parliamentary inquiry on aged care, end-of-life and palliative care and voluntary assisted dying suggesting funding for palliative care be substantially increased "so that all terminally ill patients can receive the end-of-life care to which they are entitled''.

Under current law, doctor-assisted suicide and euthanasia are criminal offences in Queensland.

It would be safe to assume that anybody who opposes abortion and euthanasia in Queensland will not vote Labor.

There is no doubt that billionaire Clive Palmer's advertising blitzkrieg against Bill Shorten hurt Labor at the last federal election.

He spent $68 million to unsuccessfully elect Palmer United Party people, but in real terms what he did was amplify and reaffirm the notion that Shorten was dodgy - he says one thing in St Kilda and another thing in Clermont. Palmer is gearing up for a similar campaign against Ms Palaszczuk.

After all, current LNP president Dave Hutchinson is controversially close to Palmer - some say too close.

Then there's One Nation and the Katter Party, formidable forces, particularly in the regions. Their preferences will help the conservatives and if there's a hung parliament, expect Katter and Hanson to side with the LNP to form government.

This contest is far from over. It will go the full distance. Expect a split decision by the judges.

Cherish Life protesters rally outside Brisbanes Parliament House in 2018 to protest the late-term abortion Bill.

Originally published as Life-and-death issues that could cost Premier election

View original post here:

Life-and-death issues that could cost Premier election - Observer

Hrithik Roshan is among the top actors in Bollywood. The actor has excelled in acting, bodybuilding as well as dancing. Fans love him because of his distinctive style and his dedication towards his work. The amount of work Hrithik puts in his characters in the movies is unparalleled.

Also read:Hrithik Roshans Acclaimed Movies Which Established These firsts In Bollywood

Apart from his acting skills, Hrithik Roshan is also popular for his chiselled body as well as his swift dance moves. The actor has now worked in various popular films. Some of these include Zindagi Na Milegi Dobara, Jodhaa Akbar, Lakshya and many more. Check out Hrithik Roshan's movies that you can watch on Netflix.

Also read:Times Hrithik Roshan Played The Role Of Character With Emotional & Traumatic Past

Directed by Ashutosh Gowariker, Mohenjo Daro stars Hrithik Roshan, Pooja Hegde, and Kabir Bedi in lead roles. The story revolves around Sarman, a poor farmer who arrives in Mohenjo Daro, a city ruled by the tyrant Maham. He plans to take revenge on him.

Lakshya is a 2004 movie directed by Farhan Akhtar. The movie stars Hrithik Roshan, Preity Zinta and Amitabh Bachchan. The story follows an aimless young man, who joins the Indian Army and learns the struggles of a soldier.

This is a 2017 action-thriller that stars Hrithik Roshan and Yami Gautam. It also stars the brother-duo Rohit Roy and Ronit Roy. In this Sanjay Gupta directorial, Hrithik essays the role of a blind voiceover artist, Rohan Bhatnagar, who turns delusional after the perpetrators who raped his wife walk free.

Guzaarish tells the story of a former magician Ethan, who is a quadriplegic. He files a petition for euthanasia. His protege, Omar, a young magic enthusiast, convinces Ethan to pass on his legacy to him. The movie is directed by Sanjay Leela Bhansali and gives a strong message on euthanasia and the amount of physical and mental trauma a patient goes through.

Jodhaa Akbar is a 2008 film directed by Ashutosh Gowarikar. The movie stars Aishwariya Rai and Hrithik Roshan as Jodha and Akbar respectively. The movie tells the story of Jodha, who is a fiery Rajput princess who is obliged to marry Mughal Emperor Akbar for political reasons. Eventually, they develop mutual respect and love for each other.

With ZNMD, we got to see the importance of friendship and several other things in life. Directed by Zoya Akhtar, Zindagi Na Milegi Dobara stars Hrithik Roshan, Farhan Akhtar, and Abhay Deol. It is considered to bea compelling watch.

