Code of Medical Ethics Opinion 5.8

Euthanasia is the administration of a lethal agent by another person to a patient for the purpose of relieving the patients intolerable and incurable suffering.

It is understandable, though tragic, that some patients in extreme duresssuch as those suffering from a terminal, painful, debilitating illnessmay come to decide that death is preferable to life.

However, permitting physicians to engage in euthanasia would ultimately cause more harm than good.

Euthanasia is fundamentally incompatible with the physicians role as healer, would be difficult or impossible to control, and would pose serious societal risks. Euthanasia could readily be extended to incompetent patients and other vulnerable populations.

The involvement of physicians in euthanasia heightens the significance of its ethical prohibition. The physician who performs euthanasia assumes unique responsibility for the act of ending the patients life.

Instead of engaging in euthanasia, physicians must aggressively respond to the needs of patients at the end of life. Physicians:

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Euthanasia | American Medical Association

Practice of intentionally ending a life in order to relieve pain and suffering

Euthanasia (from Greek: 'good death': , eu 'well, good' + , thanatos 'death') is the practice of intentionally ending life to relieve pain and suffering.[1][2]

Different countries have different euthanasia laws. The British House of Lords select committee on medical ethics defines euthanasia as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering".[3] In the Netherlands and Belgium, euthanasia is understood as "termination of life by a doctor at the request of a patient".[4] The Dutch law, however, does not use the term 'euthanasia' but includes the concept under the broader definition of "assisted suicide and termination of life on request".[5]

Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or involuntary.[6] Voluntary euthanasia is when a person wills to have their life ended and is legal in a growing number of countries. Non-voluntary euthanasia occurs when a patient's consent is unavailable and is legal in some countries under certain limited conditions, in both active and passive forms. Involuntary euthanasia, which is done without asking for consent or against the patient's will, is illegal in all countries and is usually considered murder.

As of 2006[update] euthanasia had become the most active area of research in bioethics.[7]In some countries divisive public controversy occurs over the moral, ethical, and legal issues associated with euthanasia. Passive euthanasia (known as "pulling the plug") is legal under some circumstances in many countries. Active euthanasia, however, is legal or de facto legal in only a handful of countries (for example: Belgium, Canada and Switzerland), which limit it to specific circumstances and require the approval of counselors and doctors or other specialists. In some countries - such as Nigeria, Saudi Arabia and Pakistan - support for active euthanasia is almost non-existent.

Like other terms borrowed from history, "euthanasia" has had different meanings depending on usage. The first apparent usage of the term "euthanasia" belongs to the historian Suetonius, who described how the Emperor Augustus, "dying quickly and without suffering in the arms of his wife, Livia, experienced the 'euthanasia' he had wished for."[8] The word "euthanasia" was first used in a medical context by Francis Bacon in the 17th century, to refer to an easy, painless, happy death, during which it was a "physician's responsibility to alleviate the 'physical sufferings' of the body." Bacon referred to an "outward euthanasia"the term "outward" he used to distinguish from a spiritual conceptthe euthanasia "which regards the preparation of the soul."[9]

In current usage, euthanasia has been defined as the "painless inducement of a quick death".[10] However, it is argued that this approach fails to properly define euthanasia, as it leaves open a number of possible actions which would meet the requirements of the definition, but would not be seen as euthanasia. In particular, these include situations where a person kills another, painlessly, but for no reason beyond that of personal gain; or accidental deaths that are quick and painless, but not intentional.[11][12]

Another approach incorporates the notion of suffering into the definition.[11] The definition offered by the Oxford English Dictionary incorporates suffering as a necessary condition, with "the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma",[13] This approach is included in Marvin Khol and Paul Kurtz's definition of it as "a mode or act of inducing or permitting death painlessly as a relief from suffering".[14] Counterexamples can be given: such definitions may encompass killing a person suffering from an incurable disease for personal gain (such as to claim an inheritance), and commentators such as Tom Beauchamp and Arnold Davidson have argued that doing so would constitute "murder simpliciter" rather than euthanasia.[11]

The third element incorporated into many definitions is that of intentionality the death must be intended, rather than being accidental, and the intent of the action must be a "merciful death".[11] Michael Wreen argued that "the principal thing that distinguishes euthanasia from intentional killing simpliciter is the agent's motive: it must be a good motive insofar as the good of the person killed is concerned."[15] Likewise, James Field argued that euthanasia entails a sense of compassion towards the patient, in contrast to the diverse non-compassionate motives of serial killers who work in health care professions.[16] Similarly, Heather Draper speaks to the importance of motive, arguing that "the motive forms a crucial part of arguments for euthanasia, because it must be in the best interests of the person on the receiving end."[12] Definitions such as that offered by the House of Lords Select committee on Medical Ethics take this path, where euthanasia is defined as "a deliberate intervention undertaken with the express intention of ending a life, to relieve intractable suffering."[3] Beauchamp and Davidson also highlight Baruch Brody's "an act of euthanasia is one in which one person... (A) kills another person (B) for the benefit of the second person, who actually does benefit from being killed".[17]

Draper argued that any definition of euthanasia must incorporate four elements: an agent and a subject; an intention; a causal proximity, such that the actions of the agent lead to the outcome; and an outcome. Based on this, she offered a definition incorporating those elements, stating that euthanasia "must be defined as death that results from the intention of one person to kill another person, using the most gentle and painless means possible, that is motivated solely by the best interests of the person who dies."[18] Prior to Draper, Beauchamp and Davidson had also offered a definition that includes these elements. Their definition specifically discounts fetuses to distinguish between abortions and euthanasia:[19]

In summary, we have argued... that the death of a human being, A, is an instance of euthanasia if and only if (1) A's death is intended by at least one other human being, B, where B is either the cause of death or a causally relevant feature of the event resulting in death (whether by action or by omission); (2) there is either sufficient current evidence for B to believe that A is acutely suffering or irreversibly comatose, or there is sufficient current evidence related to A's present condition such that one or more known causal laws supports B's belief that A will be in a condition of acute suffering or irreversible comatoseness; (3) (a) B's primary reason for intending A's death is cessation of A's (actual or predicted future) suffering or irreversible comatoseness, where B does not intend A's death for a different primary reason, though there may be other relevant reasons, and (b) there is sufficient current evidence for either A or B that causal means to A's death will not produce any more suffering than would be produced for A if B were not to intervene; (4) the causal means to the event of A's death are chosen by A or B to be as painless as possible, unless either A or B has an overriding reason for a more painful causal means, where the reason for choosing the latter causal means does not conflict with the evidence in 3b; (5) A is a nonfetal organism.[20]

Wreen, in part responding to Beauchamp and Davidson, offered a six-part definition:

Person A committed an act of euthanasia if and only if (1) A killed B or let her die; (2) A intended to kill B; (3) the intention specified in (2) was at least partial cause of the action specified in (1); (4) the causal journey from the intention specified in (2) to the action specified in (1) is more or less in accordance with A's plan of action; (5) A's killing of B is a voluntary action; (6) the motive for the action specified in (1), the motive standing behind the intention specified in (2), is the good of the person killed.[21]

Wreen also considered a seventh requirement: "(7) The good specified in (6) is, or at least includes, the avoidance of evil", although as Wreen noted in the paper, he was not convinced that the restriction was required.[22]

In discussing his definition, Wreen noted the difficulty of justifying euthanasia when faced with the notion of the subject's "right to life". In response, Wreen argued that euthanasia has to be voluntary, and that "involuntary euthanasia is, as such, a great wrong".[22] Other commentators incorporate consent more directly into their definitions. For example, in a discussion of euthanasia presented in 2003 by the European Association of Palliative Care (EPAC) Ethics Task Force, the authors offered: "Medicalized killing of a person without the person's consent, whether nonvoluntary (where the person is unable to consent) or involuntary (against the person's will) is not euthanasia: it is murder. Hence, euthanasia can be voluntary only."[23] Although the EPAC Ethics Task Force argued that both non-voluntary and involuntary euthanasia could not be included in the definition of euthanasia, there is discussion in the literature about excluding one but not the other.[22]

Euthanasia may be classified into three types, according to whether a person gives informed consent: voluntary, non-voluntary and involuntary.[24][25]

There is a debate within the medical and bioethics literature about whether or not the non-voluntary (and by extension, involuntary) killing of patients can be regarded as euthanasia, irrespective of intent or the patient's circumstances. In the definitions offered by Beauchamp and Davidson and, later, by Wreen, consent on the part of the patient was not considered one of their criteria, although it may have been required to justify euthanasia.[11][26] However, others see consent as essential.

