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Category Archives: Euthanasia

Euthanasia survey hints at support from doctors, nurses and division – Cootamundra Herald

Posted: June 26, 2017 at 5:48 pm

25 Jun 2017, 3 p.m.

NSW: Fewer than 30 per cent of doctors oppose the Voluntary Assisted Dying Bill, according to a survey.

Most NSW doctors and nurses support a controversial medical euthanasia bill headed for Parliament, according to research that could prompt new debateabout the medical fraternity's willingness to accept changes to assisted suicide laws.

A bill, to allow patients to apply for medically assisted euthanasia in specific circumstances when older than 25 (an age when informed consent is deemed reached), will be introduced to the NSW upper house in August for a conscience vote.

Dr Anne Jaumees, an anaesthetist based in western Sydney. A poll of doctors and nurses into what they think about euthanasia has just been conducted. Photo: Dominic Lorrimer

About 60 per cent of doctors support the Voluntary Assisted Dying Bill and fewer than 30 per cent oppose it, according to a surveyby market research company Ekas emailed to a database of 4000 NSW doctors it deemed "opinion leaders" and returned by about 500.

A smaller sample of about 100 nurses had support running at 80 per cent in favour of the law reform and opposition at fewer than 10 per cent.

A crowd-funding campaign forAnnie Gabrielides,a motor neurone disease suffererwho has progressively lost her ability to speak and is a euthanasia advocate, paid for the research.

"I'mconsistently hearing from doctors and medical expertsexpressing their sincere support of my campaign, but they're reluctant to speak out," she said.

The results suggest the medical profession and its famously powerful unions, not just Parliament, will be divided when debate on the bill kicks off.

The Australian Medical Association, which opposes changes to euthanasia law, warnedthe research could overstate doctors' support.

"It is likely that doctors with more strongly held opinions are responding to these surveys so caution must be used," AMA NSW president Brad Frankum said.

A national AMA poll of 4000 doctors last year found 50 per cent of doctors believed medical professionals should not be involved in assisted suicide, a spokesman emphasised.

But only slightly less than four in ten said they should, according to a news report.Combined with 12 per cent who neither agreed nor disagreed that left physicians close to evenly splitin some respects.

And anAustralian Doctorpoll of about 370 medicoslast year found about 65 per cent of doctors supported a change to the law on physician-assisted suicide ifstrict conditions, such as patients nearing the end of their lives and suffering "intolerable pain", some of which are mirrored in the NSW proposal, were met. About half told the journal they would be willing to help perform aprocedure.

NSW Nurses and Midwives Association general secretary Brett Holmes said: "The vast majority of nurses support change that enables medically assisted dying. Nurses know patients often choose more drastic means [to medically ending their life] in fear they cannot choose later."

A parliamentary report cited polls from the '90s that found nurses' support for euthanasia reform reached as high as about 75 per cent.

A dozen polls in the past decade hadfound between 75 to 80 per cent of Australians backed medically assisted euthanasia.

Western Sydney anaesthetistAnneJaumeesdoes too after working in palliative care for 15 years: "All their lives they want dignity and patients want that up until the end, too."

The bill is the product of cross-party collaboration and will only allow for applications frompatients expected to die within the coming year and experiencing extreme pain, suffering or incapacitation.

Safeguards proposed included allowing relatives to challenge applications in the Supreme Court,assessmentsby independent doctors and being subject to a 48-hour cooling-off period.

But Maria Cigolionisaid, while proponents arguedthe bill came laden with safeguards, it required no review of what palliative care patients had first sought before applying to end their lives or for alternatives to be suggested.

Overseas safeguards had been loosened so euthanasia could be applied forby people also suffering from psychosocial problems, Dr Cigolioni said.

"Instead of spending money on euthanasia reforms, we should be investing in psychosocial support programs to address suffering."

"People [will hasten the solution of death] when so many other things need to be looked at as the potential cause of that suffering," she said. "Once you change a criminal law [to allow] people to be killed, then [its conditions] can be extended beyond just being terminally ill, [and expand to include] the disabled and the aged and children, as it has in the Netherlands and Belgium."

The state budget last week announced a $100 million increase in funding for palliative care, something experts said would bring levels of NSW services into line with other states.

AMA policy recognises a divergence in doctors' views on euthanasia but it states doctors should not be involved in dispensing treatment that shortens a patient's life.

The Sydney Morning Herald

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ACT’s euthanasia bill ‘dangerous’ – professor | Radio New Zealand … – Radio New Zealand

Posted: at 5:48 pm

A Welsh professor of palliative medicine and cross-bench member of the House of Lords has arrived in New Zealand to challenge David Seymour's End of Life Choice Bill.