Get the latest entertainment news from India & around the world. Now follow your favourite television celebs and telly updates. Republic World is your one-stop destination for trending Bollywood news. Tune in today to stay updated with all the latest news and headlines from the world of entertainment.

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Hrithik Roshan starrers that are available to watch on Netflix; check list - Republic World - Republic World

It all started when Cheryl Wicks began walking dogs at the animal shelter for two hours a week.

One thing led to another, and now its huge, said Wicks, co-founder of Sammies Friends.

Sammies Friends has a contract with the Nevada County Sheriffs Department to run the Nevada County Animal Shelter, and celebrated 10 years of doing so Tuesday.

Over the years, when I think about all the people who have donated money or time, fostered animals, and volunteered in other ways, its very encouraging, said Wicks.

According to Wicks, Nevada County had a 68% rate of euthanasia for stray animals when she and her partner, Curt Romander, founded the organization. The rate is now less than 1%.

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Sammie, the inspiration for the nonprofits name, was a Shar-Pei Wicks adopted as a 7-week-old puppy who lived to be 16 years old. Never having had a pet until adulthood, Wicks doesnt consider herself to have had much of an animal background until Sammie, whom she calls an amazing dog that will now have an amazing legacy.

Wicks expressed that she would have enjoyed connecting with the community for a celebration of this milestone for Sammies Friends.

We had a fundraiser celebration planned for April which we had to cancel, and assuming that things improve, we plan to have it next April, she said, adding that this would make perfect timing to celebrate both this 10-year mark for operating the shelter and 20 years of Sammies Friends.

The local nonprofit has saved about 30,000 animals since 2001.

MAKING LIVES HAPPIER

As for the organizations goals in the near future, in light of some restriction as to how much in-person outreach can be done through events, its leadership is turning attention to internal projects.

The shelter itself is pretty old, and were looking to make it prettier and a bit more inviting, said Wicks. We try to figure out every possible way of making their lives happier while theyre in the shelter.

Shelter director Lizette Taylor, who has worked with the organization since 2012, echoed this, saying, While were waiting through this time, were trying to focus on how we can do more training, improve our systems, and polish the facility a bit more.

Reflecting on this milestone, Taylor said, Its funny because 10 years is a long time, but when youre doing this work, it goes so fast it feels like we just got started.

Taylor shared that one of the most impactful pieces of Sammies Friends work is the behavioral differences in animals after guidance and attention from dedicated staff.

The staff drive so much into these animals on a daily basis to love them and help them back into a place where they can be adopted, she said. It feels amazing all the things weve been able to do in these 10 years, and all the animals that have been adopted, rescued, and worked with.

Taylor said the community has continuously shown support for Sammies Friends throughout the years, but in especially high numbers throughout the last several months.

Without the public and the county, we wouldnt be here for 10 years, said Taylor. Were very grateful for the outpouring of support we see on a daily basis. We really appreciate the support of fosters, volunteers, and people who just throw love at us whenever they can.

Victoria Penate is a freelance writer for The Union.

Originally posted here:

Sammie's Friends celebrates 10-year anniversary of operating animal shelter - The Union of Grass Valley

Dear Dr. Fox: We have a 23-year-old female cocker spaniel named Ed. She was just diagnosed with very bad diabetes. It has been a heartbreaking ordeal.

The vet is still trying to determine what dose of Vetsulin to administer. She is currently refusing to eat, and has to be fed critical-care food orally by syringe. We will have to increase the feedings to give her the Vetsulin. She takes Entyce, an appetite stimulant, once per day. The vet said she may be insulin-resistant.

We have to make a decision as to what we will do, and we do not want her to suffer in any way. What advice you would give us? This is a most difficult decision to make, and our hearts are in such pain to think about seeing her go. L.P., New Rochelle, New York

Dear L.P.: Your dog has reached a remarkable age. From your account, it seems that chronic organ failure has set in, which could be partially rectified with various medications, after more tests and determining the proper dosages, but to what end?

If this were my dog, I would provide whatever she likes to eat and give her lots of tender loving care, and let her go. No more medications or tests. Whether this answer upsets or relieves you, let me know.

