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Euthanasia | American Medical Association

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:

(a) Should not abandon a patient once it is determined that a cure is impossible.

(b) Must respect patient autonomy.

(c) Must provide good communication and emotional support.

(d) Must provide appropriate comfort care and adequate pain control.

Code of Medical Ethics:Caring for Patients at the End of Life

Visit theEthics main pageto access additional Opinions, the Principles of Medical Ethics and more information about the Code of Medical Ethics.

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Euthanasia | American Medical Association

Euthanasia – American Life League

When we talk about euthanasia, what exactly do we mean? Today, we usually hear about euthanasia in the health care context. For our purposes, euthanasia amounts to doing, or not doing, something to intentionally bring about a patients death. Because theres so much confusion surrounding the term, lets make sure we understand what euthanasia is not.

It is not euthanasia to administer medication needed to control painthats called good medical care. It is not euthanasia to stop treatment that is gravely burdensome to a patientthats called letting the patient exercise the moral option to refuse extraordinary medical means. It is not euthanasia to stop tube-feeding a patient whose diseased or injured body can no longer assimilate food and waterthats called simply accepting death.

In these circumstances, pain control, refusing extraordinary means, and stopping feeding may all allow death. Butand this is crucial to our understandingunlike euthanasia, their purpose and intent is not to bring about death.

Actually, euthanasia could be called a form of suicide, assisted suicide, or even murder, depending on the patients level of involvement and consent. To define euthanasia this way, though, seems to diminish its threat. After all, arent there laws or, at the very least, strong social taboos against suicide, assisted suicide, and murder?

Unfortunately, when it comes to the sick and disabled, this is no longer entirely true. And, the rationale and cultural forces behind the movement that brought this about threaten even more to tear down the legal and social barriers to killing.

Most of us know about Jack Kevorkian and his efforts to help ailing people commit suicide. Many of us may not realize, though, that Kevorkians maverick image masks a serious crusade that is building on emerging legal and cultural trends. Our society is poised to accept euthanasia on demandand worse. What we dont know about that could kill us.

In sum, it is vitally important to understand that everyones most basic rightthe right to lifeis in jeopardy when our law and collective morality no longer view all persons as equally worthy of life, solely on the basis of our common humanity. Not only is it the right thing to do, it is also in our own best interests to protect and cherish weak and vulnerable members of our human family.

In order to do that, we must educate ourselves and others about the growing threat of euthanasia, vigorously oppose its legalization, and pray for the wisdom and compassion to properly comfort, care for and dissuade those considering suicide.

The information on euthanasia is a PowerPoint Presentation (2007) prepared for American Life League by Julie Grimstad, Executive Director of Life is Worth Living, Inc.

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Euthanasia - American Life League

Right to euthanasia for people tired of life supported by most Dutch – The Irish Times

For the first time a majority of the Dutch population supports the idea of euthanasia for those who say theyre tired of life although they remain physically healthy, a survey shows.

In 2002 the Netherlands became the first country in the world to legalise euthanasia as a form of painless escape for terminally ill patients with the emphasis on those experiencing hopeless and unbearable suffering.

The procedure remains tightly controlled. Two doctors are required to agree independently in each case that the legal conditions have been met. However, theres a growing debate about whether or not availability should be broadened to include those who feel their lives are at an end.

As a result, controversial new legislation is to be tabled in parliament by the centre-left party D66 early next year that would make euthanasia available to citizens over 75 who believe their lives are complete and who wish to have control over how and when they end.

The new representative survey by the national statistics agency will be good news for D66 because it shows clearly for the first time that public attitudes to euthanasia are changing, and that that change is very much in line with the partys proposed new guidelines.

They survey shows the same overwhelming support for euthanasia as before, with 87 per cent of the population favouring its availability in certain controlled circumstances, 8 per cent opposed to it in all circumstances and 5 per cent with no opinion.

In religious terms, the greatest support for the procedure at 98 per cent comes from those who describe themselves as non-religious, with the greatest opposition from Muslims and orthodox Protestants.

However, within those broad parameters theres been an important shift, with 55 per cent of those surveyed now of the view that euthanasia should be available in cases where people feel tired of life while being in good physical health. Thirty-two per cent remain opposed to this.

As regards other specific hard case situations, 80 per cent agreed with its provision in cases of advanced dementia where the wish had been made known in advance.

Seventy-five per cent were in favour for terminally ill children and people with severe mental disorders.

The lower age limit for assisted suicide is currently 12, and while a third of respondents said they believed the age should be lowered to include younger children in distress, roughly half said they felt age should play no role in the decision at all.

The survey confirms that although it remains controversial and some cases become high profile, euthanasia is still used infrequently. There were 6,126 deaths by euthanasia in 2018, amounting to 4 per cent of the people who died in the Netherlands last year.

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Right to euthanasia for people tired of life supported by most Dutch - The Irish Times

Euthanasia – Simple English Wikipedia, the free encyclopedia

Euthanasia is when a person's life is ended because of disease or pain, which has made them suffer. This is different from assisted suicide, where a person helps someone kill themselves. It is also different to murder, where the reason is not suffering, but to kill for the killer's own ends. Euthanasia can be voluntary, where the person who dies asks for help in ending their life. Where the person is unable to make their decision known, it is usually called non-voluntary euthanasia. Where someone is killed against their will, it is usually called murder.

Euthanasia is illegal in most countries. It is permitted in a small number of countries, such as the Netherlands, Belgium and Victoria, Australia.[1] Where it is permitted there are many rules, and only in cases where the patient is terminally ill. Though euthanasia is not legal in the United States, doctors can assist people to kill themselves. This is legal in Washington, Oregon, and Montana. Physician Assisted Suicide (PAD) is different to euthanasia; it is about who gives the medication to end a patients life. The World Federation of Right to Die Societies says physician-assisted suicide means "making lethal means available to the patient to be used at a time of the patients own choosing." In these cases the patient takes the legal dose of poison themselves, it is not given by the doctor. It is euthanasia when the doctor has the main role in ending the patients life by giving the poison.

Euthanasia can be active or passive, and voluntary, non-voluntary and involuntary. Many people see important differences and they can accept some types but not others.

Passive euthanasia means letting a person die. A terminally ill person is allowed to die, even if treatment could help them to live longer. This includes removing life support, such as a ventilator which is being used to keep the person alive, or by not giving them food or water. Active euthanasia means doing something to end a person's life. This could be giving them an injection or pills that will cause their death.[2]

Some people see passive euthanasia as a more acceptable choice, because it is not a deliberate act to kill. However, others argue that once someone has decided to allow another person to die, they should make it as fast and as painless as possible, and then act to bring about their death. This is also known as mercy killing.[3]

Voluntary euthanasia is when someone asks to be allowed to die or to be killed. This is often seen as the best option by people who believe in euthanasia, because it is clear that the person wants to die. If the person can not say that they want to die, but people think that they would ask to die if they could, then it is non-voluntary euthanasia. Non-voluntary euthanasia is a choice for people who are in a coma or who are very young, as they can not say what they want. Involuntary euthanasia is when someone is killed even though they asked not to die, or when they could have asked to die but did not.[4] Many people think that this is murder, not euthanasia.[5]

These types of euthanasia can be mixed. If someone asks to die, and another person gives them an injection that will kill them, then it is active voluntary euthanasia. Someone in a coma who is kept alive with a ventilator, and the doctors turn it off and they die, would be passive non-voluntary euthanasia.[6]

Some people believe that euthanasia should be allowed, and some people think that it should not.

Some people believe that allowing euthanasia will result in bad things happening. If it is allowed for people asking to die, then it might be allowed for people who are very sick but are not able to ask to die. If that happens, then maybe it would be allowed for people who are very sick and will not recover, but do not want to die. This is called the "slippery slope" argument.[7]

People who believe in the slippery slope argument point to times when this happened. In Germany, Adolf Hitler allowed disabled children to be killed, and called it euthanasia. People now agree that this was wrong, but if euthanasia was allowed it could happen again. They think it is too big a risk to allow euthanasia at all.[7]

Other people say there is a big difference between killing a very sick person who asks to die, and killing a child with a disability. They do not think euthanasia will lead to bad things. They say that Hitler's actions were not euthanasia.[7]

The American Medical Association (AMA) and other doctors believe it is a doctor's role to help, not kill people.[source?] In one study 76% of doctors said they would not carry out euthanasia, even if it was legal.[source?] They feel patients would not trust them. In the Netherlands where euthanasia is legal, 60% of older people in one study were scared that their their doctors would kill them.[source?]

Palliative care is when people who are ill and going to die are given special care to make them more comfortable. It may include hospice care, when the patient is sent to a special hospital for people who are dying. Palliative care can involve pain relief and help for the patient and family to come to terms with death. In some cases, doctors will give patient drugs which make them stay asleep, so that they will not feel pain.[8][9]

Palliative care is not perfect, and so it is not always seen as a replacement for euthanasia. There is still some pain, and there can be other side-effects, where the patient can still feel very sick. Palliative care is not available for all people, and not all people who wish to die through euthanasia are so sick that they will die soon. Some people have healthy bodies, but they are suffering in other ways, and palliative care will not always help them.[7]

The principle of double effect was first described by Thomas Aquinas over 700 years ago. It says that it is sometimes alright to do a bad thing if something good happens, and if a bad ending was not wanted.[10] Aquinas used the example of self defense: sometimes a person will kill someone who attacks them, but killing was not what the person was trying to do. They only wanted to protect themselves. So even though killing someone is bad, wanting to protect themselves was not.[11]

Some people say that doctors may treat a person to reduce the their pain, and as a result the person will die sooner. If the doctor gives the treatment in order to help the patient die, then it is euthanasia. But if the doctor gives the treatment in order to stop the pain, and does not intend for the patient to die, then it may not be euthanasia, even if the doctor knew that the treatment would kill the patient.[11]

Suicide is when a person kills themselves. Sometimes when a person is very sick they need help to die, and this is called assisted suicide.[12] In some countries people are allowed to help as long as they do not kill the person,[13] and it can be seen as a more acceptable option because it must be the person's own decision.[12] Because the assisting person did not kill, it is not always considered to be euthanasia. [7]

[1]

Originally posted here:

Euthanasia - Simple English Wikipedia, the free encyclopedia

Euthanasia – ProCon.org

Proponents of euthanasia and physician-assisted suicide (PAS) contend that terminally ill people should have the right to end their suffering with a quick, dignified, and compassionate death. They argue that the right to die is protected by the same constitutional safeguards that guarantee such rights as marriage, procreation, and the refusal or termination of life-saving medical treatment.