Ilora Finlay says that the End of Life Choice Bill is dangerous because it isn't at all restrictive. Photo: RBZ

The ACT leader's euthanasia bill was pulled from the members' ballot earlier this month to go before Parliament.

The End of Life Choice Bill would allow for assisted dying in cases where people are terminally ill but still mentally sound.

Ilora Finlay said that going by what had happened in Oregon and Belgium, the legalisation of assisted suicide in New Zealand would lead to 120 cases a year, while legalising euthanasia would lead to around 1200.

Baroness Finlay said Mr Seymour's bill was dangerous.

"It isn't restrictive at all, it also goes beyond physician-assisted suicide and it goes to euthanasia, but you do fundamentally change the relationship between the doctor and the patient when you go down that road."

Ilora Finlay will take part in a public panel discussion at Parliament on Wednesday.

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The time has come for euthanasia | Stuff.co.nz – Waikato Times

Posted: at 5:48 pm

PETER DORNAUF

Last updated05:00, June 26 2017

Mario Anzuoni

The documentary Autopsy focuses on the sudden and tragic end to Robin Williams' life.

OPINION: Recently I watched a television documentary called Autopsy, about the actor/comedianRobin Williams. It focused on the suddenand tragic end to his life, probing the events of his last days to unpick the reasons behind the man's shocking suicide.

It was revealed that Williams was suffering from Parkinson's disease, but that debilitating illness wasn't the thing which had brought him to the brink and pushed him over. There was something much darker going on deep in his mind which the autopsy finally exposed. He was suffering from early onset Alzheimer's, a humiliating and cruel death sentence for a man whose sharp mind was his identity as well as his bread and butter.

Williams was obviously aware that something was seriously amiss and intuited what it was early in the piece. In someone still with years ahead of him, it must have come as a devastating blow.

But what was most distressing for the viewerwas the re-enactment of what transpired as Robin Williams, the man who had brought so much wit, insight and laughter to the world, attempted to bring his life to a close, alone, without goodbyes, clumsily, painfully, violently.

Afterward, I thought how things could have been so much different in a more civilised society where assisted suicide was legal.

Currently, Parliament is to debate and vote on the issue of euthanasia. We've had to fight tooth and nail just to get some relaxation of the use of medical marijuana for suffering and terminally ill patients, so I can just imagine, in a society of roughneckswhere "suck it up"is the prevailing attitude among some, how difficult any move toward liberalisation is going to be.

Someone made the comment recently that the trouble lies with the fact that many of our rule-makers are religious, our prime minister leading the pack. It was expressed crudely and bluntly by Catholic adherentJohn Collier, who responded to the issue by saying, "Thou shalt not kill, and that's the end of it."

Such closed-mindedness demonstrates both a supreme lack of empathy for suffersas well as a denial of the right to choose for others. But more significantly it is a classic oversimplification of the matter. Reducing complex ethical questions to parroting some rote and formulaic code is lazy moral thinking. It is something the philosopher Jean Paul Sartre would have called"bad faith", a kind of moral sloth that attempts to escape from the burden of ethical responsibility on hard questions.

It also conveniently overlooks the fact that the god who is touted with issuing such a commandordered the wholesale slaughter of communities involving men, women and children. Obviously there is some wiggle room here.

Here in Hamilton, my own family is no stranger to the terrible suffering surrounding dementia and suicide. I cannot bear to think what must have been going through my grandmother's tortured mind as she took herself down to the edge of the Waikato River one morning and threw herself in.

It happened when I was 10 and all of it was rightly kept from us children to be discovered later in life. But how shockingly monstrous for my father, who never spoke of it once - about a mother, forced by the law of the land, to take such desperate measures at the end of her life.

Imagine an alternative in another time and place where she would have been able to tell her children she had had enough of life and they'd all been able to gather in a room and spend the last days together, hugged, kissed, said lovely things and said goodbye, and then quietly, with dignity, she, a doctor in attendance, could have gone to sleep.

But not here. You have to suffer to the bitter end here, albeit drugged to the eyeballs, or alternatively, hang, drown or shoot yourself, alone, forlorn and forsaken.

Some may want to cling on to the last remaining days or painful stupefying minutes of life. That is happily their choice. But others may not. At the moment, these people have other civilised options blocked off to them.

We have many rights, but the most profound one is legally denied us and so people, suffering, tired of life, have to resort to terrible means, by themselves, to terminate it. It seems quite barbarous.