L.P. replied:

Dear Dr. Fox: Thank you for reaching out to me. Yesterday, we said goodbye to her, and my heart is crushed. Its so hard to lose our companions when we love them as family. Im trying to focus on believing we made the right decision in not allowing her to suffer, but its still very hard to convince myself. I have been filled with guilt and second-guessing if we decided to let her go too soon.

You have relieved me somewhat, and for that, Im grateful. Thank you for the wonderful work you do on behalf of all beloved animals.

Dear L.P.: I always hesitate to recommend euthanasia, because it is such a huge responsibility, and often a painful decision to make for a loved one. Most veterinarians feel this burden when having to euthanize terminally ill animal patients, and those whose owners cannot afford costly treatments that may or may not improve the animals quality of life. But there are some who would delay this, not necessarily just to make more money, but because they see some diseases as conditions that should always be treated. The caregiving burden and continued worry of the animals owner-clients must also be considered. Sending warm regards and my condolences.

United Feature Syndicate

Write to Dr. Fox c/o Universal Uclick, 1130 Walnut St., Kansas City, MO 64106.

See original here:

Dr. Fox: When to stop treatments and say goodbye - Winston-Salem Journal

Is Covid-19 making you push yourself too far at work? Could you be at risk of burnout?We explore what causes burnout, how to recognise and deal with it and how burnout can even become deadly.

GUESTSProfessor Michael Leiter has extensively researched the experience of burnout at work, most recently through Deakin University in Victoria.Dr Nadine Hamilton is a psychologist who works with veterinarians and her PhD research looked at vets lived experience of animal euthanasia.And sharing their stories of burnout, Marie Cecile Godwin UX designer and Editor of Burnout: lets reignite the flame; Alice Cooney, Law Institute of Victoria young lawyer president and vet Dr Claire Stevens.

This episode kicks off our four-part series: Performing in a Pandemic. We know that things wont snap back exactly to the way they were - so how do you prepare yourself to adjust to this new way of working? In our next episode: what to eat to optimise mental performance.

FURTHER INFORMATION:

Nadine's book is Coping with Stress and Burnout as a Veterinarian and her charity is Love Your Pet Love Your Vet.

Claire's book is Love Your Dog.

Producer: Maria Tickle

Never miss a show! Subscribe to our weekly podcast on theABC Listen app,Apple Podcasts,Google Podcastsor your favourite podcast app. (And if you enjoy the show help us out by rating us with those little stars it helps others find us.)

Producer: Maria Tickle

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"I was stuck in my bed, all I could do is cry" is COVID making you burnout at work? - ABC News

Delaware News Desk

FridayJul3,2020at6:00AM

She was saved from a high-risk shelter in Louisiana and flown to safety

Piper flew to Delaware on a plane, scared and unsure of her future.

What she didnt understand was that her chances of getting adopted in Louisiana were not good. In fact, Louisiana has the fifth highest euthanasia rate in the country and at 10 months old, she was just enough of an adult to put her at risk of being euthanized for space. While the Brandywine Valley SPCAs priority is the pets in their own community, if there is extra room at the shelter, they take pets like Piper to give them a second chance.

The next thing Piper knew, she in Georgetown, surrounded by new friends who were excited to meet her. Being a playful, affectionate girl, she couldnt stop her tail from wagging and she cuddled with everyone who pet her.

Piper is dreaming of a home with an active and loving family. She is definitely dog-friendly! Meet her at the Brandywine Valley SPCAs Georgetown campus.

Go here to read the rest:

Piper is ready to be a Delaware dog - Smyrna-Clayton Sun Times

Animal models, especially mice, have given scientists valuable insights into the mechanisms behind countless human diseases. They have been instrumental to the discovery of drug targets, metabolic pathways, and gene function. Theyve helped to lay bare the basic biochemistry of metabolism, hunger, cognition, and aging. Because mice are, to a certain extent, miniature facsimiles of human anatomy and genetics, science has an array of tools at its disposal to manipulate and visualize their bodily processes in real time, in highly controlled settings.