Opponents of euthanasia and physician-assisted suicide contend that doctors have a moral responsibility to keep their patients alive as reflected by the Hippocratic Oath. They argue there may be a "slippery slope" from euthanasia to murder, and that legalizing euthanasia will unfairly target the poor and disabled and create incentives for insurance companies to terminate lives in order to save money.

PROS & CONS BY CATEGORY

CORE QUESTION

Definitions

Euthanasia in Practice

Legal Right and End-of-Life Documents

American Healthcare System

Physician Involvement in Euthanasia and PAS

Moral Differences in Forms of Assisted Dying

Historical Issues

Opponents of euthanasia and physician-assisted suicide contend that doctors have a moral responsibility to keep their patients alive as reflected by the Hippocratic Oath. They argue there may be a "slippery slope" from euthanasia to murder, and that legalizing euthanasia will unfairly target the poor and disabled and create incentives for insurance companies to terminate lives in order to save money.

PROS & CONS BY CATEGORY

CORE QUESTION

Definitions

Euthanasia in Practice

Legal Right and End-of-Life Documents

American Healthcare System

Physician Involvement in Euthanasia and PAS

Moral Differences in Forms of Assisted Dying

Historical Issues

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Euthanasia - ProCon.org

Is there tikanga around euthanasia? – RNZ

Debate has emerged as to whether euthanasia has a place in te ao Mori, with some saying it doesn't sit with the Mori worldview of death, and others saying whnau should have the choice.

A Taranaki urup. Photo: RNZ / Robin Martin

The End of Life Choice Bill, which would allow people to end their lives if they have six months or less before they die, passed its third reading last week, with the public set to vote at a referendum next year.

Maata Wharehoka, from Parihaka, has been reviving traditional methods of death and burial, with her whnau-run business, Kahu Whakatere Tppaku.

She said that based on the knowledge of her whnau, there was a form of euthanasia in pre-colonial Mori society, which involved speeding up death for people who had become wholly dependent on others for their needs.

"They didn't have food and water, and they were put outside and regardless of the weather, that's where they were placed, now, what I do know, if they didn't die immediately they were then put out into wharemate, and the wharemate was built for them to die in."

She supports legalisation of euthanasia because it would help the wairua of the person dying, leave the world faster with less pain and suffering.

"I believe that we should never have to endure the pain that some people have to go through, that we should be able to choose a time to pass over."

Ngti Porou anglican priest, Reverend Chris Huriwai, who opposed the bill, said euthanasia went against the Mori worldview on death.

"When I hear conversations and krero around euthanasia, straight away my mind flicks to how we as Mori frame our tangihanga rituals, how we understand death, and fundamentally this idea of death as something that is unwanted, something that is an aitua or an accident or something unfortunate, and I wonder how that impacts on our tikanga when we start to express more agency in that space.

"So if a whnau or a person elects for that to take place, then how do we reconcile that with our acceptable practice and tikanga around tangihanga as it stands now."

The End of Life Choice Bill passed its third in Parliament last week and puts the issue to a referendum next year. Photo: RNZ / Dom Thomas

He said that from what he had learned from the tohunga Papa Amster Reedy, euthanasia was foreign to the tikanga of Tairwhiti, but he said this might not necessarily be the case for Mori across the country.

"I think it's important we don't just call it all tikanga Mori, because tikanga Mori doesn't exist."

"We're diverse, we're fluid, we're not a homogenous group of people, so those conversations need to happen on levels smaller than tribal levels, so hap conversations need to happen and whnau conversations need to happen around what our accepted tikanga is."

Dame Iritana Twhiwhirangi agreed there was no one tikanga, and she supported the right for whnau to make a decision for themselves.

"Our people, from what I remember, made the decision together. They didn't rely on outside determinations for them and together that was their tikanga, that's what they focused on, they made their decisions and I support that."

New Zealand Nurses Organisation kaiwhakahaere Kerri Nuku said Mori nurses were polarised on the issue, but agree that it should be up to whnau Mori.

Mori nurses were looking to set up hui at different marae after Christmas, where Mori could discuss what legalisation of euthanasia would mean for them and their whnau, similar to consultation that occured around changes to the Coronial Act.

Whangarei MP Shane Reti said during the third reading debate that he opposed the bill, both as as a doctor and a Mori.

Tmaki Makaurau MP Peeni Henare supported the bill Photo: RNZ / Richard Tindiller

He singled out many of the Mori Labour MPs who supported the bill, asking them what their "Mori heart' was saying.

Tmaki Makaurau MP Peeni Henare responded by saying that historically, Mori had ways of speeding up the process of death if a disease or sickness was incurable.

He said that to him, tikanga is mana motuhake - Mori being to make the decision which is right for them.

MP for Te Tai Hauuru Adrian Rurawhe said that the overwhelming majority of people in his electorate told him at eight public hui they did not want this bill.

"We talk about kaupapa Mori, terms that just roll of our tongue - manaakitanga, rangatiratanga, aroha - it even frames our international identity but will it frame what we want for our families in this bill, I say it will not, because it is fundamentally opposed to those kaupapa."

List MP Willie Jackson told Parliament that three high-profile Mori leaders, he had spoken with said "they were tired of hearing this was a violation of our culture".

"All were unanimous that in their view tikanga evolves, tikanga changes and there is no one tikanga," he said.

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Is there tikanga around euthanasia? - RNZ

Euthanasia referendum best approached with a cool head and open mind – Stuff.co.nz

OPINION:Now that New Zealanders have been passed the responsibility of decidingwhether euthanasia is to be legalised it is time to take the passion out of an impassioned debate.

Between now and when the referendum is held next year we have a moral duty to put aside our prejudices andlisten with an open mind to all sides.

We need to be conscious there will be those in thisdebateseeking to hijack ouremotions. Yet we also need to understand they'll be doing sofrom a position of absolute sincerity.

At its most basic it appears an easy choice. Should we be allowed to end our lives when we are terminally illand death is just six months away, or should we not.

READ MORE:* Euthanasia bill passes 69-51,the final decision a referendum* Historic right to die bill passes first hurdle* Should Kiwis have the right to die with 'dignity'?* Jackson: Dying with dignity should be a right

The issue is much deeper than that. Itbelies the simple yes or no answer a referendum requires.

It's the right to dignity in your final days versus therisk of being coercedinto ending it.It's individual freedom versus thestate's duty to protect the individual and the ability of medical scienceto keep us alive versus a subjective judgment on what quality of life we must have to make it worth living.

ROSS GIBLIN

David Seymour celebrates his euthanasia bill passing on Wednesday night. It will now be included on a referendum at next year's election.

It could also bethat once you've familiarised yourself with the details of the billyou realise you support euthanasia yetreject thisapproach as flawed. The same could be true for the reverse.

Thereare certainly cases where denying someone theability to end their own life appears cruel and unusual. Few could argue lawyer Lecretia Seales' last days alive weren't made more painful by her inability to end it.

The manner of herdeath was heartbreaking. Not just because of the pain she was inbut also because of how much she sacrificed pushing for change, even when it was clear she would never benefit from that change.

Her death will certainly be used to argue for the right to end your life. Suffering like that endured by Sealesis often compared to how we treat sick animals, a demonstration that animals are treated more humanely.

Yet such a statement that so aggressively grabs for your sense of outrage must also include that this "humanity" is largely extended to avoid personal cost.

Each year millions of animals die grislydeaths in this country. From any objective viewpoint they are not treated better than humans. Not even close.

Being open to understanding the gravity of this decision meansacknowledging the validity of qualified opinions, no matter how much they clash with your values.

As a GP, National MP Shane Reti's views must be recognised as having insights those outside the medical field may not be able to appreciate.

When he says he would not want the spectre of euthanasia hanging over every consultation, we should take that on board as reasonable and consider how this bill could change the doctor-patient relationship.

Yet his other comment that the world would have lost some "brightness" had Beethoven ended his life six months earlyto relievethe suffering his cirrhosis was causing, is an appeal to our emotions rather than our logic.

Euthanasia will not result in a dearth of high culture. And surely, as a nation, we don't want to prolong an individual's suffering simply to increase the range of amusements available to us.

Whatever decision the referendum yields, that we are even having it shows the current system is not meeting our needs.

It is time to talk about what those needs are. Strip away the fears, strip away the emotions, look past the simplistic arguments, keep it reasonedand be prepared to listen.

Then let your decision come from that.

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Euthanasia referendum best approached with a cool head and open mind - Stuff.co.nz

Kent Co. Animal Shelter is overflowing due to high intake numbers coupled with lower euthanasia rate – WZZM13.com

GRAND RAPIDS, Mich The Kent County Animal Shelter took in 678 cats and dogs during the month of October alone.

"We've been steadily increasing since July," said KCAS program supervisor Namiko Ota-Noveskey. "We can't really explain why that is."

On top of a high intake number, the shelter has also been working to bring down its euthanasia rate, which means there are more animals in the shelter at any given time.

"We are moving animals as quickly as we can, but we are struggling to maintain the overall health of a large number of animals," Ota-Noveskey said.

Read more: Kent County shelter euthanized most dogs and cats in Michigan during 2017

KCAS gained attention last year for having one of the highest euthanasia rates in the state during 2017. Ota-Noveskey, who was brought on in May of this year, said they are constantly working to reduce that rate.

She said the current live release rate for cats is nearly 80% and the live release rate for dogs is close to 70%.

A 90% live release rate is the requirement for shelters that are considered 'no-kill.'

With help from rescue groups and other shelters, KCAS has been able to transfer animals more frequently to keep up with intake. The shelter has also offered fee waivers on cats for months at a time. With dogs, Ota-Noveskey says the staff is doing more extensive behavior assessments to determine the best type of home for each pet.