What is legal already in eightcountries around the world should be made so here, surrounded with all the important and necessary safeguards.

A little boy of 10 would not have been able to handle those tragic events so many years ago. But my arms go out to you now, Grandma, wishing for a better place where I could have walked back with you, up and away from that river, holding your hand.

-Stuff

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Euthanasia survey hints at support from doctors, nurses and division – Yass Tribune

Posted: June 25, 2017 at 2:40 pm

25 Jun 2017, 3 p.m.

NSW: Fewer than 30 per cent of doctors oppose the Voluntary Assisted Dying Bill, according to a survey.

Most NSW doctors and nurses support a controversial medical euthanasia bill headed for Parliament, according to research that could prompt new debateabout the medical fraternity's willingness to accept changes to assisted suicide laws.

A bill, to allow patients to apply for medically assisted euthanasia in specific circumstances when older than 25 (an age when informed consent is deemed reached), will be introduced to the NSW upper house in August for a conscience vote.

Dr Anne Jaumees, an anaesthetist based in western Sydney. A poll of doctors and nurses into what they think about euthanasia has just been conducted. Photo: Dominic Lorrimer

About 60 per cent of doctors support the Voluntary Assisted Dying Bill and fewer than 30 per cent oppose it, according to a surveyby market research company Ekas emailed to a database of 4000 NSW doctors it deemed "opinion leaders" and returned by about 500.

A smaller sample of about 100 nurses had support running at 80 per cent in favour of the law reform and opposition at fewer than 10 per cent.

A crowd-funding campaign forAnnie Gabrielides,a motor neurone disease suffererwho has progressively lost her ability to speak and is a euthanasia advocate, paid for the research.

"I'mconsistently hearing from doctors and medical expertsexpressing their sincere support of my campaign, but they're reluctant to speak out," she said.

The results suggest the medical profession and its famously powerful unions, not just Parliament, will be divided when debate on the bill kicks off.

The Australian Medical Association, which opposes changes to euthanasia law, warnedthe research could overstate doctors' support.

"It is likely that doctors with more strongly held opinions are responding to these surveys so caution must be used," AMA NSW president Brad Frankum said.

A national AMA poll of 4000 doctors last year found 50 per cent of doctors believed medical professionals should not be involved in assisted suicide, a spokesman emphasised.

But only slightly less than four in ten said they should, according to a news report.Combined with 12 per cent who neither agreed nor disagreed that left physicians close to evenly splitin some respects.

And anAustralian Doctorpoll of about 370 medicoslast year found about 65 per cent of doctors supported a change to the law on physician-assisted suicide ifstrict conditions, such as patients nearing the end of their lives and suffering "intolerable pain", some of which are mirrored in the NSW proposal, were met. About half told the journal they would be willing to help perform aprocedure.

NSW Nurses and Midwives Association general secretary Brett Holmes said: "The vast majority of nurses support change that enables medically assisted dying. Nurses know patients often choose more drastic means [to medically ending their life] in fear they cannot choose later."

A parliamentary report cited polls from the '90s that found nurses' support for euthanasia reform reached as high as about 75 per cent.

A dozen polls in the past decade hadfound between 75 to 80 per cent of Australians backed medically assisted euthanasia.

Western Sydney anaesthetistAnneJaumeesdoes too after working in palliative care for 15 years: "All their lives they want dignity and patients want that up until the end, too."

The bill is the product of cross-party collaboration and will only allow for applications frompatients expected to die within the coming year and experiencing extreme pain, suffering or incapacitation.

Safeguards proposed included allowing relatives to challenge applications in the Supreme Court,assessmentsby independent doctors and being subject to a 48-hour cooling-off period.

But Maria Cigolionisaid, while proponents arguedthe bill came laden with safeguards, it required no review of what palliative care patients had first sought before applying to end their lives or for alternatives to be suggested.

Overseas safeguards had been loosened so euthanasia could be applied forby people also suffering from psychosocial problems, Dr Cigolioni said.

"Instead of spending money on euthanasia reforms, we should be investing in psychosocial support programs to address suffering."

"People [will hasten the solution of death] when so many other things need to be looked at as the potential cause of that suffering," she said. "Once you change a criminal law [to allow] people to be killed, then [its conditions] can be extended beyond just being terminally ill, [and expand to include] the disabled and the aged and children, as it has in the Netherlands and Belgium."

The state budget last week announced a $100 million increase in funding for palliative care, something experts said would bring levels of NSW services into line with other states.