But, as the recent Covid-19 pandemic has revealed, science doesnt always have the tools to minimize loss of animal life. As the pandemic took hold and academic research labs across the U.S. shuttered indefinitely, scientists were faced with an unprecedented animal care dilemma. Without the teams of veterinary nurses and technicians who usually attend to the animals daily, many labs were forced to resort to wholesale euthanasia. Some labs sacrificed hundreds of animals, and were criticized harshly for their management of their experimental colonies. Many started to consider more durable, long-term plans for preserving and storing their mouse lines.

In the lab where I work at the University of California, San Francisco, and where for the past two years Ive been the designated rodent surgeon, we were asked to euthanize all but our most irreplaceable mice. As new animal researchers, we are trained to sacrifice our mice humanely to give them a dignified death. Returning to lab after the shutdown to find rows of empty racks that once held cages of mice we had worked with for months was a shock, and it was hard to conjure dignity in that moment.

That experience led me to reflect on how we as a research community use animal models in biomedical research, and how we might better use them in the future. And Ive become increasingly convinced that the animal model of the future will live not in a cage but in a computer chip: By simulating biological systems rather than experimenting with them, we can make drug development and biomedical research safer, more efficient, and more effective.

This is not to say that researchers treatment of animals has been haphazard. Research in animal models is highly regulated. These regulations vary in austerity from country to country and institution to institution, but they revolve around a common set of principles known as the three Rs: Replace the use of animals when possible, reduce the number of animals used per experiment, and refine methods to minimize suffering and improve welfare.

As the recent Covid-19 pandemic has revealed, science doesnt always have the tools to minimize loss of animal life.

A few years ago, when I was a new mouse surgeon, the three Rs were the guiding tenets of a week-long course I took at the Ren Remie Surgical Skills Center in Almere, Netherlands. The centers founder, Ren Remie, advocated for meticulous surgical technique, held to the same standards of sterility and post-operative care as any human surgical procedure. But he was also a proponent of the thinking that longer-term strategies can hasten recovery time from infection and surgical procedures. For instance, Remie and other researchers advocate whats called environmental enrichment, a method that helps animals cope with the inherent stress of being isolated after a surgical procedure or during an experiment. The researchers place toys, nesting material, or other inanimate objects in the cage that allow the mouse to engage with its surroundings, similar to the way it would in the wild. Studies suggest that environmental enrichment may even promote wound healing in rats.

But the success of strategies like environmental enrichment highlights an inherent weakness of the animal research model: An animals behavior is often extremely sensitive to its environment, in ways that are difficult if not impossible to control. This raises a perennial issue in biomedical research of just how reliably conclusions drawn based on studies in mice can be faithfully applied to human disease treatment. For instance, rodents are housed in groups as a rule, but certain kinds of experiments and treatments require them to be isolated, triggering a stress response that could significantly affect their immune activation. Studies have shown that mice and rats who live with companions fare better against injury, stroke, and even tumor growth than their lonely counterparts. As a result, when mice studies ask questions about human diseases, the housing status of the mouse is often a confounding factor. Even slight variation in the ambient temperature of a mouses housing room can cause stress responses that affect experimental outcomes. This variability is one reason that treatments that seem promising in mice often produce underwhelming outcomes in human clinical trials.

One attractive complement to animal studies that may address some of these shortcomings is in silico, or on a chip medicine. In silico models apply computational modeling strategies to genomic data to predict physiological responses to drugs or other stimuli. Although they are far from being able to replicate the full complexity of a living, sentient being, the U.S. Food and Drug Administration has begun consider computer modeling-based strategies to update the cumbersome and costly clinical trial pipeline. Research with in vitro models, which attempt to replicate animal physiology in test-tube style experiments, have also shown promise. These efforts have given birth to projects like the Comprehensive in Vitro Proarrhythmia Assay initiative, which integrates modeling and in vitro strategies to evaluate the potential for new drugs to cause heart rate abnormalities

Likewise, in 2013, the European Commission assembled a consortium of research groups known as the Avicenna Alliance to unify academia and industry around a set of standards for computer modeling in medicine. Based in Belgium but comprised of independent organizations around the world, the goal of the Alliance is to enable virtual clinical trials whose results can be validated by the same kinds of rigorous standards that are applied to traditional clinical trials.

