Daily Archives: July 14, 2017

Physician-assisted suicide is legal in five states and Washington, D.C., and supporters of the practice say they have plans to push for legalization in a dozen more states. The number of Americans who ask doctors to prescribe lethal doses of medication is relatively small, but support for the practice is growing. End-of-life issues have garnered attention north of the border, as well. Last year, Canadian lawmakers legalized euthanasia, a practice that differs slightly from physician-assisted suicide in that doctors administer the drugs rather than simply prescribe them. The law allows individuals whose deaths are reasonably foreseeable to request lethal doses of medication to end their lives early, though some lawmakers want to expand the law to include those who are suffering but who are not near death.

With Canadians now free to request euthanasia, some Catholic bishops there are grappling with a difficult question: Should those who end their lives with the assistance of medication be given a Catholic funeral?

Cardinal Grald Lacroix, the archbishop of Quebec, where euthanasia has been legal since 2014, told America that it is difficult to know why a patient chose to end his or her life early. As a result, the church should err on the side of mercy when it comes to funerals. He said that many elderly people are made to feel burdensome, are afraid to be alone in their final days or are nervous about experiencing pain. Increasingly, he said, society tells them that an early death is preferable.

Culturally, theyre bombarded with this [message] all the time, he said. So who are we to judge why they are like this? he asked, referring to patients who decide they want to take advantage of what proponents have dubbed medical aid in dying.

We do the best we can and leave the rest to the Lord. If the Lord accuses us of being too merciful, well, Ill take it, he said.

But not all bishops in Canada are on the same page when it comes to how the church should proceed for people who end their lives with the assistance of doctors.

Last fall, six bishops from western and northern Canada signed a statement that suggested some individuals who use euthanasia would not be eligible for a Catholic burial, especially if that person was a high-profile figure. The document notes that the church offers funerals for those who commit suicide, as pastors are not able to judge the reason the person has taken that decision or the disposition of their heart.

But when it comes to physician-assisted suicide, the bishops write, there are sometimes more clues about the intentions of the deceased. In such cases, it may not be possible to celebrate a Christian funeral, the statement reads. If the Church were to refuse a funeral to someone, it is not to punish the person but to recognize his or her decisiona decision that has brought him or her to an action that is contrary to the Christian faith, that is somehow notorious and public, and would do harm to the Christian community and the larger culture, it continues.

A few months later, bishops in Canadas eastern provincesreleased their own statement suggesting that the question of funerals was too complex for written guidelines and proposing that each case be dealt with individually.

Persons, and their families, who may be considering euthanasia or assisted suicide and who request the ministry of the church, need to be accompanied with dialogue and compassionate prayerful support, the statement reads. The fruit of such a pastoral encounter will shed light on complex pastoral situations and will indicate the most proper action to be taken including whether or not the celebration of sacraments is appropriate.

Cardinal Lacroix seems to come down somewhere in the middle, suggesting that people who opt for euthanasia could still be eligible for a Catholic funeral, so long as they and their loved ones are not promoting the practice or using the funeral to make a statement about the law.

Plus the family might not support a loved ones decision to end his or her life.

Do you think they need consolation? Of course, he said. We accompany everybody.

Still, he suggested that there are cases where a Catholic funeral would not be prudent.

The only time we will say noit hasnt happened yet but it could happen as far as Im concernedis if somebody says: Im getting euthanasia, and Im going to have a [Catholic] funeral. I deserve this, and at my funeral, those who are going to speak are going to say, Were promoting this, he said. No, no this isnt a show.

Cardinal Lacroix recalled two episodes in which pastors were asked to minister to patients considering euthanasia. In one, a frail woman dying of cancer had decided to end her life early. The hospital chaplain, a Catholic priest, asked her why, and she explained that she feared being a burden to her busy children, now with families of their own. He suggested that she talk to them about her concerns, and when she did, they were shocked and convinced her to change her mind. Accompaniment, he said. The priest didnt do it. But he helped her make the decision. He didnt tell her: What! You cant do that! Thats immoral! He helped her think.

In another instance, Cardinal Lacroix said, he visited a dying woman at the request of a friend. The woman had planned her death, which would include a final meal with her family before doctors administered the drugs. He recalled listening to the patient talk about her life and her family, but she was determined that she did not want to suffer at the end. She went through with the practice, and in her obituary, the cardinal said, the woman thanked lawmakers for legalizing euthanasia. In that case, had the woman asked for a Catholic funeral, he said it probably would have been inappropriate to grant her request.