AMA policy recognises a divergence in doctors' views on euthanasia but it states doctors should not be involved in dispensing treatment that shortens a patient's life.

The Sydney Morning Herald

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Euthanasia survey hints at support from doctors, nurses and division - Yass Tribune

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Euthanasia by text? Michelle Carter case impacts more than just free speech – The Sydney Morning Herald

Posted: at 2:40 pm

In 2014, Michelle Carter, then 17, used text messages to "encourage" her 18-year-old boyfriend Conrad Roy III to kill himself. Roy was found dead from carbon monoxide poisoning in his truck.

While the dust is still settling from this month's decision by a Massachusetts judge to convict the young "suicide texter" of involuntary manslaughter, the reaction on social media has been swift and savage.

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A Massachusetts judge finds Michelle Carter guilty of urging her boyfriend's death with text messages.

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A Massachusetts judge finds Michelle Carter guilty of urging her boyfriend's death with text messages.

On my own Facebook page, within hours of the verdict, I received nothing short of 100 irate responses to a hitherto gentle post I made casting doubt on Carter's legal, if not moral, blame for Roy's suicide.

I pondered if this was fair reason to use the very serious crime of manslaughter to teach young people a lesson in online behaviour? Clearly, Judge Lawrence Moniz thinks it is just the remedy, and in the virtual world of the internet he has many friends.

I'm not alone in worrying that the guilty decision in this judge-only criminal trial will have unintended consequences. For almost everyone involved in the debate over assisted suicide as a human right, we are all now much more concerned, and with good reason.

Mathew Segal of the Massachusetts Civil Liberties Union saysthe conviction of Carter exceeds the limits of US criminal laws and violates the free speech protections contained in the constitution at a state and federal level.

Segalnotes that, for those having or likely to have "end-of-life discussions" with their loved ones -and let's face it, that will be many of us -Carter's conviction strikes a very real chill.

New York attorney Ari Diaconistakes the debate one step further, arguing that Judge Moniz has conflated "morality and legality" and it is this that makes life post-Carter a different ball game altogether.

On the facts, Roy killed himself.He was not with Carter. She did not help him prepare for his death. What she did do was text him, not once, but often. Was Carter a good person on the night of Roy's death? Clearly not. Carter's text urging Roy to go through with his death - "I f---ingtold him to get back in [the truck]" - is not how a good girlfriend, a caring friend, would behave. But does this make her a criminal?

Just as suicide is lawful in Australia, being a bad person is not necessarily unlawful. Diaconis is correct. It is important not to conflate the law with morality, yet that is exactly what Judge Moniz has done. The challenge of keeping subjectivity out of the Carter case was something the court was acutely aware of from the get go.

In allowing the case to go to trial, the Massachusetts Judicial Court tried hard to create a narrow framework for argument. The case was not, it said"about a person ameliorating the anguish of someone confronting terminal illness and questioning the value of life".

Nor was it "about offering support, comfort, and even assistance to a mature adult who, confronted with such circumstances, has decided to end his or her life". By process of elimination, the court tried to delineate "good" suicide assistance from the reckless, misdirected and dangerous advice offered by Carter.

However, from a legal point of view, like it or not, Carter's guilty verdict has created a climate where any response to talk by a person considering ending their life is now problematic.

This is especially as Carter had earlier tried to convince her boyfriend to get help for his suicidal thoughts. She had supported him in choosing life. Her later support for Roy's suicide was certainly the result of misguided youth. But should her morally bad-person behaviour (what some might call misguided foolish youthfulness) make her a criminal? I don't think so. It is this apparent sureness of intent on the part of the Massachusetts Judicial Court that makes Carter's business our business, even here in Australia.

For instance, can a doctor (or close friend or loved one) talk to a terminally ill patient (or friend) if that mentally capable person has made the decision to end their life? Dare they agree in writing -say via a WhatsApp message -with the loved one's decision?

The legal answer is now 50 shades of grey darker.

Ironically, the assisted suicide movement's very existence depends on our ability to speak openly to people considering dying with dignity.

While the 80-year-olds whom I deal with on a daily basis are far from the troubled teen who was Roy, our chats occuron the phone, on email and in our online discussion forums. I have always gone out of my way to neither encourage nor discourage a terminally ill person, or an elderly person, who seeks my "counsel" to take one course of action over another. What I have done for the past 20 years is provide a safe and understanding space for the communication to take place.

Tricky questions abound daily. Should I be worried about what I say in response or what medium I choose? Open discussion is an essential part of the decision-making process that can surround dying. A healthy society must insist that it should not be shut down.

Dr Philip Nitschke is the director of Exit International.