As the Avicenna Alliance envisions them, virtual clinical trials would be based on unique genetic models derived from individual patients, rather than on large, genetically variable sample groups. Conceivably, this could allow a researcher to simulate a patients unique response to a treatment strategy, capturing the effects of subtle variations in baseline metabolism, bodyweight, or underlying health conditions that might influence the patients treatment outcomes. It might also significantly reduce the time and expense traditionally required to usher a new drug or medical device from the lab bench to the clinic potentially lowering the barrier to care for large swaths of the population who cant afford the often-astronomical costs of life-saving medications.

In silico clinical trials, if and when they are realized, could also address the long-standing problem of sample bias in drug development. Demographically, clinical trials tend to be disproportionately White and, until recently, overwhelmingly male. They therefore dont fully capture the therapeutic value and potential risks that drugs present to the patients who eventually rely on them. If in silico strategies become widely adopted, theyll hold potential to both increase the efficacy of new drugs and expand access to treatment.

The ethical debate around the use of animals in research has roiled for hundreds of years and will likely continue to do so. But what the Covid-19 outbreak has made clear is that there are severe weaknesses in the current animal model paradigm. As experiments have come to a halt during the coronavirus lockdowns, researchers have been given time to consider new, more sustainable approaches to discovery. Hopefully, we will look beyond the short-term technical challenges that will inevitably accompany the resumption of business as usual and gaze further afield, toward more humane, more modernized approaches to doing science.

Lindsay Gray is a lab manager at the University of California, San Francisco.

Original post:

In the Future, Lab Mice Will Live in Computer Chips, Not Cages - Undark Magazine

Reader unimpressed with HSUs previous leaders

Sundays article from Rollin Richmond on the evils of drink was interesting (What research says about alcohol and you, the Times-Standard, March 29, Page A4). Carrie Nation of the Womens Christian Temperance Union would have been proud. I wish that he had exercised that same intellectual and academic prowess while leading Humboldt State University. During his tenure he hired many administrative staff while letting the number of tenured professors dwindle.He helped recruit many students from Californias urban centers while doing very little to help them adapt to a rural setting.

He was responsible for scuttling the nursing program at HSU as being too costly; you know all those labs and things.

His successor didnt fare much better. Although she did help resurrect the nursing program in partnership with College of the Redwoods, something Rolland didnt do. She was successful in eliminating the football program after allowing the coaches to recruit student-athletes in the expectation of being able to play during their academic stay at HSU. Also she pulled the plug on KHSU, the universitys popular radio station weeks after conducting one of their periodic fundraising drives. Of course no notice, no appeals to the public, just the pulling of the plug.

In education parlance I would give Rollin and Lisa A+ for their personal retirement enrichment (you know, five years and out) and an Incomplete in their leadership.

John Kulstad, McKinleyville

Most medical experts agree it will take a number of months of limited social interaction to gain control over the COVID-19 virus. But President Trump sees this cure as more of a curse. For the sake of the U.S. economy, hed like to loosen things up in several weeks just in time for Easter.

The Republican Lt. Gov. Dan Patrick of Texas also wants the country to get back to business in weeks, not months. He says vulnerable seniors should understand we cant afford to sacrifice the countrys future because of the virus. In other words, if more seniors die its OK because the economy may not otherwise be strong enough to survive for younger generations.

I find his an interesting concept. In a sense Patrick is implying that seniors should agree to euthanasia to relieve pain, but not their own pain. Rather the pain that the economy is going through. In the U.S. today, in most states euthanasia is either illegal, or if legal, requires difficult steps to achieve. Here the Lt. Governor is approving euthanasia for all seniors a priori because he says it will benefit Americas future.

When I examine the two arguments above I find them both quite flawed. They both place the economy ahead of the health of U.S. citizens which I think is immoral by its very nature. And I also think both are examples of fake logic, which is sadly par for the course in the age of Trump.

