Friday, December 16, 2016

A couple of interesting and important events have taken place in the last few days that serve to impact the physician assisted suicide(PAS) debate in the US.
  • On December 8th, the Ohio Senate approved House Bill 470, which would make assisting a suicide a felony in the state of Ohio.  This is an excellent preemptive move in a state that currently has no law allowing PAS.
  • This last weekend the American Psychiatric Association gave a final approval to a policy statement about their ethical involvement in PAS or euthanasia.  Below is the statement:

The American Psychiatric Association, in concert with the American Medical Association’s position on Medical Euthanasia, holds that a psychiatrist should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.

https://www.washingtonpost.com/blogs/post-partisan/wp/2016/12/15/at-last-american-psychiatrists-speak-out-on-euthanasia/?utm_term=.5347028f1532

While it may seem that this statement doesn't impact the PAS issue - at this time - the truth is that history has shown in other countries the slippery slope that starts with terminal disease and then progresses to non-terminal illnesses and mental health disease.  Voluntary euthanasia extends to involuntary euthanasia.  
Those who don't learn from the past are doomed to repeat it.  

Saturday, November 26, 2016

http://tinyurl.com/h3tuql9

Australian Medical Association reaffirmed its opposition to physician assisted suicide and euthanasia.  Bravo to them!!

Hope that the American Medical Association takes note and follows suit.  In the article it states that a small number answered the survey so they didn't know what the true feeling was of Australian physicians.  

A similar parallel exists in the US.  Only about 17% of American physicians belong to the AMA but it is always looked at as speaking for the medical establishment.  

Thursday, November 24, 2016

If it's one thing that human beings do, it is to frequently forget the lessons of history, and then make the same mistakes again.  After we have demonstrated our amnesia, or maybe it's carelessness, then we again face the consequences of our actions.

Consider again the path we are taking with regard to physician assisted suicide.  Read the recent article about the California decision.  http://tinyurl.com/jeoavk5

Is history repeating itself?  I would submit to you that, examining a parallel historical period, we are at risk of making grave mistakes.  In California, one can foresee the regulations and policies, that govern who is allowed to commit suicide, to be extended to include mentally ill humans who have been deemed terminally ill.

After the Nazis came to power in Germany in the 1930s, it started out "innocently".  The first concentration camp was started in Dachau for political prisoners.  It then evolved into a death camp for thousands of Jews.  But it didn't stop there.  Eventually Hitler decided that there were groups of people who just didn't fit into his warped viewpoint of an acceptable Germany.  These groups included artists, Gypsies, the physically and mentally handicapped and homosexuals.  We all know that many more concentration, death, camps were built to exterminate Jews and these other unacceptable elements of society.

Eventually, society, or the powers that be, will begin to place value on the lives of others.  We actually have already seen that trend with the holocaust of over 50 million babies aborted since 1973's Roe v. Wade.  They were deemed not worthy of living for a variety of reasons.

So where does it stop?  Who has the moral authority to decide who is eligible for assisted suicide? When will it extend to voluntary euthanasia and then to involuntary euthanasia?

"Those who cannot remember the past are condemned to repeat it".  George Santayana

Wednesday, November 9, 2016

I posted this on Facebook this morning:

"We've prayed hard for this election that God, who is really in control, would bring into office those who would be on the side of the unborn, respect the right of conscience for health care professionals and others, and maintain a more conservative Supreme Court. 
For the first time since 1928, a Republican president comes into office with a Republican Congress. 
But with great power comes great responsibility, so let us continue to pray for the new president and congress to fulfill that responsibility to the glory of God."


In Connecticut, as we look at the likelihood of physician assisted suicide(PAS) coming back around in 2017, I'm grateful that the makeup of the state house and, especially, senate also looks promising to see this turned back again. A number of senators and representatives that were in opposition to PAS appear to have been re-elected and this is encouraging.