Voluntary euthanasia is conducted with the consent of the patient. Active voluntary euthanasia is legal in Belgium, Luxembourg and the Netherlands. Passive voluntary euthanasia is legal throughout the US per Cruzan v. Director, Missouri Department of Health. When the patient brings about their own death with the assistance of a physician, the term assisted suicide is often used instead. Assisted suicide is legal in Switzerland and the U.S. states of California, Oregon, Washington, Montana and Vermont.

Non-voluntary euthanasia is conducted when the consent of the patient is unavailable. Examples include child euthanasia, which is illegal worldwide but decriminalised under certain specific circumstances in the Netherlands under the Groningen Protocol. Passive forms of non-voluntary euthanasia (i.e. withholding treatment) are legal in a number of countries under specified conditions.

Involuntary euthanasia is conducted against the will of the patient.

Voluntary, non-voluntary and involuntary types can be further divided into passive or active variants.[27] Passive euthanasia entails the withholding treatment necessary for the continuance of life.[3] Active euthanasia entails the use of lethal substances or forces (such as administering a lethal injection), and is more controversial. While some authors consider these terms to be misleading and unhelpful, they are nonetheless commonly used. In some cases, such as the administration of increasingly necessary, but toxic doses of painkillers, there is a debate whether or not to regard the practice as active or passive.[3]

Euthanasia was practiced in Ancient Greece and Rome: for example, hemlock was employed as a means of hastening death on the island of Kea, a technique also employed in Marseilles. Euthanasia, in the sense of the deliberate hastening of a person's death, was supported by Socrates, Plato and Seneca the Elder in the ancient world, although Hippocrates appears to have spoken against the practice, writing "I will not prescribe a deadly drug to please someone, nor give advice that may cause his death" (noting there is some debate in the literature about whether or not this was intended to encompass euthanasia).[28][29][30]

The term euthanasia, in the earlier sense of supporting someone as they died, was used for the first time by Francis Bacon. In his work, Euthanasia medica, he chose this ancient Greek word and, in doing so, distinguished between euthanasia interior, the preparation of the soul for death, and euthanasia exterior, which was intended to make the end of life easier and painless, in exceptional circumstances by shortening life. That the ancient meaning of an easy death came to the fore again in the early modern period can be seen from its definition in the 18th century Zedlers Universallexikon:

Euthanasia: a very gentle and quiet death, which happens without painful convulsions. The word comes from , bene, well, and , mors, death.[31]

The concept of euthanasia in the sense of alleviating the process of death goes back to the medical historian, Karl Friedrich Heinrich Marx, who drew on Bacon's philosophical ideas. According to Marx, a doctor had a moral duty to ease the suffering of death through encouragement, support and mitigation using medication. Such an "alleviation of death" reflected the contemporary zeitgeist, but was brought into the medical canon of responsibility for the first time by Marx. Marx also stressed the distinction between the theological care of the soul of sick people from the physical care and medical treatment by doctors.[32][33]

Euthanasia in its modern sense has always been strongly opposed in the Judeo-Christian tradition. Thomas Aquinas opposed both and argued that the practice of euthanasia contradicted our natural human instincts of survival,[34] as did Francois Ranchin (15651641), a French physician and professor of medicine, and Michael Boudewijns (16011681), a physician and teacher.[29]:208[30] Other voices argued for euthanasia, such as John Donne in 1624,[35] and euthanasia continued to be practised. In 1678, the publication of Caspar Questel's De pulvinari morientibus non-subtrahend, ("On the pillow of which the dying should not be deprived"), initiated debate on the topic. Questel described various customs which were employed at the time to hasten the death of the dying, (including the sudden removal of a pillow, which was believed to accelerate death), and argued against their use, as doing so was "against the laws of God and Nature".[29]:209211 This view was shared by others who followed, including Philipp Jakob Spener, Veit Riedlin and Johann Georg Krnitz.[29]:211 Despite opposition, euthanasia continued to be practised, involving techniques such as bleeding, suffocation, and removing people from their beds to be placed on the cold ground.[29]:211214

Suicide and euthanasia became more accepted during the Age of Enlightenment.[30] Thomas More wrote of euthanasia in Utopia, although it is not clear if More was intending to endorse the practice.[29]:208209 Other cultures have taken different approaches: for example, in Japan suicide has not traditionally been viewed as a sin, as it is used in cases of honor, and accordingly, the perceptions of euthanasia are different from those in other parts of the world.[36]

In the mid-1800s, the use of morphine to treat "the pains of death" emerged, with John Warren recommending its use in 1848. A similar use of chloroform was revealed by Joseph Bullar in 1866. However, in neither case was it recommended that the use should be to hasten death. In 1870 Samuel Williams, a schoolteacher, initiated the contemporary euthanasia debate through a speech given at the Birmingham Speculative Club in England, which was subsequently published in a one-off publication entitled Essays of the Birmingham Speculative Club, the collected works of a number of members of an amateur philosophical society.[37]:794 Williams' proposal was to use chloroform to deliberately hasten the death of terminally ill patients:

That in all cases of hopeless and painful illness, it should be the recognized duty of the medical attendant, whenever so desired by the patient, to administer chloroform or such other anaesthetic as may by-and-bye supersede chloroform so as to destroy consciousness at once, and put the sufferer to a quick and painless death; all needful precautions being adopted to prevent any possible abuse of such duty; and means being taken to establish, beyond the possibility of doubt or question, that the remedy was applied at the express wish of the patient.

The essay was favourably reviewed in The Saturday Review, but an editorial against the essay appeared in The Spectator.[38] From there it proved to be influential, and other writers came out in support of such views: Lionel Tollemache wrote in favour of euthanasia, as did Annie Besant, the essayist and reformer who later became involved with the National Secular Society, considering it a duty to society to "die voluntarily and painlessly" when one reaches the point of becoming a 'burden'.[38][39] Popular Science analyzed the issue in May 1873, assessing both sides of the argument.[40] Kemp notes that at the time, medical doctors did not participate in the discussion; it was "essentially a philosophical enterprise... tied inextricably to a number of objections to the Christian doctrine of the sanctity of human life".[38]

The rise of the euthanasia movement in the United States coincided with the so-called Gilded Age, a time of social and technological change that encompassed an "individualistic conservatism that praised laissez-faire economics, scientific method, and rationalism", along with major depressions, industrialisation and conflict between corporations and labour unions.[37]:794 It was also the period in which the modern hospital system was developed, which has been seen as a factor in the emergence of the euthanasia debate.[41]

Robert Ingersoll argued for euthanasia, stating in 1894 that where someone is suffering from a terminal illness, such as terminal cancer, they should have a right to end their pain through suicide. Felix Adler offered a similar approach, although, unlike Ingersoll, Adler did not reject religion. In fact, he argued from an Ethical Culture framework. In 1891, Adler argued that those suffering from overwhelming pain should have the right to commit suicide, and, furthermore, that it should be permissible for a doctor to assist thus making Adler the first "prominent American" to argue for suicide in cases where people were suffering from chronic illness.[42] Both Ingersoll and Adler argued for voluntary euthanasia of adults suffering from terminal ailments.[42] Dowbiggin argues that by breaking down prior moral objections to euthanasia and suicide, Ingersoll and Adler enabled others to stretch the definition of euthanasia.[43]

The first attempt to legalise euthanasia took place in the United States, when Henry Hunt introduced legislation into the General Assembly of Ohio in 1906.[44]:614 Hunt did so at the behest of Anna Sophina Hall, a wealthy heiress who was a major figure in the euthanasia movement during the early 20th century in the United States. Hall had watched her mother die after an extended battle with liver cancer, and had dedicated herself to ensuring that others would not have to endure the same suffering. Towards this end she engaged in an extensive letter writing campaign, recruited Lurana Sheldon and Maud Ballington Booth, and organised a debate on euthanasia at the annual meeting of the American Humane Association in 1905 described by Jacob Appel as the first significant public debate on the topic in the 20th century.[44]:614616