Sherman Schapiro, Eureka

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Letters to the editor (March 31, 2020) - Eureka Times-Standard

People are doing what they can to stay healthy, but what about their pets?

Dr. Phyllis Sill is a veterinarian at Roscoe Veterinary Clinic. She says if you want to keep your dogs safe, there are certain things you shouldn't do:

"Dont let your dog suddenly go on a long run or a long walk if it hasntbeen conditioned to do so," she said. "They are probably going to end up with lameness issues or injuries." She continued, "Dont get a group of dogs together, they might fight."

Sill said it is important to think about things your dog can eat or swallow, like chocolate or the sugar substitute xylitol. "Try to keep them up and away," she warned, "because if dogs get into sugar-free gum, it can kill them."

The Roscoe Veterinary Clinic is considered an essential business; therefore it remains open amid Governor J.B. Pritzker's "stay-at-home" order. But, Sill said, even though they are open, they are only admitting patients with serious conditions.

"We are looking at patients who have growths or tumors that need to be removed," she said. "We are doing dentistries where our patients have uncomfortable mouths and maybe have teeth that need to be removed in order for them to eat better and do better," she added. "We are continuing to take X-rays and diagnose things that are going on orthopedically."

Sill gave examples of services they are not providing right now:

"We're trying to not have patients come in for things like a toenail trim," she said, "or vaccines that are maybe just coming due. We're trying not to have grooming type appointments except if the dog has a history of anal gland issues and we know the dog is going to be uncomfortable."

Sill said the practice now only allows one animal at a time in the building and staff are practicing curbside service with strict social distance guidelines. "We get as much of a history over the phone as we can," she said, "before we have a technician go out to the car. Then the technician brings the animal into the building."

Sill said clients aren't allowed inside the clinic unless it's for euthanasia. "Euthanasia is an extremely, extremely important part of [our] practice," she said. "People need to know that their animals went peacefully and the animals need to know that they were loved all the way until the end."

But other than that, clients may not enter the clinic. Sill said this act of social distancing helps keep the staff, public, and animals healthy. "It's nothing personal," she said. "We can't make an exception. If one person gets sick on our staff, we have to close our clinic."

Sill said most people understand why they are not allowed inside with their pets, but some do not. "They think we are being ridiculous," she said. "And that's just the one thing people have to understand -- that we want this to go away. We want to be done with it. This is not the way we want to process long term."

Sill said there are things people can do to eliminate human contact. Rather than hand a credit card to a technician, make the payment over the phone. "Think of all the times a technician has to either glove, de-glove, or just scrub in between each transaction," she said. "I promise you there is no identity theft whatsoever. We are just trying to do a transaction without touching cash or checks." She said over-the-phone payments will also speed up the process because it means less before and after santitizing.

Another thing people can do is not engage in a conversation during curbside pickup. "I don't want my technician talking through a rolled down window," she said. "It offers no protection whatsoever. So please, please, please, talk to us on the phone."

Looking ahead, Sill said, "I think this will be an unusual summer. I don't think this is going to easily and quickly go away. I think we're going to be dealing with this for months on end."

Even so, she said there isn't any need to panic. "We're going to get through this. I think everybody is trying to do what they're supposed to do."

And, Sill said, the main goal for animals remains the same as it is for other family members: Stay out of the emergency room.

The rest is here:

Veterinary Clinic Keeps Pets (& Their Humans) Safe Amid COVID-19 - WNIJ and WNIU

Reading Time: 8 minutesCaring for our elderly and terminally ill is expensive. But it is also a non-negotiable, fundamental duty of government.

It can be unethical to withdraw artificial hydration and nutrition and doing so can constitute a form of euthanasia that is, when its withdrawn with a primary intention to cause death. But withdrawal is not always unethical. Just as there are situations where it is justified to turn off a ventilator, so too there can be situations where it is justified to withdraw artificial hydration and nutrition.