Support is available for those who may be distressed by phoning Lifeline 13 11 14;Mensline1300 789 978; Kids Helpline 1800 551 800;beyondblue1300 224 636.

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The time has come for euthanasia – Waikato Times

Posted: at 2:40 pm

PETER DORNAUF

Last updated05:00, June 26 2017

Mario Anzuoni

The documentary Autopsy focuses on the sudden and tragic end to Robin Williams' life.

OPINION: Recently I watched a television documentary called Autopsy, about the actor/comedianRobin Williams. It focused on the suddenand tragic end to his life, probing the events of his last days to unpick the reasons behind the man's shocking suicide.

It was revealed that Williams was suffering from Parkinson's disease, but that debilitating illness wasn't the thing which had brought him to the brink and pushed him over. There was something much darker going on deep in his mind which the autopsy finally exposed. He was suffering from early onset Alzheimer's, a humiliating and cruel death sentence for a man whose sharp mind was his identity as well as his bread and butter.

Williams was obviously aware that something was seriously amiss and intuited what it was early in the piece. In someone still with years ahead of him, it must have come as a devastating blow.

But what was most distressing for the viewerwas the re-enactment of what transpired as Robin Williams, the man who had brought so much wit, insight and laughter to the world, attempted to bring his life to a close, alone, without goodbyes, clumsily, painfully, violently.

Afterward, I thought how things could have been so much different in a more civilised society where assisted suicide was legal.

Currently, Parliament is to debate and vote on the issue of euthanasia. We've had to fight tooth and nail just to get some relaxation of the use of medical marijuana for suffering and terminally ill patients, so I can just imagine, in a society of roughneckswhere "suck it up"is the prevailing attitude among some, how difficult any move toward liberalisation is going to be.

Someone made the comment recently that the trouble lies with the fact that many of our rule-makers are religious, our prime minister leading the pack. It was expressed crudely and bluntly by Catholic adherentJohn Collier, who responded to the issue by saying, "Thou shalt not kill, and that's the end of it."

Such closed-mindedness demonstrates both a supreme lack of empathy for suffersas well as a denial of the right to choose for others. But more significantly it is a classic oversimplification of the matter. Reducing complex ethical questions to parroting some rote and formulaic code is lazy moral thinking. It is something the philosopher Jean Paul Sartre would have called"bad faith", a kind of moral sloth that attempts to escape from the burden of ethical responsibility on hard questions.

It also conveniently overlooks the fact that the god who is touted with issuing such a commandordered the wholesale slaughter of communities involving men, women and children. Obviously there is some wiggle room here.

Here in Hamilton, my own family is no stranger to the terrible suffering surrounding dementia and suicide. I cannot bear to think what must have been going through my grandmother's tortured mind as she took herself down to the edge of the Waikato River one morning and threw herself in.

It happened when I was 10 and all of it was rightly kept from us children to be discovered later in life. But how shockingly monstrous for my father, who never spoke of it once - about a mother, forced by the law of the land, to take such desperate measures at the end of her life.

Imagine an alternative in another time and place where she would have been able to tell her children she had had enough of life and they'd all been able to gather in a room and spend the last days together, hugged, kissed, said lovely things and said goodbye, and then quietly, with dignity, she, a doctor in attendance, could have gone to sleep.

But not here. You have to suffer to the bitter end here, albeit drugged to the eyeballs, or alternatively, hang, drown or shoot yourself, alone, forlorn and forsaken.

Some may want to cling on to the last remaining days or painful stupefying minutes of life. That is happily their choice. But others may not. At the moment, these people have other civilised options blocked off to them.

We have many rights, but the most profound one is legally denied us and so people, suffering, tired of life, have to resort to terrible means, by themselves, to terminate it. It seems quite barbarous.

What is legal already in eightcountries around the world should be made so here, surrounded with all the important and necessary safeguards.

A little boy of 10 would not have been able to handle those tragic events so many years ago. But my arms go out to you now, Grandma, wishing for a better place where I could have walked back with you, up and away from that river, holding your hand.

-Stuff

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The time has come for euthanasia - Waikato Times

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Euthanasia survey hints at support from doctors, nurses and division – The Sydney Morning Herald

Posted: June 24, 2017 at 2:53 pm

Most NSW doctors and nurses support a controversial medical euthanasia bill headed for Parliament, according to research that could prompt new debateabout the medical fraternity's willingness to accept changes to assisted suicide laws.

A bill, to allow patients to apply for medically assisted euthanasia in specific circumstances when older than 25 (an age when informed consent is deemed reached), will be introduced to the NSW upper house in August for a conscience vote.