The Connecticut State Medical Society is re-evaluating its' previous statement opposing PAS and we pray that they will maintain the opposition rather than taking a neutral stance.  

Sunday, November 6, 2016

It’s been estimated that several million Christians did not vote in the last election.  They chose to sit it out because Mitt Romney was the candidate.  So Barack Obama was re-elected. 

Pastor David Jeremiah was interviewed about the election this year, and he talked about the high standards that we exact from the candidates - and how impossible that really is. 
He said “I’m not sure I can get somebody who’s like me, I’m not even sure I can get somebody who is for me, but I’m pretty sure I can get somebody who is not against me. (emphasis mine)

In the last four years, which person do you think has been, or would have been, for us - meaning Christians and the values we cherish?  You don’t have to look too far to see what has happened in our country since 2012 to answer that question. 

The most crucial aspect in this election comes down to two words:  Supreme Court
Again Dr. Jeremiah said: “You must decide who you think will appoint the best justices for the Supreme Court, and then whatever else you may think of that person, you must vote.”


Don’t’ sit this election out looking for the “perfect” person who will fulfill all your lofty ideals.  Vote for the person who will not be against you. 

Saturday, November 5, 2016

Colorado is about to vote on Proposition 106 to legalize physician assisted suicide.
Watch this poignant interview with Jason Tippett from Colorado.  "Every life is significant"
http://tinyurl.com/juowet7

Vote "NO" on Tuesday in Colorado.  

Wednesday, November 2, 2016

It's Not About Pain

C&C wants to make it about pain.  This says otherwise. 
The humanistic approach to life is to remove God from our lives and have control over everything - including when we die.  
Eliminating God from our lives - or the illusion that we are doing so - allows humans to place value on a human life.  Where is the 'line in the sand' for society to say "this person deserves to live" and "this person deserves to die because they no longer serve society's purposes"?