Australias ABC networkrecently reported a storyof an elderly South Australian woman with dementia and breast cancer, who was not mentally competent and was being given hydration and nutrition through a nasogastric tube.

The tube fell out and the Public Advocate, who was the legal guardian of the patient and decision maker for her, determined that it should not be replaced. The reasons given included that the tube was burdensome, that it was prolonging suffering, and that replacing it would be contrary to the presumed wishes of the patient which is to say, if she were able to decide for herself, she would refuse replacement.

Two of the patients daughters, a Catholic bishop and the patients Catholic priest all disagreed with the Public Advocates decision and sought to change it. The daughters argued that the patient would want to live as long as possible and that replacing the tube was consistent with her Catholic faith.

The tube was not replaced, and the patient died five weeks later.

Now, despite being a truism, a very important principle in applied ethics is that good facts are essential for good ethics. The story as reported does not provide sufficient facts to judge whether or not the cessation of artificial feeding by means of a nasogastric tube was an ethically acceptable decision.

Its worth noting that hydration wasnotwithdrawn, but was delivered by intravenous line. So a pertinent question is: what justification was there for withdrawing nutrition, but not hydration? Either both hydration and nutrition were ethically appropriate life-prolonging treatment, or neither were.

One reason for the different approach to hydration as compared with nutrition could be that delivering total parenteral nutrition is a far more invasive procedure and more burdensome for the patient than, as occurred in this case, delivering hydration by way of an intravenous drip. The hydration might also have been continued as comfort care rather than life-prolonging treatment.

I was once consulted on a comparable case.

A young woman, who was diabetic and on haemodialysis for kidney failure, had a sudden cardiac arrest. She was revived and placed on a ventilator, but several days later, when she was due for dialysis, was diagnosed as being in a deep and irreversible coma.

Her parents decided that she should not receive dialysis, but they did not want the ventilator to be removed. We complied with their wishes in order to avoid further sufferingto them, not because we believed it was necessary treatment for the young woman. We explained in the case notes that was the reason the ventilator was continued. The young woman died a natural death from renal failure, at which time the ventilator was stopped.

What often causes great emotional trauma for a patients family, as was true in the South Australian case, is the thought of starving and dehydrating the patient to death in withdrawing artificial hydration and nutrition. There is, however, research that shows the hunger and thirst mechanisms in our brains shut down when we are dying.

The reflections of the Catholic Church on medical ethics are a frequently used reference point for bioethicists around the world. Even if they reject them, bioethicists respond to its concerns. This is especially true in a case such as the one we are considering, in which the patient and her carers are of that faith.

The Catholic Church teaches that food and fluids must always be offered and supplied if the person can take these orally. Pope John Paul II (now Saint Pope John Paul II) declared in a 2004 address that the same requirement of mandatory provision applies to artificial hydration and nutrition for people in a permanent vegetative state that is, hydration and nutrition not taken orally but delivered by other means.

With great respect, I believe that this statement needs to be nuanced. In that particular document its clear that the Pope wanted to protect vulnerable patients receiving artificial hydration and nutrition who are in a stable medical condition.

There are thousands of such patients in nursing homes and they have a right to humane basic care, as the Pope says. But the Pope might not have been thinking of the acceptability of withdrawal of artificial hydration and nutrition fromallpatients in a permanent vegetative state.

One problem is that if we apply this criterion to all such patients, it actually supports the euthanasia movement, as I shall explain below. But let me first attempt to make some distinctions that could help us to decide when withdrawal of artificial hydration and nutrition is ethical and when it is not.

It depends, first, on how we classify artificial hydration and nutrition: as simply food and water, or as medical treatment for a failed alimentary system (just as a ventilator is medical treatment for a failed respiratory system). If its just food and water and basic care, then ethically itmustbe provided. If it is medical treatment, that is not always the case.

I propose that, just as there are situations where it is justified to turn off a ventilator, so too there can be situations where it is justified to withdraw artificial hydration and nutrition. Both are forms of medical life-support treatment. And what if, for instance, a PEG feeding tube is painful or has become infected? What should doctors do then?