Hunt's bill called for the administration of an anesthetic to bring about a patient's death, so long as the person is of lawful age and sound mind, and was suffering from a fatal injury, an irrevocable illness, or great physical pain. It also required that the case be heard by a physician, required informed consent in front of three witnesses, and required the attendance of three physicians who had to agree that the patient's recovery was impossible. A motion to reject the bill outright was voted down, but the bill failed to pass, 79 to 23.[37]:796[44]:618619

Along with the Ohio euthanasia proposal, in 1906 Assemblyman Ross Gregory introduced a proposal to permit euthanasia to the Iowa legislature. However, the Iowa legislation was broader in scope than that offered in Ohio. It allowed for the death of any person of at least ten years of age who suffered from an ailment that would prove fatal and cause extreme pain, should they be of sound mind and express a desire to artificially hasten their death. In addition, it allowed for infants to be euthanised if they were sufficiently deformed, and permitted guardians to request euthanasia on behalf of their wards. The proposed legislation also imposed penalties on physicians who refused to perform euthanasia when requested: a 612-month prison term and a fine of between $200 and $1,000. The proposal proved to be controversial.[44]:619621 It engendered considerable debate and failed to pass, having been withdrawn from consideration after being passed to the Committee on Public Health.[44]:623

After 1906 the euthanasia debate reduced in intensity, resurfacing periodically, but not returning to the same level of debate until the 1930s in the United Kingdom.[37]:796

Euthanasia opponent Ian Dowbiggin argues that the early membership of the Euthanasia Society of America (ESA) reflected how many perceived euthanasia at the time, often seeing it as a eugenics matter rather than an issue concerning individual rights.[42] Dowbiggin argues that not every eugenist joined the ESA "solely for eugenic reasons", but he postulates that there were clear ideological connections between the eugenics and euthanasia movements.[42]

The Voluntary Euthanasia Legalisation Society was founded in 1935 by Charles Killick Millard (now called Dignity in Dying). The movement campaigned for the legalisation of euthanasia in Great Britain.

In January 1936, King George V was given a fatal dose of morphine and cocaine to hasten his death. At the time he was suffering from cardio-respiratory failure, and the decision to end his life was made by his physician, Lord Dawson.[45] Although this event was kept a secret for over 50 years, the death of George V coincided with proposed legislation in the House of Lords to legalise euthanasia.[46]

A 24 July 1939 killing of a severely disabled infant in Nazi Germany was described in a BBC "Genocide Under the Nazis Timeline" as the first "state-sponsored euthanasia".[47] Parties that consented to the killing included Hitler's office, the parents, and the Reich Committee for the Scientific Registration of Serious and Congenitally Based Illnesses.[47] The Telegraph noted that the killing of the disabled infantwhose name was Gerhard Kretschmar, born blind, with missing limbs, subject to convulsions, and reportedly "an idiot" provided "the rationale for a secret Nazi decree that led to 'mercy killings' of almost 300,000 mentally and physically handicapped people".[48] While Kretchmar's killing received parental consent, most of the 5,000 to 8,000 children killed afterwards were forcibly taken from their parents.[47][48]

The "euthanasia campaign" of mass murder gathered momentum on 14 January 1940 when the "handicapped" were killed with gas vans and killing centres, eventually leading to the deaths of 70,000 adult Germans.[49] Professor Robert Jay Lifton, author of The Nazi Doctors and a leading authority on the T4 program, contrasts this program with what he considers to be a genuine euthanasia. He explains that the Nazi version of "euthanasia" was based on the work of Adolf Jost, who published The Right to Death (Das Recht auf den Tod) in 1895. Lifton writes:

Jost argued that control over the death of the individual must ultimately belong to the social organism, the state. This concept is in direct opposition to the Anglo-American concept of euthanasia, which emphasizes the individual's 'right to die' or 'right to death' or 'right to his or her own death,' as the ultimate human claim. In contrast, Jost was pointing to the state's right to kill.... Ultimately the argument was biological: 'The rights to death [are] the key to the fitness of life.' The state must own deathmust killin order to keep the social organism alive and healthy.[50]

In modern terms, the use of "euthanasia" in the context of Action T4 is seen to be a euphemism to disguise a program of genocide, in which people were killed on the grounds of "disabilities, religious beliefs, and discordant individual values".[51] Compared to the discussions of euthanasia that emerged post-war, the Nazi program may have been worded in terms that appear similar to the modern use of "euthanasia", but there was no "mercy" and the patients were not necessarily terminally ill.[51] Despite these differences, historian and euthanasia opponent Ian Dowbiggin writes that "the origins of Nazi euthanasia, like those of the American euthanasia movement, predate the Third Reich and were intertwined with the history of eugenics and Social Darwinism, and with efforts to discredit traditional morality and ethics."[42]:65

On 6 January 1949, the Euthanasia Society of America presented to the New York State Legislature a petition to legalize euthanasia, signed by 379 leading Protestant and Jewish ministers, the largest group of religious leaders ever to have taken this stance. A similar petition had been sent to the New York Legislature in 1947, signed by approximately 1,000 New York physicians. Roman Catholic religious leaders criticized the petition, saying that such a bill would "legalize a suicide-murder pact" and a "rationalization of the fifth commandment of God, 'Thou Shalt Not Kill.'"[52] The Right Reverend Robert E. McCormick stated that

The ultimate object of the Euthanasia Society is based on the Totalitarian principle that the state is supreme and that the individual does not have the right to live if his continuance in life is a burden or hindrance to the state. The Nazis followed this principle and compulsory Euthanasia was practiced as a part of their program during the recent war. We American citizens of New York State must ask ourselves this question: "Are we going to finish Hitler's job?"[52]

The petition brought tensions between the American Euthanasia Society and the Catholic Church to a head that contributed to a climate of anti-Catholic sentiment generally, regarding issues such as birth control, eugenics, and population control. However, the petition did not result in any legal changes.[42]

Historically, the euthanasia debate has tended to focus on a number of key concerns. According to euthanasia opponent Ezekiel Emanuel, proponents of euthanasia have presented four main arguments: a) that people have a right to self-determination, and thus should be allowed to choose their own fate; b) assisting a subject to die might be a better choice than requiring that they continue to suffer; c) the distinction between passive euthanasia, which is often permitted, and active euthanasia, which is not substantive (or that the underlying principlethe doctrine of double effectis unreasonable or unsound); and d) permitting euthanasia will not necessarily lead to unacceptable consequences. Pro-euthanasia activists often point to countries like the Netherlands and Belgium, and states like Oregon, where euthanasia has been legalized, to argue that it is mostly unproblematic.

Similarly, Emanuel argues that there are four major arguments presented by opponents of euthanasia: a) not all deaths are painful; b) alternatives, such as cessation of active treatment, combined with the use of effective pain relief, are available; c) the distinction between active and passive euthanasia is morally significant; and d) legalising euthanasia will place society on a slippery slope,[53] which will lead to unacceptable consequences.[37]:7978 In fact, in Oregon, in 2013, pain wasn't one of the top five reasons people sought euthanasia. Top reasons were a loss of dignity, and a fear of burdening others.[54]

In the United States in 2013, 47% nationwide supported doctor-assisted suicide. This included 32% of Latinos, 29% of African-Americans, and almost nobody with disabilities.[54]

A 2015 Populus poll in the United Kingdom found broad public support for assisted dying. 82% of people supported the introduction of assisted dying laws, including 86% of people with disabilities.[55]

An alternative approach to the question is seen in the hospice movement which promotes palliative care for the dying and terminally ill. This has pioneered the use of pain-relieving drugs in a holistic atmosphere in which the patient's spiritual care ranks alongside physical care. It 'intends neither to hasten nor postpone death'.[56]

One concern is that euthanasia might undermine filial responsibility.[57] In some countries, adult children of impoverished parents are legally entitled to support payments under filial responsibility laws. Thirty out of the fifty United States[58] as well as France,[59] Germany,[60] Singapore, and Taiwan[61] have filial responsibility laws.