The longer the animals stay at the shelter, though, the more prone they are to things like upper respiratory infections and stress, Ota-Noveskey said.

"We are doing what we can," she said. But, they need adopters.

Bissell Pet Foundation is hosting an Empty the Shelters event on Nov. 22 and 23 solely to help KCAS adopt out more animals.

"Shelter dogs are not damaged dogs," Ota-Noveskey said. "I am pretty certain you will find one you like, and they all need a home. A shelter is just a temporary place this cannot be a home."

Long term, Ota-Noveskey hopes the shelter can work with community members to understand why intake numbers continue to be so high.

"Are people losing housing? Are they not financially able to care for [their pet]? Are landlords still discriminating against certain breeds? There are some things I think we can address as a community," Ota-Noveskey said.

HOW TO HELP:

Click here to learn about volunteering at KCAS

Click here to learn about adopting from KCAS

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Kent Co. Animal Shelter is overflowing due to high intake numbers coupled with lower euthanasia rate - WZZM13.com

Opinion | Life is special, nobody has the right to end their own – The News Record

The approval of the principle "right to die" is dangerously trending up.

In August, New Jersey became the seventh state to legalize assisted suicide. Euthanasia is now responsible for 4.5% of deaths in the Netherlands, with many of those including people who werent terminally ill.

These are old people who may have health problems, but none of them are life-threatening, bioethicist Scott Kim told CBS. They're old, they can't get around, their friends are dead and their children don't visit anymore. This kind of trend cries out for a discussion. Do we think their lives are still worthwhile?"

Assisted suicide is often conflated with euthanasia, which has different motives, but with the same results. Assisted suicide is usually defined as helping a person end their life. Euthanasia is essentially a nicer sounding version of assisted suicide. Amazingly, euthanasia has 73% of American support in a 2017 Gallup poll. This is downright horrifying.

Assisted suicide and euthanasia in bare-bone terms, is the practice of helping people kill themselves. The principle in favor of assisted suicide and euthanasia is known as right to die, that one is entitled to end their life.

Objectively, if one wants to deny themselves life sustaining treatment, I feel that is understandable. We didnt have these life sustaining devices until recently. Denying themselves life sustaining treatment is just letting life go through its intended course. The National Health Service distinguishes this from euthanasia. The BBC says The NHS says withdrawing life-sustaining treatment can be part of good palliative care and should not be confused with euthanasia.

But to me, you arent ending your life; youre letting life carry itself on which is very different from euthanasia or assisted suicide.

I have much sorrow for those who are terminally ill. However, that doesnt mean you should end your life.

Does one have the right to die? Well philosophically speaking, no. If you believe that people have the right to be born, then yes, one has the right to die. You have to be born to die. But since most believe the right to choose outweighs that, then the right to die isnt a philosophically consistent one.

People often forget how the practices of the right to die, euthanasia and assisted suicide are seen in the eyes of the society: murder. In the majority of states, the preservation of life is considered the biggest priority.

In terms of law, the Supreme Court has ruled that from FindLaw, the government's interest in preserving life and preventing intentional killing outweighed the patient's interest in the liberty to choose to die, regardless of the patient's condition.

Supreme Court Justise Neil Gorsuch once said, Once we open the door to excusing or justifying the intentional taking of life as 'necessary,' we introduce the real possibility that the lives of some persons (very possibly the weakest and most vulnerable among us) may be deemed less 'valuable,' and receive less protection from the law, than others."

The right to die forgets how special life really is.

Continued here:

Opinion | Life is special, nobody has the right to end their own - The News Record

Long Beach City Council to consider increasing allowed pets from 4 to 6 to reduce animal euthanasia – Signal Tribune

The City of Long Beach may soon allow residents to have up to six pets in their homes, two more than it currently allows.

Gerardo Mouet, director of Long Beachs Parks, Recreation and Marine Department, stated in a Nov. 15 memo to the city manager that next month the city council will consider amending an ordinance to increase allowed pets from four to six and also regulate animals brought into the city for adoption.

The purpose of the amendments is to promote the Long Beach Animal Care Services (LBACS) Compassion Saves approach designed to minimize the number of animals euthanized, Mouet said.

According to the memo, LBACS already reduced the number of its animals euthanized by 82% between 2010 and 2018, dropping from 5,651 to 1,044. It also increased pet adoptions by 370% from 144 to 677 during that period.

Courtesy City of Long BeachA table from a Nov. 15 memo to the Long Beach city manager showing how Long Beach Animal Care Services (LBACS) reduced animal-euthanasia rates and increased adoptions between 2010 and 2018.

As recent as 2012, LBACS started seeing less animals coming into the shelter due to effective population-control efforts, Mouet said in the memo, adding that it reduced euthanasia rates with the help of a 2015 spay-and-neuter ordinance and partnering with adoption organizations.

Mouet further stated that city staff plans to work with spcaLA (the Los Angeles Society for the Prevention of Cruelty to Animals) which is housed in the same facility as LBACS in negotiating a memorandum of understanding (MOU) to maximize the effectiveness of LBACSs Compassion Saves approach.

That approach stems from an April 16 LBACS study session showing the positive impact of animal population-control efforts. The City had created a task force the previous October following results of a two-phased city-auditors report on LBACS completed last year. The City also hired a new LBACS manager, Staycee Dains, last February.

Along with deficiencies in LBACS operations, the audit noted that though they maintain separate leadership and identities, both LBACS and spcaLA are housed at the P.D. Pitchford Companion Animal Village in Long Beach, with a 55-year lease-back agreement expiring in 2053. LBACS leases part of the facility from spcaLA for its shelter operations and the City pays spcaLA 50% of the total facilitys operating expenses, according to the audit.

And though LBACSs live-release rates (LRR) of animals have increased, the audit found that the LRRs and impound improvements strained LBACSs resources and spread thin the shelters staff.

It also found deficiencies in LBACSs standard-operating procedures, resulting in inconsistent decision-making, conflicting shelter practices and changes implemented without proper direction and explanation.

No killThough Mouet said the three proposed steps are designed to aid LBACSs effectiveness in reducing euthanized animals, Dr. Patricia Turner of No Kill Long Beach, an advocacy group calling for no animal to be put down unless it has untreatable pain or illness, told the Signal Tribune that the steps are too limited.These actions dont go far enough, Turner said, adding that the real problem is LBACSs physical and operational proximity to spcaLA.

The MOU must establish LBACSs independence from spcaLA [] as its own entirely city-operated animal shelter and facility so that they can operate at scale to meet the needs of the people of Long Beach, she said.

Turner said that such a separation would allow LBACS to operate full-service adoption and foster programs and a robust volunteer program.Ideally, spcaLA would not be associated with the City of Long Beach, she said. They are on taxpayer land.

Turner also said that the MOU should require transparency by spcaLA about the outcome of animals under its care, such as how many it euthanizes or sends out to adoption, foster care or to other shelters.

That MOU is the most important thing, Turner said when comparing the three steps.

The step of limiting the number of animals brought into the city for adoption is a response to the general perception that spcaLA brings in animals from other places, Turner said, but noted that the memo doesnt specify that organization as the problem.

Nothing in this memo, in regards to animals being brought into Long Beach, mentions spcaLA, she said. It applies to anybody.

Turner said therefore a person who finds a kitten in Lakewood couldnt by law bring it to the Long Beach shelter, nor could a rescue organization that finds a dog in neighboring Compton bring it in for adoption.

It places a burden on these rescue organizations who are already overburdened, under-resourced and theyre doing the work that LBACS should be doing of adopting animals out, she said. LBACS is not adopting large numbers of animals out because spcaLA doesnt want them to. Its just foisting the problem back on the community.

She remarked that the 677 adoptions LBACS reports is small next to comparable cities like Sacramento, whose shelter managed 5,000 adoptions. That citys website states that the shelter sent out 5,037 dogs and cats for adoption last year and 4,321 as of October this year.

And regarding the proposed ordinance amending the number of pets people can have, Turner said her organization advocates for eight rather than six but said such laws dont impact animal welfare by themselves.

If youre concerned about animal welfare, the laws dont do anything in terms of changing human behavior except to deter responsible people who would take good care of a larger number of animals from having them, she said, adding that Sacramento allows up to 10 pets per household. Sacramentos website states that residents can harbor up to three dogs and seven cats.

Public opinion supports a no-kill policy and stronger adoption efforts, Turner said, but also noted that LBACS and spcaLA practices affect all pet owners.If your dog gets out, your dog could go to the shelter, Turner said. And if he gets sick, [] he could be killed.

Shelter progressDespite these concerns, Staycee Dains, LBACS manager, told the Signal Tribune that she collaborated with Mouet on the steps and is hopeful for continued progress.She said that the City has already made great strides in reducing its stray-animal population following the four-year-old spay-and-neuter ordinance.

Courtesy City of Long BeachGraph from Phase 2 of the City of Long Beachs audit of its animal-care services showing increases in live-release rates of animals in recent years

The City increasing its limit of how many pets residents can have will further reduce the stray-animal population, she said.The idea is to allow people to have more animals so they can adopt more animals from the shelter, she said.

Dains said she is also hopeful that the MOU with spcaLA will formalize the ways in which their operations work together, especially as LBACS has evolved over the past decade.

We really want to make sure our efforts are collaborative and make sure whatever were putting into place is going to be definitely beneficial for the LBACS shelter animals she said. Im very hopeful that we will be able to come up with a memorandum of understanding.

Dains added that LBACS will begin negotiations as soon as possible and expects the process to be short, hoping to complete the agreement early in 2020.

Dains said she is also confident in LBACSs Compassion Saves model to ensure the animals in its care get everything they need and especially an appropriate outcome, whether that means being returned to an owner, adopted, placed in foster care or sent to a rescue organization.

We want to make sure that were making excellent outcome decisions for them, Dains said. Making sure that animals are getting to their outcome as soon as possible is a really important part of the Compassion Saves model.

Dains said she is also pleased with reforms allowing volunteers to come on board faster.

Weve streamlined some of our training so that those who can come to the shelter and go through the screening process and be trained has been thankfully truncated, she said.

She added the City has opened up the window of time it can screen volunteer candidates by contracting with another organization to provide such services as fingerprinting.