We accompanied her, we accompanied her family, he said. Thats what we can do. We can harp and harp, and say, This is bad, this is bad, and it is and we do in some ways. But he prefers a more proactive approach, and to that end, he has supported a program that will train hundreds of volunteers to spend time with those in their final days, so that people are not alone when it is time to die.

Thats what we do. We accompany life, in real situations. We propose the best we can offer, which is what the church teaches, Cardinal Lacroix continued. The rest is not in our hands.

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Canadian bishops grapple with legal euthanasia and funerals ... - America Magazine

Shutterstock.comPain and death. Death and pain. They often go hand in hand. But for Dani McVety, DVM, and her fellow veterinarians in the Lap of Love hospice and in-home euthanasia network, the goal is to minimize painand the anxiety that often accompanies itas much as possible before the end. Maybe even to prevent it altogether.

We as veterinarians are very comfortable with the concept of quality of life, she told her audience at a recent CVC. But I want to provide a good quality of death as well. That means no panicky trips to the ER in the middle of the night. Id rather have the family out on the dock with the pet at sunset, everyone saying a prayer before I push the plunger. Whatever it takes to give that family and that pet a peaceful experience.

A major part of creating that peaceful experience is educating and preparing clients for what to expect as their pet reaches end of life, along with helping them know when euthanasia is an appropriate choice. Here are the top six conditions Lap of Love veterinarians see in association with euthanasia (based on data collected by the company) and how Dr. McVety handles each one with clients.

1. Old age

Obviously old age isnt a disease, but it sure is a killer, Dr. McVety says. Its the No. 1 reason Lap of Love clients call to request euthanasia, and what it really means is that the pets medical condition is undiagnosed. That means anything can happen, so client and doctor alike should brace for the unexpected. Problems with cognition, along with stroke, seizures and organ failure, are all possibilities.

2. Osteoarthritis and mobility issues

This painful disease is the second-most-common reason Dr. McVety receives calls requesting consultation on euthanasia for pets. The pain increases with progression, and clients should be instructed to watch for signs of intensifying discomfort. Sundowners syndromeawakeness or awareness in the middle of the night, accompanied by panting, pacing, whining and cryingis very common with osteoarthritis (as well as a number of other end-of-life conditions).

While the pet should be on an osteoarthritis treatment protocol, clients may also need rescue drugs to get the pet through a pain crisis before the euthanasia takes place. Dr. McVety says she leaves rescue medications with clients if theyre not ready to euthanize yet or if theyre trying to make a deadline, such as getting through Christmas or waiting for Mom or Dad to get home to say goodbye.

Along with gabapentin, Dr. McVety uses tramadol for osteoarthritis patients as a rescue drug. Weve learned that tramadol is not necessarily fantastic for pain, but Ill tell you how I use it, she says. Tramadol is like a glass of winesometimes we need one glass of wine to get through the night; sometimes we need three or four. Of course, if were using three or four doses multiple nights in a row, we have a quality-of-life issue and we need to have a conversation about that.

Dr. Dani McVetyAs far as knowing the right time to euthanize, we have the curse and the luxury of time, Dr. McVety says. With osteoarthritis patients there is major variation in when a client and veterinarian can make the decision and have it be appropriate and ethical. Sometimes animals will eat through pain and wag their tail right up to the end, so cessation of these activities is not always a reliable indicator, Dr. McVety says. Tell clients this, and let them know its still OK to say goodbye if pain and anxiety are detracting from the patients life.

3. Renal failure

With chronic kidney disease, pain is variable depending on the patient: It can range from uncomfortable to very painful. Again, its best to educate clients on signs of pain and watch for progression in their pets. Rescue drugs can include buprenorphine, tramadol, fluids, anti-emetics and appetite stimulants.

When is it right to euthanize a kidney disease patient? Again, we have the curse and the luxury of time, Dr. McVety says. The goal for a high quality of death is to make it a peaceful experience and avoid a crisis that leads to an ER trip.

4. Heart failure

As with chronic kidney disease, pain associated with congestive heart failure (CHF) can range from uncomfortable to sufferable, Dr. McVety says. The main thing she tells her clients to watch for is change, particularly changes in eating. If a CHF patient comes in and is still eating, we can usually mitigate, says Dr. McVety, who worked in emergency practice before founding Lap of Love and has seen her share of heart failure. Not at the very end. If the pet stops eating, thats a huge red flag.