Passive euthanasia legal (refusal of treatment / withdrawal of life support)

Active euthanasia illegal, passive euthanasia not legislated or regulated

All forms of euthanasia illegal

West's Encyclopedia of American Law states that "a 'mercy killing' or euthanasia is generally considered to be a criminal homicide" and is normally used as a synonym of homicide committed at a request made by the patient.[62][63]

The judicial sense of the term "homicide" includes any intervention undertaken with the express intention of ending a life, even to relieve intractable suffering.[64][63][65] Not all homicide is unlawful.[66] Two designations of homicide that carry no criminal punishment are justifiable and excusable homicide.[66] In most countries this is not the status of euthanasia. The term "euthanasia" is usually confined to the active variety; the University of Washington website states that "euthanasia generally means that the physician would act directly, for instance by giving a lethal injection, to end the patient's life".[67] Physician-assisted suicide is thus not classified as euthanasia by the US State of Oregon, where it is legal under the Oregon Death with Dignity Act, and despite its name, it is not legally classified as suicide either.[68] Unlike physician-assisted suicide, withholding or withdrawing life-sustaining treatments with patient consent (voluntary) is almost unanimously considered, at least in the United States, to be legal.[69] The use of pain medication to relieve suffering, even if it hastens death, has been held as legal in several court decisions.[67]

Some governments around the world have legalized voluntary euthanasia but most commonly it is still considered to be criminal homicide. In the Netherlands and Belgium, where euthanasia has been legalized, it still remains homicide although it is not prosecuted and not punishable if the perpetrator (the doctor) meets certain legal conditions.[70][71][72][73]

In a historic judgment, the Supreme court of India legalized passive euthanasia. The apex court remarked in the judgment that the Constitution of India values liberty, dignity, autonomy, and privacy. A bench headed by Chief Justice Dipak Misra delivered a unanimous judgment.[74]

A 2010 survey in the United States of more than 10,000 physicians found that 16.3% of physicians would consider halting life-sustaining therapy because the family demanded it, even if they believed that it was premature. Approximately 54.5% would not, and the remaining 29.2% responded "it depends".[75] The study also found that 45.8% of physicians agreed that physician-assisted suicide should be allowed in some cases; 40.7% did not, and the remaining 13.5% felt it depended.[75]

In the United Kingdom, the assisted dying campaign group Dignity in Dying cites research in which 54% of general practitioners support or are neutral towards a law change on assisted dying.[76] Similarly, a 2017 Doctors.net.uk poll reported in the British Medical Journal stated that 55% of doctors believe assisted dying, in defined circumstances, should be legalised in the UK.[77]

One concern among healthcare professionals is the possibility of being asked to participate in euthanasia in a situation where they personally believe it to be wrong. In a 1996 study of 852 nurses in adult ICUs, 19% admitted to participating in euthanasia. 30% of those who admitted to it also believed that euthanasia is unethical.[78]

The Roman Catholic Church condemns euthanasia and assisted suicide as morally wrong. It states that, "intentional euthanasia, whatever its forms or motives, is murder. It is gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator". Because of this, the practice is unacceptable within the Church.[79] The Orthodox Church in America, along with other Eastern Orthodox Churches, also opposes euthanasia stating that "euthanasia is the deliberate cessation of human life, and, as such, must be condemned as murder."[80]

Many non-Catholic churches in the United States take a stance against euthanasia. Among Protestant denominations, the Episcopal Church passed a resolution in 1991 opposing euthanasia and assisted suicide stating that it is "morally wrong and unacceptable to take a human life to relieve the suffering caused by incurable illnesses."[80] Protestant and other non-Catholic churches which oppose euthanasia include:

The Church of England accepts passive euthanasia under some circumstances, but is strongly against active euthanasia, and has led opposition against recent attempts to legalise it.[90] The United Church of Canada accepts passive euthanasia under some circumstances, but is in general against active euthanasia, with growing acceptance now that active euthanasia has been partly legalised in Canada.[91]

Euthanasia is a complex issue in Islamic theology; however, in general it is considered contrary to Islamic law and holy texts. Among interpretations of the Qur'an and Hadith, the early termination of life is a crime, be it by suicide or helping one commit suicide. The various positions on the cessation of medical treatment are mixed and considered a different class of action than direct termination of life, especially if the patient is suffering. Suicide and euthanasia are both crimes in almost all Muslim majority countries.[92]

There is much debate on the topic of euthanasia in Judaic theology, ethics, and general opinion (especially in Israel and the United States). Passive euthanasia was declared legal by Israel's highest court under certain conditions and has reached some level of acceptance. Active euthanasia remains illegal, however the topic is actively under debate with no clear consensus through legal, ethical, theological and spiritual perspectives.[93]

See the article here:

Euthanasia - Wikipedia

Indian J Med Res. 2012 Dec; 136(6): 899902.

Department of Psychiatry National Institute of Mental Health & Neuro Sciences (Deemed University) Bangalore 560 029, India

Department of Psychiatry National Institute of Mental Health & Neuro Sciences (Deemed University) Bangalore 560 029, India

Department of Psychiatry National Institute of Mental Health & Neuro Sciences (Deemed University) Bangalore 560 029, India

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The word euthanasia, originated in Greece means a good death1. Euthanasia encompasses various dimensions, from active (introducing something to cause death) to passive (withholding treatment or supportive measures); voluntary (consent) to involuntary (consent from guardian) and physician assisted (where physician's prescribe the medicine and patient or the third party administers the medication to cause death)2,3. Request for premature ending of life has contributed to the debate about the role of such practices in contemporary health care. This debate cuts across complex and dynamic aspects such as, legal, ethical, human rights, health, religious, economic, spiritual, social and cultural aspects of the civilised society. Here we argue this complex issue from both the supporters and opponents perspectives, and also attempts to present the plight of the sufferers and their caregivers. The objective is to discuss the subject of euthanasia from the medical and human rights perspective given the background of the recent Supreme Court judgement3 in this context.

In India abetment of suicide and attempt to suicide are both criminal offences. In 1994, constitutional validity of Indian Penal Code Section (IPC Sec) 309 was challenged in the Supreme Court4. The Supreme Court declared that IPC Sec 309 is unconstitutional, under Article 21 (Right to Life) of the constitution in a landmark judgement4. In 1996, an interesting case of abetment of commission of suicide (IPC Sec 306) came to Supreme Court5. The accused were convicted in the trial court and later the conviction was upheld by the High Court. They appealed to the Supreme Court and contended that right to die be included in Article 21 of the Constitution and any person abetting the commission of suicide by anyone is merely assisting in the enforcement of the fundamental right under Article 21; hence their punishment is violation of Article 21. This made the Supreme Court to rethink and to reconsider the decision of right to die. Immediately the matter was referred to a Constitution Bench of the Indian Supreme Court. The Court held that the right to life under Article 21 of the Constitution does not include the right to die5.

Regarding suicide, the Supreme Court reconsidered its decision on suicide. Abetment of suicide (IPC Sec 306) and attempt to suicide (IPC Sec 309) are two distinct offences, hence Section 306 can survive independent of Section 309. It has also clearly stated that a person attempts suicide in a depression, and hence he needs help, rather than punishment. Therefore, the Supreme Court has recommended to Parliament to consider the feasibility of deleting Section 309 from the Indian Penal Code3.

Eliminating the invalid: Euthanasia opposers argue that if we embrace the right to death with dignity, people with incurable and debilitating illnesses will be disposed from our civilised society. The practice of palliative care counters this view, as palliative care would provide relief from distressing symptoms and pain, and support to the patient as well as the care giver. Palliative care is an active, compassionate and creative care for the dying6.

Constitution of India: Right to life is a natural right embodied in Article 21 but suicide is an unnatural termination or extinction of life and, therefore, incompatible and inconsistent with the concept of right to life. It is the duty of the State to protect life and the physician's duty to provide care and not to harm patients. If euthanasia is legalised, then there is a grave apprehension that the State may refuse to invest in health (working towards Right to life). Legalised euthanasia has led to a severe decline in the quality of care for terminally-ill patients in Holland7. Hence, in a welfare state there should not be any role of euthanasia in any form.