People wont have to wait from their orientation to their processing time, which for some people could be weeks, Dains said. Weve definitely seen an increase in volunteer retention from going to that process.

More volunteers have allowed LBACS to develop new programs, such as behavior rehabilitation for dogs, Dains said.

Prior to starting this program, [some dogs] were not getting their needs met and so would languish in the shelter [and] their behaviors would become increasingly concerning because they werent getting the right type of enrichment, like getting out of their kennels and getting the right type of handling, Dains said.

She noted that a lot of the dogs at the shelter have been through trauma and need someone to guide them through that experience through specific activities with volunteers, such as educational training that helps them cope with the shelter environment.

It has made a huge difference in the stress level of our dogs in our kennels and the ease of volunteers being able to handle the dogs, she said.

As for cats, Dains said her own office has become the place for especially scared cats to calm down before continuing into the shelter.

People have been so invested and have really made a lot of personal sacrifices to see our animal-services department succeed, Dains said. Were very excited to keep up the momentum and progress that everyone in our community has worked on for so many years.

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Long Beach City Council to consider increasing allowed pets from 4 to 6 to reduce animal euthanasia - Signal Tribune

Reality check: Most changes to WA’s assisted dying bill now not Goiran’s – Sydney Morning Herald

Of the 142 amendments still on the notice paper, only 53 are from Mr Goiran.

The rest a total of 89 are from other MPs and include 12 proposed by the government itself, including six announced by Health Minster Roger Cook just yesterday.

Just a few weeks ago, Premier Mark McGowan said Mr Goiran's behaviour was "disgraceful", accusing him of "just trying to wreck the bill with these ridiculous, endless amendments".

But if the government's bill was as pure as the driven snow, why did it need more amendments yesterday? And this doesn't include five the upper house has already agreed to, including a variation of one previously proposed by Labor MP Margaret Quirk in the lower house?

As 6PR's Gareth Parker pointed out on Twitter: "I know Nick Goiran is supposed to be public enemy no.1 with horns growing out of his forehead, but is anyone going to reflect on the fact the McGowan Government now WILL amend its supposedly unimpeachable VAD Bill in the Upper House?"

Before yesterday, the government's bill as it stood would have permitted any health practitioner to suggest euthanasia to a dying patient. That included optometrists, pharmacists, a podiatrist, a dental hygienist or a Chinese medicine practitioner.

Of the five amendments agreed to by the upper house on Tuesday, only one was from the government.

An amendment moved by Mr Goiran to ensure people in the regions had the same level of access to palliative care as those in Perth came close to passing, falling short by a hair-raising one vote.

Luckily for the government, Nationals MPs came to the rescue to oppose it.

Also under scrutiny are claims by the government that the Australian Medical Association is now supporting its euthanasia bill.

President Andrew Miller has not said his association supports the legislation.

"There's a range of things that the AMA suggested in amendments that the government are saying would be more appropriate to address in the guidelines or the implementation phase, so we'll have a look at that," Dr Miller said.

"The AMA hasn't pledged anything, what we've said is we're welcoming these amendments.

"We're not going to tell anyone how to vote, we're just saying we're hear to provide information, we're here to provide feedback from doctors on the ground and we want it to be safe for patients."

Far from a glowing endorsement of the bill from the profession who will be expected to implement it.

And while the government has introduced an amendment to reduce the number of people who can propose euthanasia, the change still falls short of Labor MP Tony Buti's proposal to bring the laws into line with Victoria's.

Dr Buti, a supporter of the bill, wanted the laws to prevent anyone proposing euthanasia to a sick patient, including doctors and nurses.

"I've spoken to Tony Buti and explained to him the amendments that go to the heart of his concerns. He's very pleased with the compromise that's been struck," Mr Cook said on Tuesday.

"He said that while he prefers his amendment, but in the event that that is not successful he's very satisfied with the actual compromise that's now been reached."

This would be astonishing, given Dr Buti proposed the change to protect people with disabilities and Aboriginal people considered vulnerable because of language or cultural differences.

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All this just goes to show the upper house still has its work cut out dealing with this legislation.

The state government's bill is complex, not perfectly understood even by the government itself, which is still discovering reasons it needs to be changed and some upper house MPs are waveringin their support.

Putting pressure on MPs by forcing it through by Christmas might make tactical sense for the government, which hasn't really been able to explain the rush, but it might make for bad legislation.

Let's pray the upper house takes its time to get the balance right.

Nathan is WAtoday's political reporter.

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Reality check: Most changes to WA's assisted dying bill now not Goiran's - Sydney Morning Herald

End of life and legalising cannabis referendums make for a complicated election – Stuff.co.nz

OPINION:Next year's general election just got a whole lot more complicated, voters.

Not only are we going to be drowned in the usual tub-thumping rhetoric and "pick me" bluster that comes with a national election, we're now going to be caught up in a maelstrom of two referendums.

The first follows last week's historic decision in Parliament to allow a referendum on voluntary euthanasia; the second is on the regulation of cannabis.

These two issues not to mention a general election are major, and, if followed through the way that is seemingly expected, will fundamentally change New Zealand.

READ MORE:* Labour and the referendums of dread* MPs pass the buck to the public* Is a referendum democracy at work or abdication of political will?

Both the voluntary euthanasia and cannabis issues need, and deserve, enough time and information for us to get to grips with them, if we're going to be asked to vote on them.

For those of you who read these columns regularly, you'll know that I have already developed an aversion to referendums since watching the damage done to the United Kingdom over the farce that is Brexit.

ROSS GIBLIN/STUFF

ACT MP David Seymour's euthanasia bill was passed by Parliament.

That's been a great example of what happens if you ask people to vote on issues when they really have no clue what's going on and don't have the time, access or the will to search out enough information to make a good decision.

I know we all have a duty to make ourselves fully aware of these issues, but most of us won't, because we have other stuff going on. We'll get half informed and go with our gut instinct when faced with the moment we have to put an 'X' in the box.

Those who shout loudest, have the deepest pockets and have the least regard for truth will do well, if the UK is anything to go by.

I can't think of two more emotive issues for the public to decide on than death and drugs.

Two countries and 11 US states have legalised cannabis, but the exact details of laws and regulations varies from place to place.

Groups who want the vote to go one way will become more strident, vocal, political and polarised; as will those on the opposing side.

Both viewpoints may be valid, but polarised behaviour is how referendums work they push people into opposing positions where they start shouting over each other to make their points heard so they can 'win'.

And politicians will be at the forefront of this as they jump on these issues to get air-time, increase their profile and, of course, gain votes.

These are huge issues to decide on and people are going to feel really strongly: just look at the interest already on the euthanasia bill.

GETTY-IMAGES

legalising cannabis will probably become an also-ran issue when put into a two-horse referendum race with euthanasia, but it deserves a thorough hearing in its own right.

The End of Life Choice Bill passed by a relatively slim margin of 69 votes to 51, after two years of fierce arguments. It gained a record 39,000 submissions from the public during its passage through Parliament.

By comparison, legalising cannabis will probably become an also-ran issue when put into a two-horse referendum race with euthanasia, but it deserves a thorough hearing in its own right.

These issues need plenty of clear air to be properly considered by the general public who are being asked to vote on them.

SUPPLIED

Sue Allen says both referendums will need plenty of clear air to be properly considered by the general public who are being asked to vote on them.

This is all aside from a general election, which is when we have to work out who we want to run the country. And that's a whole can of worms for us: getting to the bottom of issues around education, health, the economy, housing.That list goes on and on.

My plea, though I'm sure no one will hear it, is that if we want informed debate and voting behaviour, then the Government needs to invest some serious time and money into ensuring we lesser mortals fully understand what it is we're voting on.

Sue Allen has worked in journalism, communications, marketing andbrand management for 15 years in the United Kingdom and New Zealand.

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End of life and legalising cannabis referendums make for a complicated election - Stuff.co.nz

Expanding the Availability of Controversial Medical Procedures Need Not Interfere with the Religious Freedom of Doctors and Nurses – Mosaic

A set of regulations by the Department of Health and Human Services, intended to go into effect tomorrow, would have expanded the right of medical professionals to refuse, as a matter of conscience, to perform certain procedures or provide certain drugs. But, earlier this month, a federal court struck down the rules, which would apply, for instance, to a doctor who doesnt wish to perform euthanasia in a state where it is legal to do so or to a nurse who doesnt wish to administer a vaccine manufactured from fetal tissue. Without objecting to the largely technical grounds on which the court invalidated the regulations, Moishe Bane and Nathan Diament argue in favor of such protections:

American law, both legislative and judicial, has a magnificent tradition of accommodating the rights and needs of individuals with conflicting interests. Surely, such mutual accommodations should be the aspiration of regulations regarding health and medical care. Sadly, in certain contextssuch as regarding womens reproductive rights and euthanasiaachieving a balanced approach to competing rights is not the goal of some judges and legislators who instead seek to diminish, and [even] to dismiss, the rights of those Americans committed to abide by their religious tenets.

Even in controversial contexts, legislators have successfully found a middle ground to provide rights to services for some individuals while simultaneously ensuring protections for those unable to provide those services on religious grounds. . . . Unfortunately, [however], respect for the conscience rights of healthcare providers (and other Americans of faith) has been persistently attacked.

The denigration and dismissal of religious belief is frequently advanced in association with both abortion and LGBT rights. Rather than seeking to ensure that these legal rights are balanced with the competing, authentic religious rights of others, many abortion and LGBT advocates frame values borne of religion as illegitimate and undeserving of respect, let alone entitled to legal protection. They assert that any accommodation of religious belief is tantamount to using religion as a sword to harm others. Experience has now shown that the preservation of religious-conscience protections need not impose significant burdens on others.

Our courts and our culture must be reminded that America was founded by those who were seeking religious freedom; that is why they enshrined its protection in the First Amendment. A devout Jewish doctor who declines to issue an assisted-suicide prescription shouldnt be forced to choose between her career and conscience any more than a faithful Catholic attorney who doesnt want to work on a death-penalty case, or a committed feminist web designer who doesnt want to build a pornographic website.