One distinction that is sometimes made in order to determine whether a given medical treatment must be offered is whether the intervention is ordinary or extraordinary medical treatment. The Catholic moral teaching is that the former must be provided, whereas the latter need not be.

Bishop Gregory OKellyis quotedas saying in his letter to the Office of the Public Advocate that, To deny food or drink, no matter how it is delivered, to such a person is to deny themordinary[emphasis added] means for sustaining life.

But this distinction betweenordinaryandextraordinarymedical treatment is not always clear cut. It can be that the patients quality of life is being judged and not the treatment. When a patient is in very fragile health in ICU, a certain treatment can be judged as extraordinary; but when the patient improves and is living in a nursing home, thesame treatmentfor the same personcan be characterised as ordinary.

In short, circumstances need to be taken into account. Moreover, whether a treatment is judged ordinary or extraordinary can be a very subjective and discretionary decision, which can leave it open to abuse.

Justifications for withdrawing life support treatment include that withdrawal is required to respect a patients right to refuse medical treatment, including through an advance directive that is, withdrawing treatment is required in order to respect a patients rights to inviolability (the right not to be touched without ones informed consent) and competent patients rights to autonomy.

Artificial hydration and nutrition would not be forcibly imposed on such a patient. Justifications also include: that the treatment is medically futile; that the burdens of continuing treatment outweigh any benefits; and that the treatment is prolonging dying, not living.

The Public Advocatedescribed the patient in questionas pre-terminal, which might or might not mean that she was dying, although her daughters denied that she was. With respect to the burden of the nasogastric tube, they are admittedly very uncomfortable, but its at least an open question whether the suffering involved for the patient could have justified not replacing it. Further questions include how the tube fell out (did the patient pull it out?) and whether, if the tube had not fallen out, its removal would have been justified?

To repeat, these decisions about providing or withdrawing artificial hydration and nutrition can be very difficult ones in relation to determining the right ethical path to take. Every case (and person) is different; assessments must be made on that basis and, importantly, in the light of all the relevant facts.

As I said, advocates of legalising euthanasia use cases such as the one describedin the ABC reportto promote their cause. They argue that withholding artificial hydration and nutritionis euthanasia often called slow euthanasia or passive euthanasia; therefore, we are already practising euthanasia and, if we are to be consistent, should recognise the legal right to do so by means of lethal injection.

Consequently, people who oppose the withdrawal of artificial hydration and nutrition when this withdrawal could be justified, and object to such a withdrawal on the grounds that it would be euthanasia, sadly help the pro-euthanasia cause.

Moreover, when members of the public think euthanasia isanyfailure to useallpossible means to prolong life and believe thatallrefusals of medical treatment that could prolong life are euthanasia, they respond positively to survey questions that ask, Do you agree with legalising euthanasia? because they want to have the right to refuse treatment. The publics responses are even more compromised when asked, If someone is in terrible pain and suffering should they be able to consent to euthanasia?

The option of saying yes to fully adequate pain and suffering management and no to euthanasia adopting a position that we must kill the pain and suffering, but not the personwiththe pain and suffering is often not possible in surveys. They tend to pose conjunctive questions (rather than two disjunctive ones)that is, do you agree with fully adequate pain and suffering managementandas a separate question, do you agree with euthanasia?.

It bears always keeping clearly in mind when discussing withdrawal of artificial hydration and nutrition that it can be employed unethically, when it does become a form of euthanasia that is, when its used with a primary intention to cause death.

This is most likely to occur when it is paired with an unwarranted use of palliative sedation, where the patient is unjustifiably deeply sedated until they die. Such a use is better called terminal sedation to differentiate it from the ethical use of palliative sedation, that is, when sedation is necessary and used appropriately to relieve a patients pain and suffering and not to hasten their death.

Margaret Somervilleis Professor of Bioethics in theSchool of Medicine and the Institute for Society and Ethics at the University of Notre Dame Australia.

This article was originally published at Mercatornet.com.

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Margaret Somerville: Withdrawing artificial hydration and nutrition - The Catholic Weekly