Symptom of mental illness: Attempts to suicide or completed suicide are commonly seen in patients suffering from depression8, schizophrenia9 and substance users10. It is also documented in patients suffering from obsessive compulsive disorder11. Hence, it is essential to assess the mental status of the individual seeking for euthanasia. In classical teaching, attempt to suicide is a psychiatric emergency and it is considered as a desperate call for help or assistance. Several guidelines have been formulated for management of suicidal patients in psychiatry12. Hence, attempted suicide is considered as a sign of mental illness13.

Malafide intention: In the era of declining morality and justice, there is a possibility of misusing euthanasia by family members or relatives for inheriting the property of the patient. The Supreme Court has also raised this issue in the recent judgement3. Mercy killing should not lead to killing mercy in the hands of the noble medical professionals. Hence, to keep control over the medical professionals, the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 discusses euthanasia briefly in Chapter 6, Section 6.7 and it is in accordance with the provisions of the Transplantation of Human Organ Act, 199414. There is an urgent need to protect patients and also medical practitioners caring the terminally ill patients from unnecessary lawsuit. Law commission had submitted a report (no-196) to the government on this issue15.

Emphasis on care: Earlier majority of them died before they reached the hospital but now it is converse. Now sciences had advanced to the extent, life can be prolonged but not to that extent of bringing back the dead one. This phenomenon has raised a complex situation. Earlier diseases outcome was discussed in terms of CURE but in the contemporary world of diseases such as cancer, Aids, diabetes, hypertension and mental illness are debated in terms best CARE, since cure is distant. The principle is to add life to years rather than years to life with a good quality palliative care. The intention is to provide care when cure is not possible by low cost methods. The expectation of society is, cure from the health professionals, but the role of medical professionals is to provide care. Hence, euthanasia for no cure illness does not have a logical argument. Whenever, there is no cure, the society and medical professionals become frustrated and the fellow citizen take extreme measures such as suicide, euthanasia or substance use. In such situations, palliative and rehabilitative care comes to the rescue of the patient and the family. At times, doctors do suggest to the family members to have the patient discharged from the hospital wait for death to come, if the family or patient so desires. Various reasons are quoted for such decisions, such as poverty, non-availability of bed, futile intervention, resources can be utilised for other patients where cure is possible and unfortunately majority of our patient's family do accordingly. Many of the terminally ill patients prefer to die at home, with or without any proper terminal health care. The societal perception needs to be altered and also the medical professionals need to focus on care rather in addition to just cure. The motive for many euthanasia requests is unawareness of alternatives. Patients hear from their doctors that nothing can be done anymore. However, when patients hear that a lot can be done through palliative care, that the symptoms can be controlled, now and in the future, many do not want euthanasia anymore16.

Commercialisation of health care: Passive euthanasia occurs in majority of the hospitals across the county, where poor patients and their family members refuse or withdraw treatment because of the huge cost involved in keeping them alive. If euthanasia is legalised, then commercial health sector will serve death sentence to many disabled and elderly citizens of India for meagre amount of money. This has been highlighted in the Supreme Court Judgement3,17.

Research has revealed that many terminally ill patients requesting euthanasia, have major depression, and that the desire for death in terminal patients is correlated with the depression18. In Indian setting also, strong desire for death was reported by 3 of the 191 advanced cancer patients, and these had severe depression19. They need palliative and rehabilitative care. They want to be looked after by enthusiastic, compassionate and humanistic team of health professionals and the complete expenses need to be borne by the State so that Right to life becomes a reality and succeeds before Right to death with dignity. Palliative care actually provides death with dignity and a death considered good by the patient and the care givers.

Caregivers burden: Right-to-die supporters argue that people who have an incurable, degenerative, disabling or debilitating condition should be allowed to die in dignity. This argument is further defended for those, who have chronic debilitating illness even though it is not terminal such as severe mental illness. Majority of such petitions are filed by the sufferers or family members or their caretakers. The caregiver's burden is huge and cuts across various domains such as financial, emotional, time, physical, mental and social. Hence, it is uncommon to hear requests from the family members of the person with psychiatric illness to give some poison either to patient or else to them. Coupled with the States inefficiency, apathy and no investment on health is mockery of the Right to life.

Refusing care: Right to refuse medical treatment is well recognised in law, including medical treatment that sustains or prolongs life. For example, a patient suffering from blood cancer can refuse treatment or deny feeds through nasogastric tube. Recognition of right to refuse treatment gives a way for passive euthanasia. Many do argue that allowing medical termination of pregnancy before 16 wk is also a form of active involuntary euthanasia. This issue of mercy killing of deformed babies has already been in discussion in Holland20.

Right to die: Many patients in a persistent vegetative state or else in chronic illness, do not want to be a burden on their family members. Euthanasia can be considered as a way to upheld the Right to life by honouring Right to die with dignity.

Encouraging the organ transplantation: Euthanasia in terminally ill patients provides an opportunity to advocate for organ donation. This in turn will help many patients with organ failure waiting for transplantation. Not only euthanasia gives Right to die for the terminally ill, but also Right to life for the organ needy patients.

Constitution of India reads right to life is in positive direction of protecting life. Hence, there is an urgent need to fulfil this obligation of Right to life by providing food, safe drinking water and health care. On the contrary, the state does not own the responsibility of promoting, protecting and fulfilling the socio-economic rights such as right to food, right to water, right to education and right to health care, which are basic essential ingredients of right to life. Till date, most of the States has not done anything to support the terminally ill people by providing for hospice care.

If the State takes the responsibility of providing reasonable degree of health care, then majority of the euthanasia supporters will definitely reconsider their argument. We do endorse the Supreme Court Judgement that our contemporary society and public health system is not matured enough to handle this sensitive issue, hence it needs to be withheld. However, this issue needs to be re-examined again after few years depending upon the evolution of the society with regard to providing health care to the disabled and public health sector with regard to providing health care to poor people.

The Supreme Court judgement to withhold decision on this sensitive issue is a first step towards a new era of health care in terminally ill patients. The Judgment laid down is to preserve harmony within a society, when faced with a complex medical, social and legal dilemma. There is a need to enact a legislation to protect terminally ill patients and also medical practitioners caring for them as per the recommendation of Law Commission Report-19615. There is also an urgent need to invest in our health care system, so that poor people suffering from ill health can access free health care. Investment in health care is not a charity; Right to Health is bestowed under Right to Life of our constitution.

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Euthanasia: Right to life vs right to die - PMC

Euthanasia (good death) is the practice of intentionally ending a life in order to relievepainandsuffering. It is also known as mercy killing. In many countries,there is a divisive public controversy over the moral, ethical, and legal issues of euthanasia.Euthanasia is categorized in different ways, which include voluntary, non-voluntary, or involuntary. Euthanasia is also classified into active and passive Euthanasia.

Voluntary, non-voluntary and involuntary euthanasia can all be further divided into passive or active variants.

Historically, the euthanasia debate has tended to focus on a number of key concerns. According to euthanasia opponent Ezekiel Emanuel, proponents of euthanasia have presented four main arguments:

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Emanuel argues that there are four major arguments presented by opponents of euthanasia:

Passive euthanasia is legal in India. On 7 March 2011, the Supreme Court of India legalised passive euthanasia by means of the withdrawal of life support to patients in a permanent vegetative state. The decision was made as part of the verdict in a case involving Aruna Shanbaug, who had been in a Persistent Vegetative State (PVS) for 42 years until her death in 2015.

In March 2011, the Supreme Court of India passed a historic judgement-law permitting Passive Euthanasia in the country. This judgment was passed in the wake of Pinki Viranis plea to the highest court in December 2009 under the Constitutional provision of Next Friend. Its a landmark law which places the power of choice in the hands of the individual, over government, medical or religious control which sees all suffering as destiny. The Supreme Court specified two irreversible conditions to permit Passive Euthanasia Law in its 2011 Law:

The same judgement-law also asked for the scrapping of 309, the code which penalises those who survive suicide-attempts. In December 2014, the Government of India declared its intention to do so.