Read more at Washington Times

More about: Abortion, American law, Euthanasia, Freedom of Religion, Medicine

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Expanding the Availability of Controversial Medical Procedures Need Not Interfere with the Religious Freedom of Doctors and Nurses - Mosaic

Townsville Bishop says Church will never accept assisted suicide because it is intentional killing – Catholic Leader

Life is sacred: Townsville Bishop Tim Harris has spoken out strongly against euthanasia.

TOWNSVILLE Bishop Tim Harris has spoken out strongly against euthanasia and defended comments he made likening a push to allow voluntary assisted dying in Queensland to a mentality that existed in Nazi Germany.

Bishop Harris said it was an important time to have a conversation on the grim topic following the Queensland Governments committee hearings, which could result in new laws being presented to parliament early next year.

He joined other Catholic leaders across Queensland, including Brisbane Archbishop Mark Coleridge, in observing Dying Peacefully No Euthanasia Sunday on November 17, advocating against the introduction of so called voluntary assisted dying.

It reminds me of Nazi Germany; these are some of the things that people did because if someone was not 100 per cent, crippled, if they had something wrong with them, if they were aged or not of use to society any more the state then would select certain people and say well experiment on you or well kill you because youre not worth anything, he told parishioners during Mass at Sacred Heart Cathedral, Townsville.

Bishop Harris said he was not surprised media picked up on his comments, and he stood by them.

Everyone is referring to the reference with the Nazis. It (VAD) has that feel about it, for sure. Its not exactly the same but its got that feel about it, he said.

A shiver goes up my spine with this whole matter.

Both my parents had palliative care in the last couple of years of life and it never entered my mind that we would somehow have a law that would allow them to end their life prematurely.

They wouldnt have wanted it, we didnt want it.

The point was the more chances Ive got to say I love you, to me its worth every second of every day.

During his cathedral comments, Bishop Harris said he was not suggesting any evil intent from people with a different view.

Good people are believing that voluntary assisted (dying) is the way to go and I respect their views, but Ive also got to be in there and say there is another way and challenge it, just as theyll be challenging me, he said.

The Church wants to emphasise that we are created in the image and likeness of God and because of that it puts us right up there at the top in terms of Gods creations.

Our bodies are the temple of God and his Holy Spirit and you dont muck around with that, you respect it to the very end.

I believe to assist someone to die in an intentional manner is clearly intentional killing and the Church does not believe in intentional killing.

Instead, Bishop Harris said there should be more attention on improving palliative care services.

A state-sanctioned voluntary assisted suicide can have all the safeguards it likes but even then things can go wrong; the best safeguard is not to do it, he said.

Archbishop Coleridge said Catholic support for better palliative care was grounded in the common good of society.

Better end-of-life care begins with better conversations about death and dying, and how we can die well in ways that do not undermine the foundational values of our society, he said.

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Townsville Bishop says Church will never accept assisted suicide because it is intentional killing - Catholic Leader

Citizens and activists seek to end gas euthanization of shelter animals – Universe.byu.edu

A former gas chamber from the Heber City Animal Services in Heber, Utah. (Jim Urquhart/AP Images for The Humane Society of the United States)

An online petition to end the practice of gas chamber euthanization of shelter animals in Missouri, Ohio, Wyoming and Utah has gained momentum among activists and citizens.

The petition aims to create a federal ban on the euthanization of shelter animals by asphyxiation in a gas chamber, a practice that can include putting multiple animals in the same chamber for gassing and that can take half an hour or more. Proponents of the petition say they favor safer and cleaner methods, such as euthanization by injection.

According to a statement by the Humane Society of the United States, animal welfare experts agree that if an animal needs to be euthanized, the most humane way is by injection.

Gas chambers cannot provide humane euthanasia for shelter populations, the statement said. Old, ill, injured or otherwise circulatory-compromised animals may suffer from medical conditions that delay the effects of gas, causing them to experience distress prior to unconsciousness.

Instead of banning the gassing practice on a shelter-by-shelter basis, proponents of the petition hope to gain Congressional support to create a federal ban.

For years, efforts to create a ban have had little success in the Utah Legislature, however.

Instead of going to the capitol again, the Humane Society of Utah aims to educate shelter employees of the superiority of injection euthanization over gas chamber euthanization.

Deann Shepherd, director of marketing and communications at the Humane Society of Utah, helps educate shelter workers by explaining to them that injection is less expensive, faster, painless, more humane and safer for staff members since they arent exposed to carbon monoxide when they get an animal out of the gas chamber.

She said that much of the training is well-received by shelter employees who face the often difficult task of euthanizing animals.

We have found through our research that they know that it is better for the animal to be euthanized by injection, Shepherd said. They feel better knowing that they ended the animals life in a humane way instead of putting them in a chamber.

The South Utah Valley Animal Shelter is one of four shelters in Utah that the Humane Society said still practices euthanization via gas chamber.

Kierstan Munford, the executive director of the shelter, said that in some instances, its better to euthanize via gas chamber.

If were dealing with a fractious animal or a mean dog, its safer for our staff to handle the animal for the least possible amount of time, Nord said.

Nord said that if a federal ban were to be placed on gas euthanization, the shelter would need to implement new euthanization procedures.

While the practice of gas euthanization is still in place in Utah, many pet owners are in favor of either creating a ban on gas euthanization or using educational measures to stop it.

Former Provo council member and pet owner Laura Cabanilla is a staunch denouncer of gas chamber euthanization.

Gas chamber euthanization is inhumane, Cabanilla said. I feel like there are so many better ways to deal with fractious animals or feral cats.

The owner of several animals herself, Cabanilla recalled an experience of having to put a cat of her own down by means of injection, a euthanasia practice she is strongly in favor of.

It was such as peaceful experience, Cabanilla said. We got to hold our friend while she just dozed off.

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Citizens and activists seek to end gas euthanization of shelter animals - Universe.byu.edu

Euthanasia | Definition of Euthanasia by Merriam-Webster

: the act or practice of killing or permitting the death of hopelessly sick or injured individuals (such as persons or domestic animals) in a relatively painless way for reasons of mercy

Euthanasia is a mass noun (or noncount noun), that is, a noun used only in the singular form.

The word comes from the Greek euthanatos, which means easy death. In English, euthanasia has been used in exactly this sense since the early seventeenth century, when Francis Bacon described the phenomenon as after the fashion and semblance of a kindly & pleasant sleepe. Nowadays, the word usually refers to the means of attaining such a death.

a physician who refuses to practice euthanasia

Recent Examples on the Web

These example sentences are selected automatically from various online news sources to reflect current usage of the word 'euthanasia.' Views expressed in the examples do not represent the opinion of Merriam-Webster or its editors. Send us feedback.

1605, in the meaning defined above

Greek, easy death, from euthanatos, from eu- + thanatos death more at thanatos

More Definitions for euthanasia

called also mercy killing

called also mercy killing

Other Words from euthanasia

Comments on euthanasia

What made you want to look up euthanasia? Please tell us where you read or heard it (including the quote, if possible).

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Euthanasia | Definition of Euthanasia by Merriam-Webster

Euthanasia | law | Britannica.com

Euthanasia, also called mercy killing, act or practice of painlessly putting to death persons suffering from painful and incurable disease or incapacitating physical disorder or allowing them to die by withholding treatment or withdrawing artificial life-support measures. Because there is no specific provision for it in most legal systems, it is usually regarded as either suicide (if performed by the patient himself) or murder (if performed by another). A physician may, however, lawfully decide not to prolong life in cases of extreme suffering, and he may administer drugs to relieve pain even if this shortens the patients life. In the late 20th century, several European countries had special provisions in their criminal codes for lenient sentencing and the consideration of extenuating circumstances in prosecutions for euthanasia.

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ethics: Abortion, euthanasia, and the value of human life

A number of ethical questions are concerned with the endpoints of the human life span. The question of whether abortion or the use of human

The opinion that euthanasia is morally permissible is traceable to Socrates, Plato, and the Stoics. It is rejected in traditional Christian belief, chiefly because it is thought to contravene the prohibition of murder in the Ten Commandments. The organized movement for legalization of euthanasia commenced in England in 1935, when C. Killick Millard founded the Voluntary Euthanasia Legalisation Society (later called the Euthanasia Society). The societys bill was defeated in the House of Lords in 1936, as was a motion on the same subject in the House of Lords in 1950. In the United States the Euthanasia Society of America was founded in 1938.

The first countries to legalize euthanasia were the Netherlands in 2001 and Belgium in 2002. In 1997 Oregon became the first state in the United States to decriminalize physician-assisted suicide; opponents of the controversial law, however, attempted to have it overturned. In 2009 the Supreme Court of South Korea recognized a right to die with dignity in its decision to approve a request by the family of a brain-dead woman that she be removed from life-support systems.

The potential of modern medical practice to prolong life through technological means has provoked the question of what courses of action should be available to the physician and the family in cases of extreme physical or emotional suffering, especially if the patient is incapable of choice. Passively doing nothing to prolong life or withdrawing life-support measures has resulted in criminal charges being brought against physicians; on the other hand, the families of comatose and apparently terminal patients have instituted legal action against the medical establishment to make them stop the use of extraordinary life support.

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Euthanasia | law | Britannica.com

Euthanasia in the United States – Wikipedia

Euthanasia is illegal in most of the United States. Assisted suicide/assisted death is legal in Washington, D.C.[1] and the states of California, Colorado, Oregon, Vermont, New Jersey (Starting August 1, 2019),[2] Hawaii, and Washington;[3][4] its status is disputed in Montana. The key difference between euthanasia and assisted suicide is that in cases of assisted suicide, the individual receives assistance, but ultimately voluntarily causes their own death. In euthanasia the individual does not directly end their life, but another person acts to cause the individual's death.[5]

Debates about the ethics of euthanasia and physician-assisted suicide date from ancient Greece and Rome. After the development of ether, physicians began advocating the use of anesthetics to relieve the pain of death. In 1870, Samuel Williams first proposed using anesthetics and morphine to intentionally end a patient's life. Over the next 35 years, debates about euthanasia raged in the United States which resulted in an Ohio bill to legalize euthanasia in 1906, a bill that was ultimately defeated.[6]

Euthanasia advocacy in the U.S. peaked again during the 1930s and diminished significantly during and after World War II. Euthanasia efforts were revived during the 1960s and 1970s, under the right-to-die rubric, physician assisted death in liberal bioethics, and through advance directives and do not resuscitate orders.