Kaiser Health News
Terminally Ill Patients Don't Use Aid-in-Dying Laws to Relieve Pain
Liz Szabo
October 27, 2016
Supporters of "death with dignity" have succeeded in legalizing medical aid-in-dying in five states by convincing voters, lawmakers and courts that terminally ill patients have the right to die without suffering intractable pain in their final days or weeks.
When Gov. Jerry Brown signed California's law in 2015, he said: "I do not know what I would do if I were dying in prolonged and excruciating pain" and that it would be a "comfort to consider the options afforded by this bill."
Yet the latest research shows that terminally ill patients who seek out aid-in-dying aren't primarily concerned about pain. Those who've actually used these laws thus far have been far more concerned about controlling the way they exit the world than controlling pain.
The research suggests that patients' motivations are more complicated than they're often portrayed and could affect or shape how people vote on the issue in other cities and states.
Colorado voters will decide on a ballot initiative to legalize physician aid-in-dying in November. The city council in Washington, D.C., is expected to vote on legalizing the practice next month.
"It's almost never about pain," said Lonny Shavelson, a Berkeley, Calif., physician who specializes in the care of the terminally ill and who began writing prescriptions for lethal doses of medication in June, when California's law took effect. "It's about dignity and control."
Pain ranks near the bottom of a list of patients' concerns in Oregon and Washington, the first two states to legalize physician-assisted dying, which provide the most complete details about people's motivations. Only 25 percent of the 991 Oregon patients who died after taking lethal prescriptions from 1998 to 2015 were concerned about pain or had inadequate pain control, according to reports filed with the state by their doctors. In Washington, 36 percent of 917 who died were concerned about pain.
In contrast, at least 90 percent of patients in both states were motivated by a loss of autonomy, state records show. Forty-one percent of patients in Oregon and 53 percent in Washington said they feared burdening the people they loved. Montana, Vermont and California also permit aid-in-dying, but haven't released detailed information about patients' motivations.
Seeking Control
Compassion & Choices, an advocacy group that supports aid-in-dying, focuses heavily on the need to relieve dying patients of pain.
One of the group's new ads promotes the District of Columbia's Death With Dignity Act as giving "a dying person the option to avoid the worst pain and suffering at the end of life." The widower of Brittany Maynard, a 29-year-old California woman who became the best-known advocate for the right to die, has spoken publicly in support of the legislation. Maynard, who had an aggressive brain tumor, moved to Oregon in 2014 in order to use that state's aid-in-dying law. She died that year after using a lethal prescription.
"The dying process is what Brittany feared," said her husband, Dan Diaz. "She was afraid that her final few days on this green earth would be ones where she was tortured by the tumor."
Mary Klein, a 68-year-old resident of the District who is fighting advanced ovarian cancer, said she wants choices at the end of her life.
"I want to have the option to control my own body and control my own life," said Klein, a retired journalist and artist who appears in a video supporting legislation to legalize aid-in-dying in the city, created by Compassion & Choices.
Although Klein says she may also enroll in hospice care, which focuses on the needs of people with six months or less to live, she wants to have an alternative if the services don't meet her needs.
"The dominant reasons for wanting euthanasia or assisted suicide are psychological and involve control factors," said Ezekiel Emanuel, chair of medical ethics and health policy at the University of Pennsylvania. He noted that most of those who've used aid-in-dying laws are white, well-insured and college educated. "These are people who are used to controlling every aspect of their lives, and they want to control this aspect of their lives."
A study of 56 Oregon patients interested in physician aid-in-dying reached similar conclusions. Although patients were concerned about the risk of future pain, they ranked "current pain" as unimportant, according to the 2009 study in Archives of Internal Medicine (now known as JAMA Internal Medicine). Patients told researchers they were primarily motivated by a desire to "control the circumstances of death and die at home," as well as a loss of independence, poor quality of life and their inability to care for themselves.
The patients interviewed "look forward to this period in their terminal illness, this time in which they will be not in control, when they will be dependent on others, when they will have a bunch of physical symptoms that will undermine their quality of life, and they want to avoid that," said Linda Ganzini, a professor of psychiatry and medicine at Oregon Health & Science University.
Critics of aid-in-dying laws have for years warned that they could set the country on a "slippery slope," in which lethal prescriptions are dispensed not just to the terminally ill, but to anyone with a disease that harms their quality of life. Those fears haven't come to pass. But physician Ira Byock, who specializes in palliative care, said aid-in-dying laws are creating a slope of another kind. Instead of helping only terminally ill patients in physical pain, they're being used by patients in psychological distress.
"It's a bait and switch," said Byock, executive director and chief medical officer for the Institute for Human Caring of Providence Health and Services, based in Torrance, Calif. "We're actually helping people hasten their deaths because of existential suffering. That's chilling to me."
Although right-to-die campaigns suggest that excruciating pain is often unavoidable, Byock said that "we can relieve the suffering of almost everyone that we care for if we have the time to prepare."
Hospice staff are on call 24 hours a day to help patients in pain, Byock said. Palliative care and hospice teams also can train family caregivers how to administer emergency pain medications that take effect before nurses can arrive.
Hospice may have alleviated some patients' concerns, said physician Thomas Smith, director of palliative medicine at Johns Hopkins Medicine in Baltimore. Just 64 percent of Oregon patients and 82 percent of Washington patients last year actually used the lethal medications they were prescribed. Others died without taking them.
"Many people who have the prescriptions don't use them," Smith said. "That suggests to me that some people find meaning and purpose and adequate symptom control, not just that they are too weak to take the pills."
Many Kinds of Suffering
Barbara Coombs Lee, president of Compassion & Choices, said it's difficult for people to predict how they will feel as they face a deadly illness. While a healthy person might not imagine being able to tolerate physical disability, people facing the prospect of an early death are often willing to accept harsh treatments or a reduced quality of life in exchange for more time.
That change in perspective could help explain why some of those who advocate for the right to die, including those who obtain lethal prescriptions, never actually choose to hasten their death, Coombs Lee said. But she said that having the prescription on hand can ease patients' anxiety and give them peace of mind, because they can control the timing and method of death.
Coombs Lee also notes that people can suffer in many ways beyond physical pain. Maynard's brain tumor caused her to suffer frequent seizures, for example. Coombs Lee also described the case of a dying woman who took a lethal prescription after she began leaking fecal matter, which prevented her from ever feeling clean.
Coombs Lee quotes the woman, Penny Schleuter, in her book, Compassion in Dying: Stories of Dignity and Choice. Schleuter said the pain from her cancer could be controlled. But, she added, "I like doing things for myself, and the idea of having somebody take care of me like I am a little 2-month-old baby is just absolutely repulsive. It's more painful than any of the pain from the cancer."
Coombs Lee said, "everyone who is terminally ill has some kind of nightmare that would be worse than death to them. They want to achieve sufficient control to avoid that nightmare for their family."
Dan Diaz said people shouldn't underestimate how devastating it can be to lose one's autonomy.
"If I find myself in a situation where I can't go to the bathroom on my own, where someone has to change my diapers, where I can't feed myself, where I can't care for the people around me, where other people have to move me around to keep me from having bed sores, I would then submit, is that really living?" Diaz asked.
Some people who pursue physician-assisted death "don't want to be in a hospital, don't want to be connected to tubes," Coombs Lee said. "They say, 'I want to be at home with those I love. I don't want to be delirious or unconscious at the end of life. Those are all things that play into their fears about what their disease might descend into."
The District of Columbia council voted to legalize physician assisted suicide. 
This dangerous move will further impact and destroy the trust that patients have had in their physicians for over two thousand years - trust that your physician will do everything to heal you but not become an active participant in your death. 