However on 25 February 2014, a three-judge bench of Supreme Court of India had termed the judgment in the Aruna Shanbaug case to be inconsistent in itself and has referred the issue of euthanasia to its five-judge Constitution bench on a PIL filed by Common Cause, which case is the basis of the current debate. Then, the CJI referred to an earlier Constitution Bench judgment which, in the Gian Kaur case, did not express any binding view on the subject of euthanasia; rather it reiterated that the legislature would be the appropriate authority to bring change. Though that judgment said the right to live with dignity under Article 21 was inclusive of the right to die with dignity, it did not arrive at a conclusion on the validity of euthanasia, be it active or passive. So, the only judgment that holds the field with regard to euthanasia in India is the ruling in the Aruna Shanbaug case, which upholds the validity of passive euthanasia and lays down an elaborate procedure for executing the same on the wrong premise that the Constitution Bench in Gian Kaur had upheld the same, the CJI said.

OnDecember 23, 2014, Government of India endorsed and re-validated the Passive Euthanasia judgement-law in a Press Release, after stating in the Rajya Sabha as follows: that The Honble Supreme Court of India, while dismissing the plea for mercy killing in a particular case, laid down comprehensive guidelines to process cases relating to passive euthanasia. Thereafter, the matter of mercy killing was examined in consultation with the Ministry of Law and Justice and it has been decided that since the Honble Supreme Court has already laid down the guidelines, these should be followed and treated as law in such cases. At present, there is no legislation on this subject and the judgment of the Honble Supreme Court is binding on all.

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The court rejected active euthanasia by means of lethal injection. In the absence of a law regulating euthanasia in India, the court stated that its decision becomes the law of the land until the Indian parliament enacts a suitable law. Active euthanasia, including the administration of lethal compounds for the purpose of ending life, is still illegal in India, and in most countries.

As India had no law about euthanasia, the Supreme Courts guidelines are law until and unless Parliament passes legislation. The following guidelines were laid down:

Recently, the issue was in the news, as the Govt. said it was open to making a law on the subject. The law commission too has proposed a legislation on passive euthanasia, it said. According to the Centre, the decision to come out with a bill was taken after considering the directives of the apex court, the law commissions 241st report and a private member bill introduced in Parliament in 2014. The Centre said that initially, a meeting was held under the chairmanship of B.P. Sharma, secretary in the health and family welfare ministry, on May 22, 2015, to examine the draft of The Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill and the draft of The Euthanasia (Regulation) Bill.

This move to introduce a bill is a welcome step to clear the grey areas in Euthanasia debate.Students can also link to this issue while answering questions on:

Article by: Jishnu J Raju

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Euthanasia - Arguments in Favour and Against - ClearIAS

For years now, the euthanasia debate has still not ended, as no middle path has been struck to pacify those who are for and against this practice. The right to life and the gift of God are the major arguments that surface when the topic arises.

While some believe it is only humane to enable a human being to end his suffering by means of assisted suicide, others believe that all pain and suffering endured by human beings is Gods will, and should be accepted as it has been given by God. In this heated debate are also included religious, political, and personal views. Among all this, those who desperately want to end their lives because they simply cannot go on in any way are the ones who suffer.

Every individual or group has a different viewpoint regarding euthanasia. Some are practical, some emotional, and some religious. There is also a deep history of euthanasia, which cannot be ignored when having a debate regarding this subject. Based on this history, beliefs, and viewpoints, certain arguments for and against euthanasia have been put forward.

When a person is terminally ill or in a vegetative state, it is often considered sensible to alleviate the pain and suffering by ending her/his life. But there are several arguments about this. Euthanasia allows a person to end their perpetual state of suffering and die with dignity. When a person is not in a condition to perform any physical tasks, experience any emotion, or on the other hand, is in extreme physical pain, propagators of this method of ending life argue, why should a person like this continue to live in pain? This is one of the biggest arguments for euthanasia. The problem is that at times the patient is in no condition to make this decision, and such a decision is made on behalf of the family. For situations like these there is a specific government regulation that demands complete evidence that euthanasia is the only option left. Such appeals can only be made when all other methods to ease the suffering of the patient, or to treat her/him have been made and failed. Again, those who believe in euthanasia and are for it, believe that the right to die is a personal matter, and it has nothing to do with society or humanity at large. A persons right to die will not affect the state or harm it in any manner, and thus, they believe that no such regulation is needed to govern euthanasia.

On the flip side of the coin, it has to be understood that the decision to die will definitely affect family and friends. There will be guilt, remorse, anger, frustration, and sadness associated with the decision of choosing death. In this way, it is considered improper to demand death when so much depends on a person. Also, it is believed that the person in question has an obligation towards society, where she/he simply cannot choose to die. But what can a person who is terminally ill do? How can she/he ease the pain and grief of others when she/he is in immense pain her/himself? What kind of an obligation towards society can a person fulfill when she/he lacks the capacity to do so? Further, there are numerous costs of health care that need to be taken care of when it comes to keeping a person who is incapable of functioning in any manner, alive. Bearing these costs is difficult which is why, when the ill person her/himself cannot make a request for euthanasia, this request is put forth by family.

One of the biggest arguments against this process is belief about the casual nature with which it will be approached in the future. If euthanasia is permitted without the necessity to abide by government regulations and laws, people will use it as a means to get out of even simpler troubles. Moreover, there may be ways in which pressure may be put on individuals to die or end their lives because they may seem as burdens to the family. They may also use it as a method of avoiding heavy medical expenditures that may be needed in cases that are complicated. Religious views suggest that only God has the right to take life, and it is something us human beings should not meddle with. Further, they believe that life is a precious gift that has been bestowed upon us by the Almighty, and giving it up due to some pain is no way to value it. Political views suggest that euthanasia will have an effect on society, no matter how personal a decision it is. As a society that survives on following the footsteps of others, deciding to request for death will cause other individuals (in less deplorable situations) to follow these methods too.

These are simply some thoughts on the ongoing debate that is a cause for concern all over the world. From the humanitarian point of view, the right to die (with dignity) belongs to every individual, and this cannot be ignored no matter how many arguments are put forth against this practice. Though several facts may be presented to you to persuade or dissuade you about this practice, it is ultimately your belief that will allow you to think whether or not such a practice should be legalized. It is a good idea to remember that death and dying is inevitable and an ultimate eventuality. In effect, the legalization of euthanasia under the strict governing of laws and regulations will allow those who wish to avail of this right, to do so with dignity. It is a process that will take a while, while the pros and cons of euthanasia are considered, and till all human beings are convinced that it may be a boon when viewed from the perspective of the right to life.

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Euthanasia Debate - Opinion Front

In celebration of Star Wars Day 2022, Alachua County Animal Resources and Care (AR&C) is hosting a May the Fourth adoption event. AR&C is lowering adoption fees to just four dollars next week (May 3, through May 7, 2022). The shelter is open Tuesday through Saturday 10:30 a.m. to 5:30 p.m., excluding holidays. Come dressed as your favorite Star Wars character, make crafts, eat snacks, and take home your chosen one.

In an animal shelter very, very close by, a chosen one will bring balance to the light. For good to triumph and balance to be restored, AR&C needs the communitys help. The shelter took in more animals than it could find homes for last year. To prevent the unwarranted euthanasia of healthy, adoptable shelter pets, staff have been working extra hard to find homes for all of them. Good progress was being made until the March intakes and lack of adoptions broke that winning streak. With puppies and kittens already starting to come in, the shelter needs to place upwards of 100 animals in loving homes to restore the balance (aka capacity for care).

We appreciate our employees continued dedication to the lost, homeless, abused, and abandoned animals of our community, said AR&C Director Ed Williams. Try as they might, an open admission, municipal shelter is no substitute for a forever home. And room must be made for the many new intakes arriving daily. Come on out and show us your love Gainesville. May the 4th be with you.

Pet adopters must be 18 years or older and show identification with proof of current address. If there are already pets in the home, potential adopters must show proof that owned animals are current on rabies and county licenses. All adoptable cats and dogs are vaccinated, microchipped, and sterilized before going home.

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Animal Resources and Care's May the Fourth Adoption Event - Alachua County

Written for Daily Hive byChantelle Archambault of theVancouver Humane Society

A new rodeo may be coming to the Lower Mainland and that could spell bad news for animals and residents.

Organizers have requested approval from the Canadian Professional Rodeo Association to host the event in Langley this September. The group name, Valley West Stampede Society, may not ring any bells, but at least one familiar face hints at ties to BC rodeos problematic recent history.