Several major court cases advanced the legal rights of patients, or their guardians, to practice at least voluntary passive euthanasia (physician assisted death). These include the Karen Ann Quinlan case (1976), Brophy and Nancy Cruzan cases. More recent years have seen policies fine-tuned and re-stated, as with Washington v. Glucksberg (1997) and the Terri Schiavo case. The numerous legislative rulings and legal precedents that were brought about in the wake of the Quinlan case had their ethical foundation in the famous 1983 report completed by the President's Commission for the Study of Ethical Problems in Medicine, under the title "Deciding to Forgo Life-Sustaining Treatment."[7] The Commission sustained in its findings that it was morally acceptable to give up a life-supporting therapy and that withholding or withdrawing such a therapy is the same thing from an ethical stand-point, while artificial feeding and other life-supporting therapy are of the same importance for the patients and doctors. Before this report, to withdraw a medical therapy was regarded as much more serious decision than not to start a therapy at all, while artificial feeding was viewed as a special treatment. By 1990, barely a decade and a half after the New Jersey Supreme Courts historic decision, patients were well aware that they could decline any form of medical therapy if they simply choose to do that either directly or by expressing their wish via appointed representative.

In a 2004 article in the Bulletin of the History of Medicine, Brown University historian Jacob M. Appel documented extensive political debate over legislation to legalize physician-assisted suicide in both Iowa and Ohio in 1906. The driving force behind this movement was social activist Anna S. Hall. Canadian historian Ian Dowbiggen's 2003 book, A Merciful End, revealed the role that leading public figures, including Clarence Darrow and Jack London, played in advocating for the legalization of euthanasia.

In the 1983 case of Barber v. Superior Court, two physicians had honored a family's request to withdraw both respirator and intravenous feeding and hydration tubes from a comatose patient. The physicians were charged with murder, despite the fact that they were doing what the family wanted. The court held that all charges should be dropped because the treatments had all been ineffective and burdensome. Withdrawal of treatment, even if life-ending, is morally and legally permitted. Competent patients or their surrogates can decide to withdraw treatments, usually after the treatments are found ineffective, painful, or burdensome.[8]

On May 31, 2013, the Maine state legislature rejected decriminalization of physician assisted suicide and voluntary euthanasia (95-43).

In the United States legal and ethical debates about euthanasia became more prominent in the Karen Ann Quinlan case who went into a coma after allegedly mixing tranquilizers with alcohol, surviving biologically for 9 years in a "persistent vegetative state" even after the New Jersey Supreme Court approval to remove her from a respirator. This case caused a widespread public concern about "lives not worth living" and the possibility of at least voluntary euthanasia if it could be ascertained that the patient would not have wanted to live in this condition.[9] In April 2019, New Jersey became the 7th US state to allow assisted dying after the Governor of New Jersey signed the bill into law and goes into effect on August 1, 2019.[10]

In 1999, the state of Texas passed the Advance Directives Act. Under the law, in some situations, Texas hospitals and physicians have the right to withdraw life support measures, such as mechanical respiration, from terminally ill patients when such treatment is considered to be both futile and inappropriate. This is sometimes referred to as "passive euthanasia".

In 2005, a six-month-old infant, Sun Hudson, with a uniformly fatal disease thanatophoric dysplasia, was the first patient in which "a United States court has allowed life-sustaining treatment to be withdrawn from a pediatric patient over the objections of the child's parent".[11]

Attempts to legalize euthanasia and assisted suicide resulted in ballot initiatives and legislation bills within the United States in the last 20 years. For example, Washington voters saw Ballot Initiative 119 in 1991, California placed Proposition 161 on the ballot in 1992, Oregon passed the Death with Dignity Act in 1994, and Michigan included Proposal B in their ballot in 1998.

Reflecting the religious and cultural diversity of the United States, there is a wide range of public opinion about euthanasia and the right-to-die movement in the United States. During the past 30 years, public research shows that views on euthanasia tend to correlate with religious affiliation and culture, though not gender.

In one recent study dealing primarily with Christian denominations such as Southern Baptists, Pentecostals, and Evangelicals and Catholics tended to be opposed to euthanasia. Moderate Protestants, (e.g., Lutherans and Methodists) showed mixed views concerning end of life decisions in general. Both of these groups showed less support than non-affiliates, but were less opposed to it than conservative Protestants. Respondents that did not affiliate with a religion were found to support euthanasia more than those who did. The liberal Protestants (including some Presbyterians and Episcopalians) were the most supportive. In general, liberal Protestants affiliate more loosely with religious institutions and their views were not similar to those of non-affiliates. Within all groups, religiosity (i.e., self-evaluation and frequency of church attendance) also correlated to opinions on euthanasia. Individuals who attended church regularly and more frequently and considered themselves more religious were found to be more opposed to euthanasia than to those who had a lower level of religiosity.[12]

Recent studies have shown white Americans to be more accepting of euthanasia than black Americans. They are also more likely to have advance directives and to use other end-of-life measures.[13] African Americans are almost 3 times more likely to oppose euthanasia than white Americans. Some speculate that this discrepancy is due to the lower levels of trust in the medical establishment.[14] Select researchers believe that historical medical abuses towards minorities (such as the Tuskegee Syphilis Study) have made minority groups less trustful of the level of care they receive. One study also found that there are significant disparities in the medical treatment and pain management that white Americans and other Americans receive.[15]

Among African Americans, education correlates to support for euthanasia. Black Americans without a four-year degree are twice as likely to oppose euthanasia than those with at least that much education. Level of education, however, does not significantly influence other racial groups in the US. Some researchers suggest that African Americans tend to be more religious, a claim that is difficult to substantiate and define.[14] Only black and white Americans have been studied in extensive detail. Although it has been found that minority groups are less supportive of euthanasia than white Americans, there is still some ambiguity as to what degree this is true.

A 2005 Gallup Poll found that 84% of males supported euthanasia compared to 64% of females.[16] Some cite the prior studies showing that women have a higher level of religiosity and moral conservatism as an explanation for major opposition to euthanasia. Within both sexes, there are differences in attitudes towards euthanasia due to other influences. For example, one study found that black American women are 2.37 times more likely to oppose euthanasia than white American women. African American men are 3.61 times more likely to oppose euthanasia than white American men.[17]

In "Gender, Feminism, and Death: Physician-Assisted Suicide and Euthanasia" Susan M. Wolf warns of the gender disparities if euthanasia or physician-assisted suicide were legal. Wolf highlights four possible gender effects: higher incidence of women than men dying by physician-assisted suicide; more women seeking physician-assisted suicide or euthanasia for different reasons than men; physicians granting or refusing requests for assisted suicide or euthanasia because of the gender of the patient; gender affecting the broad public debate by envisioning a woman patient when considering the debate.[18]

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Euthanasia in the United States - Wikipedia

What Happens When You Put Your Pet to Sleep? – WebMD

In this Article In this Article In this Article

Now that youve made the hard -- but humane -- choice to put your aging or ill pet to sleep, you may have questions. Will it hurt? Can I be with my pet during the process? Can it be done in my home?

Knowing the facts can help you and your family feel more at peace with what's going to happen.

It can be done at home or at your veterinarian's office. Not all vets will do this at your home so its important to check first. You may want to search for one that offers this service.

Make a time for your entire family to say goodbye. If you have children, explain what's happening in advance to help them prepare for the loss of their friend. The American Humane Association recommends books such as Fred Rogers When a Pet Dies as a way to provide comfort and understanding for children.

If you choose a vets office, bring your pets bed with you -- or a comfy blanket or pillow -- where she can rest. Most vets will provide a blanket, bugt one from home may be more soothing to you pet,

You may want to sit with your friend so you can pet and comfort her while the vet gives her the medicine.

Many vets give the pet a shot of sedative before the euthanasia drug. The vet will explain to you what he's doing and where he's giving the shot. Some vets only use a sedative if the pet is frightened or can't relax. The shot may may stin a little bit, and the drug can have side effects.So talk to your vet about whether your pet should get it. If she's very sick and already quiet or has trouble breathing she may not need it.

The euthanasia medication most vets use is pentobarbital, a seizure medication. In large doses, it quickly renders the pet unconscious. It shuts down her heart and brain functions usually within one or two minutes. It is usually given by an IV injection in one of her legs.

When your pet passes, her eyes may not fully close. She may urinate or defecate. You may see her twitch or take a final breath. This can be startling, but it's a normal part of the process. Your pet isn't in pain. Use of a sedative makes this step less likely.

In-home euthanasia can be easier if your dog has trouble moving or gets panicky at the vet's office.

Plus, if there are other animals at your house, they can see that their friend has passed. This is important for dogs -- as pack animals, they may get confused if they see another dog leave the house and not come back. Dogs often cry and search for a deceased animal after it's gone.

On the other hand, you may not want to associate your home with a beloved pet's death. It can be upsetting to children to see it happen, too. Or you may not want to be there when your pet passes.

If you want to bury your pet at home, be sure to check local, county, or state ordinances to make sure this is legal. You may also consider a pet cemetery.

The International Association of Pet Cemeteries and Crematories has a directory of pet cemeteries on its website.

Many people choose to have their pet cremated. Your city may have a company that will pick up your friend's remains from the vet's office or from your home. They'll cremate the pet and let you have time for a memorial service before if you want. Your vet may have a service he uses. If not, contact your local or state government for guidance and regulations.

Putting your pet to sleep is the final step of a lifetime of care. You're making sure your friend is treated with compassion and dignity in his final moments.

SOURCES:

American Humane Association: "Euthanasia: Making the Decision."

The Humane Society of the United States: "Euthanasia Reference Manual."

Interview: Kristen Brauer, DVM, Tampa, Fla.

Interview: Bill DeBusk, Pet Angels, Pinellas Park, Fla.

The International Association of Pet Cemeteries and Crematories.