It is dangerous to patients, to families and to our society going forward. 

This isn't about a patient's right to die - it's about giving your doctor the right to kill. 

You don't have to kill the patient to alleviate their suffering - of any kind. 


Colorado is about to vote on this issue next Tuesday. Make your voice known. 


http://tinyurl.com/zeb3ujs

Monday, October 31, 2016

Physician Assisted Suicide: A Dangerous Undertaking

As Connecticut state director for the American Academy of Medical Ethics (www.ethicalhealthcare.org), I've created this blog to enlighten the public and our legislators about the dangers of Physician Assisted Suicide (PAS); dangers to patients, physicians, families and society in Connecticut, and any other state.  Here in Connecticut, three attempts to pass such legislation were turned back.  In 2016, the proponents of this dangerous measure elected to stand down their efforts and regroup, but they will likely be back in 2017.

  • Suicide is not illegal.  It is tragic, to be sure, but this is not about giving patients the right to die, but giving physicians the right to kill.  It destroys the trust in your doctor that has been in place for thousands of years; trust that they are your healer and not your killer.  Society is suddenly reverting back 2500 years, to the time of Hippocrates, when you didn't know if your physician would heal or kill you.  It all depended on who paid the most money.  
  • This tragic act can be accomplished without ever having to notify the family.  How would you like to get a call to find out that your mom, dad, brother or sister took lethal pills and you never knew about the decision?!  Can you imagine the grief and remorse that follows discovering it too late?
  • Think about the effect on society as human life is devalued.  With the high price of healthcare, especially in the last years of life, society and insurers begin deciding that a handful of pills is cheaper than the alternative.  
  • Don't ignore the same trend that happened in other countries:  it will go from a handful of pills supplied by your doctor to a doctor giving lethal injections - the definition of euthanasia.  
  • It will go from the terminally ill to the chronically ill; from the physically ill to the mentally ill.
  • It will go from voluntary to involuntary euthanasia.
  • It will culminate in the euthanization of children - which is already happening in other countries.  
  • Netherlands is currently debating legislation to allow assisted suicide for those who are tired of living and feel their life is complete.
  • Once you say that there are lives not worthy to live - where do you draw the line?