About 60 per cent of doctors support the Voluntary Assisted Dying Bill and fewer than 30 per cent oppose it, according to a surveyby market research company Ekas emailed to a database of 4000 NSW doctors it deemed "opinion leaders" and returned by about 500.

A smaller sample of about 100 nurses had support running at 80 per cent in favour of the law reform and opposition at fewer than 10 per cent.

A crowd-funding campaign forAnnie Gabrielides,a motor neurone disease suffererwho has progressively lost her ability to speak and is a euthanasia advocate, paid for the research.

"I'mconsistently hearing from doctors and medical expertsexpressing their sincere support of my campaign, but they're reluctant to speak out," she said.

The results suggest the medical profession and its famously powerful unions, not just Parliament, will be divided when debate on the bill kicks off.

The Australian Medical Association, which opposes changes to euthanasia law, warnedthe research could overstate doctors' support.

"It is likely that doctors with more strongly held opinions are responding to these surveys so caution must be used," AMA NSW president Brad Frankum said.

A national AMA poll of 4000 doctors last year found 50 per cent of doctors believed medical professionals should not be involved in assisted suicide, a spokesman emphasised.

But only slightly less than four in ten said they should, according to a news report.Combined with 12 per cent who neither agreed nor disagreed that left physicians close to evenly splitin some respects.

And anAustralian Doctorpoll of about 370 medicoslast year found about 65 per cent of doctors supported a change to the law on physician-assisted suicide ifstrict conditions, such as patients nearing the end of their lives and suffering "intolerable pain", some of which are mirrored in the NSW proposal, were met. About half told the journal they would be willing to help perform aprocedure.

NSW Nurses and Midwives Association general secretary Brett Holmes said: "The vast majority of nurses support change that enables medically assisted dying. Nurses know patients often choose more drastic means [to medically ending their life] in fear they cannot choose later."

A parliamentary report cited polls from the '90s that found nurses' support for euthanasia reform reached as high as about 75 per cent.

A dozen polls in the past decade hadfound between 75 to 80 per cent of Australians backed medically assisted euthanasia.

Western Sydney anaesthetistAnneJaumeesdoes too after working in palliative care for 15 years: "All their lives they want dignity and patients want that up until the end, too."

The bill is the product of cross-party collaboration and will only allow for applications frompatients expected to die within the coming year and experiencing extreme pain, suffering or incapacitation.

Safeguards proposed included allowing relatives to challenge applications in the Supreme Court,assessmentsby independent doctors and being subject to a 48-hour cooling-off period.

But Maria Cigolionisaid, while proponents arguedthe bill came laden with safeguards, it required no review of what palliative care patients had first sought before applying to end their lives or for alternatives to be suggested.

Overseas safeguards had been loosened so euthanasia could be applied forby people also suffering from psychosocial problems, Dr Cigolioni said.

"Instead of spending money on euthanasia reforms, we should be investing in psychosocial support programs to address suffering."

"People [will hasten the solution of death] when so many other things need to be looked at as the potential cause of that suffering," she said. "Once you change a criminal law [to allow] people to be killed, then [its conditions] can be extended beyond just being terminally ill, [and expand to include] the disabled and the aged and children, as it has in the Netherlands and Belgium."

The state budget last week announced a $100 million increase in funding for palliative care, something experts said would bring levels of NSW services into line with other states.

AMA policy recognises a divergence in doctors' views on euthanasia but it states doctors should not be involved in dispensing treatment that shortens a patient's life.

See the rest here:

Euthanasia survey hints at support from doctors, nurses and division - The Sydney Morning Herald

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A Dutch euthanasia pioneer surveys the wreckage and despairs – BioEdge

Posted: at 2:53 pm

If there is anyone who could be called a patron saint of Dutch euthanasia, it is the psychiatrist Boudewijn Chabot. In 1991 he gave one of his patients, Mrs B, a lethal dose of medication. After accompanying her until she died he reported himself to the police and was subsequently tried. In 1993, the Supreme Court declare that he was guilty of assisting a suicide, but did not punish him and allowed him to keep practicing medicine.

Physically, there was nothing wrong with Mrs B. Nor did she have depression. But her personal life was tragic and Dr Chabot felt that she in a state of existential distress that she should be allowed to die. It was a landmark case in the steady advance towards legalisation in 2002.

That was 25 years ago. Now Dr Chabot looks back and is horrified. Writing in one of the leading Dutch newspapers, NRC Handelsblad, he says that legal safeguards for euthanasia are slowly eroding away and that the law no longer protects people with psychiatric condition and dementia.