Pagination

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What Happens When You Put Your Pet to Sleep? - WebMD

Euthanasia, Assisted Suicide & Health Care Decisions Part 1 …

Euthanasia, Assisted Suicide & Health Care Decisions:Protecting Yourself & Your Family

Table of Contents |Part 1 |Part 2

byRita L. Marker

INTRODUCTION

The words euthanasia and assisted suicide are often used interchangeably. However, they are different and, in the law, they are treated differently. In this report, euthanasia is defined as intentionally, knowingly and directly acting to cause the death of another person (e.g., giving a lethal injection). Assisted suicide is defined as intentionally, knowingly and directly providing the means of death to another person so that the person can use that means to commit suicide (e.g., providing a prescription for a lethal dose of drugs).

Part I of this report discusses the reasons used by activists to promote changes in the law; the contradictions that the actual proposals have with those reasons; and the logical progression that occurs when euthanasia and assisted suicide are transformed into medical treatments. It explores the failure of so-called safeguards and outlines the impact that euthanasia and assisted suicide have on families and society in general.

Withholding and withdrawing medical treatment and care are not legally considered euthanasia or assisted suicide. Withholding or withdrawing food and fluids is considered acceptable removal of a medical treatment.

Part II of this report includes information about practical ways to protect oneself and loved ones during any time of incapacity and a discussion of some of the policies that have led to patients being denied care that they or their decision-makers have requested. It concludes with an examination of the ethical distinction between treatment and care.

PART I

EUTHANASIA & ASSISTED SUICIDE

MOVING THE BOUNDARIES

In 2002, the International Task Force report, Assisted Suicide: Not for Adults Only? (1) discussed euthanasia and assisted suicide for children and teens. At that time, such concerns were largely considered outside the realm of possibility.

Then, as now, assisted-suicide advocates claimed that they were only trying to offer compassionate options for competent, terminally ill adults who were suffering unbearably. By and large, their claims went unchallenged.

A crack in that carefully honed image appeared in 2004 when the Groningen Protocol elicited worldwide outrage. The primary purpose of that protocol formulated by doctors at the Groningen Academic Hospital in the Netherlands was to legally and professionally protect Dutch doctors who kill severely disabled newborns. (2)

While euthanasia for infants (infanticide) was not new, widespread discussion of it was. Dutch doctors were now explaining that it was a necessary part of pediatric care.

Also in 2004, Hollands most prestigious medical society (KNMG) urged the Health Ministry to set up a board to review euthanasia for people who had no free will, including children and individuals with mental retardation or severe brain damage following accidents. (3)

At first, it seemed that these revelations would be harmful to the euthanasia movement, but the opposite was true.

Why?

Awareness of infanticide and euthanasia deaths of other incompetent patients moved the boundaries.

Prior to the widespread realization that involuntary euthanasia was taking place, advocacy of assisted suicide for those who request it seemed to be on one end of the spectrum. Opposition to it was on the other end.

Now, the practice of involuntary euthanasia took its place as one extreme, opposition to it as the other extreme, and assisted suicide for terminally ill competent adults appeared to be in the moderate middle a very advantageous political position and expansion of the practice to others had entered the realm of respectable debate.

This repositioning has become a tool in the assisted-suicide arsenal. In May 2006, an assisted-suicide bill, patterned after Oregons law permitting assisted suicide, failed to gain approval in the British Parliament. The bills supporters immediately declared that they would reintroduce it during the next parliamentary session.

Within two weeks, Professor Len Doyal a former member of the British Medical Associations ethics committee who is considered one of Englands leading experts on medical ethics called for doctors to be able to end the lives of some patients swiftly, humanely and without guilt, even without the patients consent. (4) Doyals proposal was widely reported and, undoubtedly, when the next assisted-suicide bill is introduced in England, a measure that would permit assisted suicide only for consenting adults will appear less radical than it might have seemed prior to Doyals suggestion.

Currently, euthanasia is a medical treatment in the Netherlands and Belgium. Assisted suicide is a medical treatment in the Netherlands, Belgium and Oregon. Their advocates erroneously portray both practices as personal, private acts. However, legalization is not about the private and the personal. It is about public policy, and it affects ethics, medicine, law, families and children.

A FAMILY AFFAIR

In December 2005, ABC News World News Tonight reported, Anita and Frank go often to the burial place of their daughter Chanou. Chanou died when, with her parents consent, doctors gave her a lethal dose of morphine. Im convinced that if we meet again somewhere in heaven, her father said, shell tell us we reached the most perfect solution.'(5)

The report about the six-month-old Dutch childs death was introduced as a report on the debate over euthanizing infants. A Dutch legislator who agrees that doctors who intentionally end their tiny patients lives should not be prosecuted said, Im certainly pro-life. But Im also a human being. I think when there is extreme, unbearable suffering, then there can be extreme relief. (6)

Gone was the previous years outrage over the Groningen Protocols. Infanticide had entered the realm of respectable debate in the mainstream media. The message given to viewers was that loving parents, compassionate doctors and caring legislators favor infanticide. It left the impression that opposing such a death would be cold, unfeeling and, perhaps, intentionally cruel.

In Oregon, some assisted-suicide deaths have become family or social events.

Oregons law does not require family members to know that a loved one is planning to commit suicide with a doctors help. (7) Thus, the first knowledge of those plans could come when a family member finds the body. However, as two news features illustrate, some Oregonians who die from assisted suicide make it a teachable moment for children or a party event for friends and family.

According to the Mail Tribune (Medford, Oregon), on a sunny afternoon, Joan Lucas rode around looking at houses, then she sat in a park eating an ice cream cone. A few hours later, she committed suicide with a prescribed deadly drug overdose. Grandchildren were made to understand that Grandma Joan would be going away soon. Those who were old enough to understand were told what was happening. (8

Did these children learn from Grandma Joan that suicide is a good thing?

UCLAs student newspaper, the Daily Bruin, carried an article favoring assisted suicide. It described how Karen Janoch who committed suicide under the Oregon law, sent invitations for her suicide to about two dozen of her closest friends and family. The invitation read, You are invited to attend the actual ending of my life. (9) At the same time Californias legislature was considering an assisted-suicide bill that was virtually identical to Oregons law, UCLA students learned that suicide can be the occasion for a party.

In Oregon, assisted suicide has gone from the appalling to the appealing, from the tragic to the banal.

During the last half of 2005 and the first half of 2006, bills to legalize assisted suicide were under consideration in various states and countries including, but not limited to, Canada, Great Britain, California, Hawaii, Vermont, and Washington. All had met failure by the end of June 2006. But plans to reintroduce them with some cosmetic changes are currently underway. A brief examination of arguments used to promote them illustrates the small world nature of assisted-suicide advocacy.

TWO PILLARS OF ADVOCACY

Wherever an assisted-suicide measure is proposed, proponents arguments and strategies are similar. Invariably, promotion rests on two pillars: autonomy and the elimination of suffering.

Autonomy

Autonomy (independence and the right of self-determination) is certainly valued in modern society and patients do, and should, have the right to accept or reject medical treatment. However, those who favor assisted suicide claim that autonomy extends to the right of a patient to decide when, where, how and why to die as the following examples illustrate.

During debate over an assisted-suicide measure then pending before the British Parliament, proponents emphasized personal choice. The bill, titled The Assisted Dying for the Terminally Ill Bill, was introduced by Lord Joel Joffe. Dr. Margaret Branthwaite, a physician, barrister and former head of Englands Voluntary Euthanasia Society (recently renamed Dignity in Dying (10)), called for passage of the Joffe bill in an article in the British Medical Journal. As a matter of principle, she wrote, it reinforces current trends towards greater respect for personal autonomy. (11)

The focus on autonomy was also reflected in remarks about a plan to introduce an assisted-suicide initiative in Washington. Booth Gardner, former governor of Washington, said he plans to promote the initiative because it should be his decision when and how he dies. He told the Seattle Post-Intelligencer, When I go, I want to decide. (12)

The rationale is that when, where, why and how one dies should be a matter of self-determination, a matter of independent choice, and a matter of personal autonomy.

Elimination of suffering

The second pillar of assisted-suicide advocacy is elimination of suffering. During each and every attempt to permit euthanasia and assisted suicide, its advocates stress that ending suffering justifies legalization of the practices.

California Assemblywoman Patty Berg, the co-sponsor of Californias euphemistically named Compassionate Choices Act, (13) said the assisted-suicide measure was necessary so that people would have the comfort of knowing they could escape unbearable suffering if that were to occur. (14)

In an opinion piece supporting the failed 1998 assisted-suicide initiative in Michigan, a spokesperson for those favoring the measure wrote that the patients targeted by the proposal were those who were tortured by the unbearable suffering of a slow and agonizing death. (15)

In the United Kingdom, Lord Joffe said his bill would enable those who are suffering unbearably to get medical assistance to die. (16) Testimony before the British House of Lords Select Committee studying the bill noted that, where assisted dying has been legalized, it has done so as a response to patients who were suffering. (17)

The centerpiece of the 1994 Measure 16 campaign that resulted in Oregons assisted-suicide law was a television commercial featuring Patti Rosen. Describing her daughter who had cancer, Rosen said, The pain was so great that she couldnt bear to be touched. Measure 16 would have allowed my daughter to die with dignity. (18)

When an assisted-suicide proposal that later failed was being considered by the Hawaiian legislature in 2002, a public relations consultant who was working on behalf of the bill, e-mailed a template for use in written or oral testimony. The template suggested inclusion of the phrases agonizingly painful, pain was uncontrollable, and pain beyond my understanding. (19)

During consideration of an assisted-suicide bill in Vermont, the states former governor Philip Hoff said, The last thing I would want in this world is to be around and be in pain, and have no quality of life, and be a burden to my family and others. (20) Dick Walters, chairman of Death with Dignity Vermont, said the proposal would permit a person to peacefully end suffering and hasten death. (21)

Thus, the rationale given by euthanasia and assisted-suicide proponents for legalization always includes autonomy and/or elimination of suffering. However, the laws they propose actually contradict this rationale.

CONTRADICTIONS

When proposed, laws such as those now in existence in Oregon and similar measures introduced elsewhere include conditions or requirements limiting assisted suicide to certain groups of qualified patients. A patient qualified to receive the treatment of assisted suicide must be an adult who is capable of making decisions and must be diagnosed with a terminal condition.