The committee contact listed on the Pro Rodeo website is Rich Kitos the former vice president of the Cloverdale Rodeo & Exhibition Association and one of the keyboard members named in the human rights complaint filed against the Association in July of last year. The complaint alleges that board members including Kitos conspired to cover up racist, sexist, and physically abusive conduct.

To see a new rodeo proposed in connection with this name should be a cause for concern to the Langley community.

This new proposal is especially shocking given the widespread opposition to rodeo in BC. According to a poll from earlier this month, 64% of BC residents are opposed to the use of animals in rodeos.

Animal suffering is becoming increasingly difficult for British Columbians to stomach as awareness grows. More and more, the science of how animals think, feel, socialize, and perceive the world is bringing to light the suffering inherent in rodeo practices.

Its a natural next step, then, to prevent as much unnecessary suffering as we can for these animals. We would not goad a puppy in a chute so that he bursts out at a high speed, only to be roped by the neck and tied at the legs; yet this is the treatment rodeo supporters would have us accept for 3-month-old calves in tie-down roping events. All the while, research and common sense tell us that calves experience stress and fear while being chased, roped and roughly handled.

One of the common arguments for rodeo events is that they educate the public about where their animal-based food comes from. The truth is, if these same practices were to occur on a farm, they would be against the law. The National Farm Animal Care Council requires quiet handling techniques to minimize stress. Roping an animal by the neck at over 40 kilometres per hour would be considered abusive under section 5.2 of the Veal Cattle Code of Practice because of the dragging that can occur.

There is further concern with animals being purpose-bred for rodeo, leading to distressing predispositions like bulls or horses who are more sensitive to negative stimuli. This causes the animals to buck when they are exposed to fear, pain, and stress, such as from the use of spurs and from a flank strap tied around their sensitive hindquarters in bucking events.

Combine this with the increased risk of injury that could put animals in line for euthanasia, and it is clear that rodeo is fundamentally at odds with how we should be treating animals.

The growing awareness around animal welfare is largely responsible for the recent shift away from rodeo events in BC. In 2007, the death of a calf prompted the Cloverdale Rodeo to drop four of its most concerning events: calf roping, team roping, steer wrestling, and wild cow milking. In 2015, the Luxton Rodeo near Victoria was cancelled; the Abbotsford Rodeo followed suit in 2016. The following year, Chilliwack Rodeo implemented modest rule changes to its calf roping and steer wrestling events, including that a steer must be on his feet before being rolled to the ground.

To approve a new rodeo now which would not only introduce unnecessary suffering to animals, but also have ties to concerning allegations of discrimination in a recent human rights complaint, would fly in the face of our societys values and the progress we have made. If our community is committed to justice and compassion, we cannot sit by and permit these major steps backward for animals and humans.

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Opinion: Proposed rodeo in Langley flies in the face of community values | News - Daily Hive

Reading Time: 4 minutesKeith Cox is our first person highlighted in a new series published by The Catholic Weekly called Parish Heroes. Photo: Alphonsus FokParish Heroes

For the past 100 years our parishes have been the cornerstones of local Australian communities. Its those special people that help make our nation thrive. As we move into the 21st century who are the people in your parish that stand out and who make our community what it is today? Tell us their story and why they deserve to be recognised as a Parish Hero.

Keith Cox OAM has spent almost 50 years living with the dying.

As Australias first dedicated oncology nurse, he has cared for tens of thousands of people going through some of the toughest times of their lives.

Affectionately known as Mister Sister, the life-long parishioner at St Marks Drummoyne believes he was born to help others and that his faith has never been far from his side.

God is my all, to have faith is such a gift, he smiled.

It is very comforting to know that God is there with you.

Being asked am I dying is something that is very difficult, many patients need that acknowledgement that they are dying and that they can let go.

I can remember saying from time to time Our Lord has got your room ready for you now and you can let go and that did bring some peace. My faith has certainly assisted me in not only my career but all aspects of my life and for that I am very thankful.

In a lifetime of firsts, not only was Keith one of the first male nurses in the country and Australias first dedicated oncology nurse, but also The Catholic Weeklys first Parish Hero.

Launched this week, it is a series which will feature inspirational individuals making a difference in their local communities and beyond.

And making a difference is what Keith has spent almost 50 years doing, while retirement is not a word he recognises.

You can palliate people without killing them. Its that simple. Keith Cox

In addition to his ground-breaking career in cancer care, he is a dedicated member of his parish and volunteers for St Vincent de Paul and Canices Kitchen, is an acolyte, as well as a Eucharistic Minister, giving communion to residents in local nursing homes.

Seeing people through their best and worst times has been a privilege Keith couldnt be more grateful for, which he has documented in his new book, A Caring Life, giving a fascinating insight into his extraordinary life.

He has dedicated most of his life to patient care, mentoring cancer nurses, writing research papers and addressing medical conferences around the world. In 2006, he was the third-ever Australian to become a cancer nurse practitioner and in 2007 was awarded an OAM for his services to nursing and community volunteer work.

A staunch advocate for palliative care, Keith said he has witnessed dramatic advances in medical treatment, and also the limits of what medical intervention can achieve.And after almost half a century of nursing, said he can now answer the most commonly asked question during his oncology care, Will I be in pain when I am dying, with honesty and respect.

You can palliate people without killing them, its that simple, he said.

I am a very strong supporter of palliative care.

Sadly most people think dying will mean pain, which just isnt the case.

I understand euthanasia is not an easy topic to address but I just dont believe in killing someone because they dont have any hope.

WATCH THE VIDEO OF KEITH ON THE PROJECT PROGRAM

I think in this day and age in 2022, you can give patients good palliation without lethal injection. A lot of people wont agree with me but thats my belief. Born in regional NSW in the early 1950s and one of nine children five of whom became nurses he grew up in a traditional Catholic family and remembers being torn between two vocations, nursing or becoming a Franciscan Brother.

His older sister had become a nun at the St John of God Convent in Perth, and while studying nursing at Sydneys Royal Prince Alfred Hospital, he experienced a religious calling. However, after visiting a Franciscan friary in Campbelltown, he decided it was nursing or nothing.

He completed his oncology training at the Royal Marsden Hospital in London and on return to Sydney assisted in the establishment of the first cancer and chemotherapy service back at RPA before helping set up the Chris OBrien Lifehouse centre. Staff, patients and their families sing his praises and thank him for his almost 50 years of tireless dedication and empathy.

Nursing has quite simply taught me that many of the gifts I have come from our Lord, he said. I guess my advice to anybody would be believe in yourself, you can do anything in life and dont worry about being the first in something.Everything in my life I have done has been with great faith, and can honestly say I wouldnt change a thing.

A Caring Life by Keith Cox and Grant Jones is published by Pan Macmillan Australia and available now.

NOMINATE YOUR PARISH HERO AT: [emailprotected]m.au

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Parish Heroes: 50 years of caring a 'gift' - The Catholic Weekly

A collection of personal anecdotes co-authored by Art Sesnovich and Frank Quaglia

WORCESTER, Mass., April 27, 2022 /PRNewswire/ -- Vampires. Peeing monkeys. Clients who wore their clothes backwards. Even nudist wakes.

In four decades as a world-renowned funeral director a reputation enhanced by his role as the man who buried the Boston Marathon Bomber, Tamerlan Tsarnaev Peter Stefan truly saw it all. The owner of Graham Putnam Mahoney Funeral Parlors in Worcester, MA, Stefan met, buried, and worked with a cast of characters that kept his life, and his job, very interesting.

Many of the people and the stories that go with them - were so strange yet so amusing, Stefan felt compelled to put them into a collection entitled "Mumblings of a Mortician" (available on Amazon, $19.99 print, $14.99 Kindle). Written by co-authors Art Sesnovich and Frank Quaglia, the collection of personal anecdotes focus on the bizarre, head-shaking situations Stefan encountered as a funeral director, along with his unique perspective on various matters, both vital and trivial.

There was the Asian family that cooked a chicken in a hubcap on the floor of the viewing room, setting the carpet on fire in the process. There was the time when two funerals were going on at the same time, after which each funeral party followed the wrong hearse to the cemetery. There was the team of paranormal researchers, convinced there were ghosts in Stefan's building and that they had captured the creatures on film, only to discover it was Stefan's pipe smoke.