The Dutch are complacent about their famous law, he says. But there is no room for complacency.

Under current legislation, euthanasia is only legal if a doctor believes that three conditions have been met: (1) the request must be voluntary and deliberate; (2) there must be unbearable suffering with no hope of improvement; and (3) there must no reasonable alternative to euthanasia.

However, as euthanasia has sunk its roots deeper and deeper into Dutch medicine, the second and third conditions have shrivelled up. Patients define what is unbearable and they define what is a reasonable alternative. Unhappiness can be unbearable and a nursing home may not be a reasonable alternative. So, as one ethicist has observed, requirements (2) and (3) add little to the requirement of a voluntary and thoughtful request. Autonomy has trumped medicine. As a result, the number of euthanasia cases roughly tripled between 2007 and 2016, from 2000 to 6000.

In itself, this does not bother Dr Chabot. After all, he is the Grand Old Man of Dutch euthanasia. He says that he is prepared to accept tens of thousands of euthanasia cases. But he is aghast at the rapid rise in the number of people with psychiatric illness or dementia who have been euthanised:

What does worry me is the increase in the number of times euthanasia was performed on dementia patients, from 12 in 2009 to 141 in 2016, and on chronic psychiatric patients, from 0 to 60. That number is small, one might object. But note the rapid increase of brain diseases such as dementia and chronic psychiatric diseases.More than one hundred thousand patients suffer from these diseases, and their disease can almost never be completely cured.

One sign of the changing times is the rapid expansion of the services of the End of Life Clinic Foundation (Stichting Levenseindekliniek). This organisation offers euthanasia to patients whose own doctors have refused. They never offer to treat the underlying illness, whether it is physical or mental.

By 2015, a quarter of euthanasia cases on demented patients were performed by these doctors; in 2016 it had risen to one third. By 2015, doctors of the End of Life Clinic performed 60 percent of euthanasia cases in chronic psychiatric patients, by 2016 that had increased to 75 percent (46 out of 60 people).

Last year, Dr Chabot points out, doctors from the End of Life Clinic each performed about one euthanasia every month. What happens to doctors for whom a deadly injection becomes a monthly routine? he asks.

Now the End of Life Clinic is recruiting psychiatrists to service the mentally ill and demented. One obvious problem is that there is a shortage of good psychiatric help in the Netherland which tends to take a long time have an effect, in any case because of budget cuts.

Without a therapeutic relationship, by far most psychiatrists cannot reliably determine whether a death wish is a serious, enduring desire. Even within a therapeutic relationship, it remains difficult. But a psychiatrist of the clinic can do so without a therapeutic relationship, with less than ten in-depth conversations? Well

Dr Chabot is deeply sceptical about euthanasia for the demented: we are dealing with a morally problematic act: how do you kill someone who does not understand that he will be killed?.

How? It turns out that sometimes a relative or doctor secretly laces their food or drink with a sedative to make it easier to give them a lethal injection. In one notorious case last year, the sedative didnt work and relatives pinned the terrified woman to the bed while the doctor gave the lethal injection. Dr Chabot was astonished to discover that surreptitious administration of medication has previously occurred, but has never been mentioned in an annual report.

Isnt anyone paying attention to these developments, Dr Chabot asks.

The euthanasia practice is running amok because the legal requirements which doctors can reasonably apply in the context of physically ill people, are being declared equally applicable without limitation in the context of vulnerable patients with incurable brain diseases. In psychiatry, an essential limitation disappeared when the existence of a treatment relationship was no longer required. In the case of dementia, such a restriction disappeared by making the written advance request equivalent to an actual oral request. And lastly, it really went off the tracks when the review committee concealed that incapacitated people were surreptitiously killed.

After surveying the wreckage of the euthanasia law, Dr Chabot concludes bitterly,

I dont see how we can get the genie back in the bottle. It would already mean a lot if wed acknowledge hes out.

Michael Cook is editor of BioEdge. Dr Chabots original article in NRC Handelsblad was translated by Professor Trudo Lemmens, of the University of Toronto Faculty of Law. Excerpts have been republished from his blog with permission.

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A Dutch euthanasia pioneer surveys the wreckage and despairs - BioEdge

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Medical students’ perspectives on euthanasia – BioEdge

Posted: at 2:53 pm

What do medical students think about euthanasia? A new article in the journal Chest discusses some of the concerns held by the next generation of US medical professionals. The authors of the paper, students from several of the leading medical schools in the country, express grave concerns about the normalisation of euthanasia in end-of-life care.