If one accepts the premise that assisted suicide is a good medical treatment that should be permitted on the basis of personal autonomy or elimination of suffering, other questions must be raised.

If the reason for permitting assisted suicide is autonomy, why should assisted suicide be limited to the terminally ill?

Does ones autonomy depend upon a doctors diagnosis (or misdiagnosis) of a terminal illness? If a person is not terminally ill, but is suffering whether physically, psychologically or emotionally why isnt it up to that person to decide when, why and how to die? Does a person only have autonomy if he or she has a particular condition or illness? Is autonomy a basis for the law?

If assisted suicide is a good and acceptable medical treatment for the purpose of ending suffering, why should it be limited to adults who are capable of decision-making?

Isnt it both discriminatory and cruel to deny that good and acceptable medical treatment to a child or an incompetent adult? Why is a medical treatment that has been deemed appropriate to end suffering available to an 18-year-old, but not to a 16-year-old or 17-year-old? Why is a person only eligible to have his or her suffering ended if he or she has reached an arbitrary age?

And, what of the adult who never was, or no longer is, capable of decision-making? Should that person be denied medical treatment that ends suffering? Are euthanasia and assisted-suicide laws based on the need to eliminate suffering, or not?

Establishing arbitrary requirements that must be met prior to qualifying for the medical treatment of euthanasia or assisted suicide does, without doubt, contradict the two pillars on which justification for the practices is based.

The question then must be asked: Why are those arbitrary requirements included in Oregons law and other similar proposals? The answer is simple. After a series of defeats, euthanasia and assisted-suicide proponents learned that they had to propose laws that appeared palatable.

In April 2005, Lord Joffe, the British bills sponsor, acknowledged that his bill was intended to be only the first step. During hearings regarding the measure, he said that this is the first stage and went on to explain that one should go forward in incremental stages. I believe that this bill should initially be limited. (22)

He repeated his remarks a year later when discussing hearings about his bill. I can assure you that I would prefer that the [proposed] law did apply to patients who were younger and who were not terminally ill but who were suffering unbearable, he said and added, I believe that this bill should initially be limited. (23)

STEP-BY-STEP APPROACH

Proposals for euthanasia and assisted suicide have always emanated from advocacy groups, not from any grassroots desire. Those groups learned that attempting to go too far, too fast, leads to certain defeat.

After many failed attempts, most recently those in the early 90s in Washington and California when ballot initiatives that would have permitted both euthanasia by lethal injection and assisted suicide by lethal prescription were resoundingly defeated death with dignity activists changed their strategy. They decided to take a step-by-step approach, proposing an assisted-suicide-only bill which, when passed, would serve as a model for subsequent laws. Only after several such laws were passed, would they begin to expand them. That was the strategy that led to Oregons Measure 16, the Oregon Death with Dignity Act.

Those who were most involved in the successful Oregon strategy were not new to the scene.

Cheryl K. Smith, who wrote the first draft of Oregons law, had served as a special counsel to the political action group Oregon Right to Die (ORD). Smith had been the National Hemlock Societys legal advisor after her graduation from law school in 1989 and had been a top aide to Hemlocks co-founder, Derek Humphry. While a student at the University of Iowa College of Law, Smith helped draft a Model Aid-in-Dying Act that provided for childrens lives to be terminated either at their own request or, if under 6 years of age, by parental request. (24)

Barbara Coombs Lee was Measure 16s chief petitioner. At the time, she was a vice president for a large Oregon managed care program. After the laws passage, she took over the leadership of Compassion in Dying. (25) [Note: In early 2005, Compassion in Dying merged with the Hemlock Society. The combined organization is now called Compassion and Choices.]

Coombs Lees promotion of assisted suicide and euthanasia began prior to her involvement with the Death with Dignity Act. As a legislative aide to Oregon Senator Frank Roberts in 1991, she worked on Senate Bill 114 that would have permitted euthanasia on request of a patient and, if the patient was not competent, a designated representative would have been authorized to request the patients death. (26)

Upon passage of the Oregon law in 1994, many assisted-suicide supporters were certain that other states would immediately fall in line. However, that did not occur. Between 1994 and mid-2006, assisted-suicide measures were introduced in state after state.(27) Each and every proposal failed. All of the proposals were assisted-suicide-only bills and, with one exception, (28) every one was virtually identical to the Oregon law.

Among supporters of assisted suicide and euthanasia, though, the Oregon law is seen as the model for success and is referred to in debates about assisted suicide throughout the world. For that reason, a careful examination of the Oregon experience is vital to understanding the problems with legalized assisted suicide.

OREGON

Under Oregons law permitting physician-assisted suicide, the Oregon Department of Human Services (DHS) previously called the Oregon Health Division (OHD) is required to collect information, review a sample of cases and publish a yearly statistical report. (29)

However, due to major flaws in the law and the states reporting system, there is no way to know for sure how many or under what circumstances patients have died from physician-assisted suicide. Statistics from official reports are particularly questionable and have left some observers skeptical about their validity.

For example, when a similar proposal was under consideration in the British Parliament, members of a House of Lords Committee traveled to Oregon seeking information regarding Oregons law for use in their deliberations. The public and press were not present during the closed-door hearings. However, the House of Lords published the committees proceedings in three lengthy volumes, which included the exact wording of questions and answers.

After hearing witnesses claim that there have been no complications associated with more than 200 assisted-suicide deaths, committee member Lord McColl of Dulwich, a surgeon, said, If any surgeon or physician had told me that he did 200 procedures without any complications, I knew that he possibly needed counseling and had no insight. We come here and I am told there are no complications. There is something strange going on. (30)

The following includes statistical data from official reports and other published information dealing with troubling aspects of the practice of assisted suicide in Oregon. Statements from the 744-page second volume of the House of Lords committee proceedings are also included. None of the included statements from the committee hearings were made by opponents of Oregons law.

OFFICIAL REPORTS

Assisted-suicide deaths reported during the first eight years

Official Reports: 246Actual Number: Unknown

The latest annual report indicates that reported assisted-suicide deaths have increased by more than 230% since the first year of legal assisted suicide in Oregon. (31) The numbers, however, could be far greater. From the time the law went into effect, Oregon officials in charge of formulating annual reports have conceded theres no way to know if additional deaths went unreported because Oregon DHS has no regulatory authority or resources to ensure compliance with the law. (32)

The DHS has to rely on the word of doctors who prescribe the lethal drugs. (33) Referring to physicians reports, the reporting division admitted: For that matter the entire account [received from a prescribing doctor] could have been a cock-and-bull story. We assume, however, that physicians were their usual careful and accurate selves. (34)

The Death with Dignity law contains no penalties for doctors who do not report prescribing lethal doses for the purpose of suicide.

Complications occurring during assisted suicide

Official Reports: 13 (12 instances of vomiting & one patient who did not die fromlethal dose.)

Actual number: Unknown

Prescribing doctors may not know about all complications since, over the course of eight years, physicians who prescribed the lethal drugs for assisted suicide were present at only 19.5% of reported deaths. (35) Information they provide might come from secondhand accounts of those present at the deaths (36) or may be based on guesswork.

When asked if there is any systematic way of finding out and recording complications, Dr. Katrina Hedberg who was a lead author of most of Oregons official reports said, Not other than asking physicians. (37) She acknowledged that after they write the prescription, the physician may not keep track of the patient. (38) Dr. Melvin Kohn, a lead author of the eighth annual report, noted that, in every case that they hear about, it is the self-report, if you will, of the physician involved. (39)

Complications contained in news reports are not included in official reports

Patrick Matheny received his lethal prescription from Oregon Health Science University via Federal Express. He had difficulty when he tried to take the drugs four months later. His brother-in-law, Joe Hayes, said he had to help Matheny die. According to Hayes, It doesnt go smoothly for everyone. For Pat it was a huge problem. It would have not worked without help. (40) The annual report did not make note of this situation.

Speaking at Portland Community College, pro-assisted-suicide attorney Cynthia Barrett described a botched assisted suicide. The man was at home. There was no doctor there, she said. After he took it [the lethal dose], he began to have some physical symptoms. The symptoms were hard for his wife to handle. Well, she called 911. The guy ended up being taken by 911 to a local Portland hospital. Revived. In the middle of it. And taken to a local nursing facility. I dont know if he went back home. He died shortly someperiod of time after that. (41)

Overdoses of barbiturates are known to cause vomiting as a person begins to lose consciousness. The patient then inhales the vomit. In other cases, panic, feelings of terror and assaultive behavior can occur from the drug-induced confusion. (42) But Barrett would not say exactly which symptoms had taken place in this instance. She has refused any further discussion of the case.

Complications are not investigated

David Prueitt took the prescribed lethal dose in the presence of his family and members of Compassion & Choices. After being unconscious for 65 hours, he awoke. It was only after his family told the media about the botched assisted suicide that Compassion & Choices publicly acknowledged the case. (43) DHS issued a release saying it has no authority to investigate individual Death with Dignity cases. (44)

Referring to DHSs ability to look into complications, Dr. Hedberg explained that we are not given the resources to investigate and not only do we not have the resources to do it, but we do not have any legal authority to insert ourselves. (45)

David Hopkins, Data Analyst for the Eighth Annual Report, said, We do not report to the Board of Medical Examiners if complications occur; no, it is not required by law and it is not part of our duty. (46)

Jim Kronenberg, the Oregon Medical Associations (OMA) Chief Operating Officer, explained that the way the law is set up there is really no way to determine that [complications occurred] unless there is some kind of disaster. [P]ersonally I have never had a report where there was a true disaster, he said. Certainly that does not mean that you should infer there has not been, I just do not know. (47)

In the Netherlands, assisted-suicide complications and problems are not uncommon. One Dutch study found that, because of problems or complications, doctors in the Netherlands felt compelled to intervene (by giving a lethal injection) in 18% of cases.(48)

This led Dr. Sherwin Nuland of Yale University School of Medicine to question the credibility of Oregons lack of reported complications. Nuland, who favors physician-assisted suicide, noted that the Dutch have had years of practice to learn ways to overcome complications, yet complications are still reported. The Dutch findings seem more credible [than the Oregon reports], he wrote. (49)

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