A special place has been reserved for Stefan's employees, like the one who came into work every morning feeling sick, only to recover in the afternoon. Stefan discovered the employee was brushing his teeth with hemorrhoid cream.

An entire chapter is devoted to the story behind Stefan's decision to bury the Boston Marathon Bomber, and how he accomplished this task with the attention of the world upon him. Many people respected his decision to perform the burial, believing, as he did, that every human being regardless of what they did in life - deserves a proper burial. Just as many, however, hated him for it; he received death threats daily, and police details were stationed outside his funeral home for days while the logistics were being worked out.

Not surprisingly, the unflappable Stefan bought pizza and soda for the protesters. Why? His answer was typically simple: "They were hungry."

And the peeing monkey? Little Bixby was a pet that a friend could no longer keep, so Stefan brought him home to his family. To show his gratitude to Stefan for saving him from certain euthanasia, Bixby constantly peed on him no one else, just him. Stefan was philosophical: "I should have been grateful: some monkeys throw their feces at people," he observed.

On a somber note, Stefan passed away on March 21, 2022 at the age of 85. He got to see his book in print, realizing a long-time dream of his.

Media Contact: Arthur Sesnovich508 612-4179[emailprotected]

SOURCE Arthur Sesnovich

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World-Renowned Mortician Publishes Collection of Stories About His Four Decades in the "Death Business" - PR Newswire

COLUMBUS, Ohio Editor's Note: This report has been updated with new information and clarifies that the "rule change" in an earlier draft of this story is in place already but was resubmitted in a new document and is now under review.

After a News 5 story aired regarding a controversial rule under review at the statehouse that allows some dog breeders to dock the tails and remove dewclaws for puppies ages 2 to 5 days old, the rule was pulled by the Ohio Department of Agriculture so they could have more time to look at it and possibly revise it, according to the Joint Committee on Agency Rule Review (JCARR).

This rule was being re-proposed by the Ohio Department of Agriculture (ODA), and has been in place for years, despite some lawmakers and animal rights activists saying it was against the Ohio Revised Code.

JCARR was supposed to be hearing testimony on Tuesday on a rule that would allow any commercial or high-volume breeders to perform these procedures.

The original documents have been removed from the JCARR website, but News 5 obtained copies.

Although this is a common cosmetic practice for some dogs, the question of who is doing the procedure is causing concern for animal activists.

"There are rules that the Ohio Department of Agriculture are trying to continue to operate under and to pass, that would allow dog breeders without a vet being present without pain, medication, without anesthesia to lop off the tails of dogs and also utilize equipment to pull out their dewclaws," said Vicki Deisner, state government affairs advisor for Animal Welfare Institute.

The Humane Society describes "puppy mills" as inhumane high-volume dog breeding facilities. Ohio ranks second in the nation for most mills.

Deisner believed this proposal would cause even more inhumane conditions.

"Now I would like to show you some of the equipment that we understand the puppy mill breeders will use to do this," she said, taking out equipment. "Here are a pair of small garden clippers. Here is a knife that they use to cut it off. Here is a pair of scissors, just plain old garden scissors and a rubber band because that process would be to tie tightly the end of the tail and basically cut the blood supply till it rots and falls off."

A report in 2021 done by the Humane Society showed Ohio breeders were one of the worst offenders for inhumane treatment of animals with performing botched dental surgery, dogs living in feces and out in the cold in the winter, and keeping dogs in crates with other dead or severely injured puppies.

"To just simply say, 'yeah, we can lob off a tail or a dewclaw and not understand the anatomy behind that, not mitigate the pain behind that and not knowing how to properly heal that wound,' you could put a puppy into grave danger," said Dr. Ole Alcumbrac, medical director for White Mountain Animal Hospital.

Alcumbrac is a longtime veterinarian and wildlife expert. He has seen many botched cases from breeders and non-professionals trying to alter their dogs, he said.

After speaking on the phone about setting up an interview, an ODA spokesperson emailed News 5 that it was not able to do an on-camera interview and provided answers via message instead.

"These procedures have been allowed to be performed by the licensed high volume dog breeder since the inception of the law," ODA spokesperson Bryan Levin said. "The OAC requires the high volume dog breeder to have a veterinary health care plan developed by their veterinarian that addresses how the licensee will perform these procedures, if applicable (not all breeds of dog have their tails docked or dewclaws removed). So, although the licensee may be performing these procedures, there is required veterinary oversight."

Deisner said that although that may be their code to do that practice, it directly goes against Ohio law. House Bill 506 that was put into law by the 132nd General Assembly revised the law governing high volume dog breeders and other dog-related professionals and facilities.

In Section 4741.01 of the ORC,the "practice of veterinary medicine" is defined as any person who administers to or performs any medical or surgical technique on any animal that has any disease, illness, pain, deformity, defect, injury, or other physical, mental, or dental condition or performs a surgical procedure on any animal. It also adds that a licensed veterinarian means a person licensed by the board to practice veterinary medicine.

In Section 956.031 of the ORC, the law states that if a surgical or euthanasia procedure is required, use a veterinarian to perform the procedure.

Despite what some animal advocates say, the ODA tells News 5 the rule is not against the law but further defines it. However, the ODA's Levin emailed that the rule change is also intended to bring the rules up to date to reflect current ORC.

"There are no provisions allowing for the practice of veterinary medicine based on the age of companion animal, whether it is two to five days," she said. "Allowing layperson to perform these procedures is in violation of the laws that establish the qualifications for a licensed veterinarian and places animals in danger by providing permission to an unqualified individual to perform a surgical procedure, one which also alters the animal's body and can result in long term damage."

She also added that the law states, in regard to high-volume commercial dog breeders if a surgical or euthanasia procedure is required, use a veterinarian to perform the procedure. As the legislation clearly states that a veterinarian is to perform all surgical procedures, the ODA lacks the authority to enact regulations that allow anyone other than veterinarians to conduct such procedures, she said.

A representative from the Ohio Veterinary Medical Association (OVMA) said that some activists may be misconstruing the regulation. He said, technically, tail docking and dewclaw removal isnt surgery. Alcumbrac disagrees.

"Any time you cut into a body that is considered surgery," Alcumbrac said.

As it turns out, the OVMA, as well as the kennel vets-on-record of ODA's licensed high-volume breeders are part of ODA's stakeholder group, Levin said.

The ODA referred to the actions as surgical procedures, citing that Surgical procedures, except between two to five days of age the removal of the dew claw and tail docking, shall only be performed by a licensed veterinarian.

Allowing a person to perform a cosmetic surgical procedure on any animal regardless of age without proper pain management and euthanasia is considered animal cruelty, torture and torment, Deisner added, citing the law.

WEWS

If people do really want their dog to have the same aesthetic as the rest of its breed, go to a vet, Alcumbrac said, even though he doesn't like the procedures.

"It's going to be done properly and the standards are met for the breeds," he said. "For instance, if we're doing tails on a puppy, there's already pre-established standards for where we cut that tail, how we make that tail look and we're going to be doing it, aseptically. We're going to be suturing wounds. We're going to be doing everything that we need to do in order to have the best outcome for that desired look on that dog."

The main reason that people don't want to take their puppies to the vet is that the vet can be expensive, Deisner said.

"It would save them money," she said. "If you look at what the cost to the pet store, where the puppy mills dogs go, you see dogs being sold between $2-5,000 often. There is obviously money being made, and if there's that much money being made, it should go back and some of it needs to be spent on those animals who are suffering."

She also adds that when someone has a large number of dogs, there is no possible way they are actively caring for each one of them in the best way possible. A lot of the dogs are just for profit, she said.

"Our mission is to prevent cruelty to animals in the state of Ohio and nationwide and in that respect, we are actually urging the viewers and those who care and advocate for dogs that come from puppy mills and end up being sold in pet stores, to speak up to their legislators but particularly legislators that have oversight over JCARR," she said. "Ask them to invalidate these rules and abide by what the law says only surgical procedures can be done by veterinarians."

Follow WEWS statehouse reporter Morgan Trau on Twitter and Facebook.

See original here:

Ohio may continue allowing breeders without veterinary training to perform surgery on dogs - News 5 Cleveland WEWS

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