Commenting on new legislation introduced in US states such as Colorado, the authors remark:

Doctor-patient trust, the authors assert, is founded upon the notion that doctors will commit to doing their best to heal and care for patients and will not intentionally kill those entrusted to their care. The students fear that PAS/E violates the fundamental bond of trust.

Indeed, the authors call upon doctors to return to the original meaning of euthanasia:

The American Medical Student Association currently has a position of conditional support for physician aid in dying.

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Medical students' perspectives on euthanasia - BioEdge

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Disabled Professor: Nazi Euthanasia Program No Different Than Push to Euthanize People Today – LifeNews.com

Posted: at 2:53 pm

Recently the euthanasia lobby attacked Dr Harvey Schipper for comparing assisted dying to the Nazi T-4 euthanasia program. This would not have been a big deal other than that fact that Schipper had been appointed to chair a working group that was to examine Canadas euthanasia law and make recommendations concerning possible extensions to the law.

Catherine Frazee, who is an Officer of the Order of Canada and professor emerita at the Ryerson University School of Disability Studies wrote an article titled: Look into the dark corners of history that was published in the Victoria Times Colonist on June 15. Frazee wrote:

None of Schippers critics disputed the facts upon which his reference was made, nor should they. As historians have chronicled, the Nazi euthanasia program originated when a father in Leipzig petitioned to end the life of his disabled daughter and Adolf Hitler dispatched his personal physician, Karl Brandt, to authorize her death as an act of mercy.

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According to historian Hugh Gallagher, as the story of the little Leipzig girl became known in medical circles, other families sent similar appeals to the Fhrer. It fell to Brandt to make determinations on each of these requests and ultimately to authorize the killing of at least 70,000 people with disabilities pursuant to what the American Holocaust Museum describes as a medically administered program of mercy death.

Frazee then challenges the attack on Schipper:

Schippers recusal as working group chairman will no doubt be applauded by advocates who seek to broaden the availability of assisted death in Canada. Others, such as myself, who know Schipper to be a man of considerable wisdom and integrity, are saddened that the 43-member panel which includes expert advocates on both sides of this debate failed to seize the opportunity to rise above the clamour and reject any suggestion that politics, rather than evidence, would govern their work.

Had they spoken out together, and forcefully, in defence of their colleague, the outcome might have been different.

This is not the first time that a measured and accurate reference to the historical facts of the Nazi euthanasia program has been condemned as strident, distasteful or offensive. It should be the last.

Nothing about medically assisted death is ahistorical. As we review current law and practice, and consider potential expansion to the Criminal Code exemptions that permit Canadian doctors and nurse practitioners to end the lives of certain patients, surely we have the maturity to invite history into the conversation.

Frazee then outlines the reality that people with disabilities have historically faced:

Doctors, at times, have killed. This is fact. Often, when they have killed or harmed, they have not acted alone, but as agents of state authority.

With all of their immense skill and influence, doctors have played indispensable roles in residential schools and asylums in Canada, comfort stations in Southeast Asia, enhanced interrogation facilities at Guantnamo Bay and extermination centres in Nazi Germany.

People with disabilities have suffered violence and harm at the hands of doctors, parents and caregivers. Sometimes, as with Satoshi Uematsu in Sagamihara, Japan, the world has instantly recoiled in horror. Sometimes, as with parent Robert Latimer in Saskatchewan, a court of law might ultimately uphold conviction, but not before public opinion solidifies in support of the perpetrator.

Sometimes, as with Brandt, a nation colludes.

The Nazi Aktion T4 euthanasia program is part of my history as a disabled person. Importantly, its also part of Schippers history as a physician. Those who would forbid us to speak of this history, or police our speech as strident and unwelcome, can only fuel doubt about whether its lessons have been learned.

Frazee concludes by challenging the working groups to examine the extension of euthanasia through the lens of history:

If our federal government is to benefit from the comprehensive reviews it assigned to the Council of Canadian Academies, and if the councils working groups are to gather the evidence Canadians require to guide policy decisions about providing medically assisted death to mature minors, to people with mental illness and to people no longer capable of expressing consent, then the history of euthanasia, and questions arising from the darkest corners of that history, must not be out of bounds.

As Margaret MacMillan, the distinguished Canadian historian, has said: We dont always know best, and the past can remind us of that.

Thank you to Catherine Frazee for setting the record straight.

LifeNews.com Note: Alex Schadenberg is the executive director of the Euthanasia Prevention Coalition and you can read his blog here.

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