Rescue drugs for heart failure include high-dose furosemide, and Dr. McVety will even sometimes leave an oxygen machine with the family if theyre trying to delay euthanasia until a family member can be present.

When is the right time to euthanize? Much sooner than you want to if you want a peaceful end-of-life experience, Dr. McVety tells clients.

5. Hemangiosarcoma

Pain associated with hemangiosarcoma, the fifth-most-common condition leading to euthanasia requests, ranges from uncomfortable (in hypoxic patients) to sufferable (discomfort related to pulmonary metastases and pressure from ascites).

Hemangiosarcoma declines rapidly under most conditions in elderly patients. Thismakes the use ofrescuemedications (those that act rapidly to mitigate pain) not as applicable in these cases. But theyre still useful, if only for their placebo effect with both patient and pet parent, Dr. McVety says. Oxygen may also help certain patients.

A key factor with hemangiosarcoma patients is to educate their owners about what the end will look likeit might be a slow bleed and it might be a fast bleed. We need to let clients know what to expect so they dont freak out, Dr. McVety says. I told one lady about the possibility of a fast bleed, and she said later that because she knew what was happening, her dog died peacefully in her arms and she didnt panic. She gave me a huge hug and a thank you that she knew what to expect.

With hemangiosarcoma, its also important to tell clients that euthanasia sooner rather than later is better for a peaceful goodbye experience.

6. Osteosarcoma

Rounding out the top six end-of-life conditions from Dr. McVety, osteosarcoma ranges in painfulness from discomfort to sufferability. Awareness of progression is key for clients, and rescue drugs for controlling pain are very important. The answer to when should I euthanize? is, again, Sooner than you want to, Dr. McVety says.

Whether its one of these conditions or any other health problem that makes euthanasia a reasonable choice for client and patient, the bottom line is to let pet owners know what the dying process looks like in their pets disease context. This helps them stay calm and make good decisions, with your help, about their pets care. After all, death comes calling for all animals, whether veterinarians step in or not, so everyone involved can release judgment and guilt and focus on the petthe joy it has brought in life, and the peace and love it can experience with its family at the end.

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When death comes calling: Top diseases leading to veterinary euthanasia - dvm360

Euthanasia has long been debated in Australia on both sides, and now former longtime Victorian Premier Steve Bracks has thrown his support behind the Andrews governments campaign to legalise the assisted-dying method.

Mr Bracks, Victorias second-longest-serving premier from 1999 to 2007, is a Catholic and was widely regarded as a conservative during his time in power.

Speaking on the topic, Mr Bracks recognised that during his stint as Premier, the timing wasnt right to put forward to the bill, even though he has long been a supporter.

I think it would be a sensible and appropriate change, done well and considered well, Mr Bracks told The Australian.

I think its good timing, it is an appropriate and sensible reform, one which is not without controversy but one which should go ahead.

His comments come as an Independent panel works on recommendations for a framework that will be Australias first attempt at government-supported legislation on assisted suicide.

This panel is expected to hand down its finding within the next few weeks, and The Australian reports a bill could even be tabled in the Victorian Parliament as early as the week of August 22nd.

There has been a parliamentary committee which has worked on this in Victoria and the product of that work will be extremely useful in finding a way forward and one which can allow for the consideration of parliament.

The proposed legislation would contain strict criteria, with eligibility for euthanasia limited to Australians who are suffering from a serious and incurable condition.

It is expected the legislation would be amongst the most conservative euthanasia models in the world, and those wishing to undertake must request three times to die, including once in writing.

Mr Bracks backed a conservative approach to euthanasia, citing concerns over the potential for families to coerce vulnerable patients into assisted-suicide.

If it is done well and effectively with proper and appropriate referrals that will not be the case and I think that is the experience internationally; across Scandinavia that has not occurred, he said.

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Former Premier supports Euthanasia push - Ten Eyewitness News

MATT STEWART

Last updated15:28, July 13 2017

STUFF

The Painless Path website uses a Stuff picture of supporters protesting outside the assisted suicide case of Wellington euthanasia advocate Susan Austen. The site purports to sell the suicide drug Nembutol.

Pro-euthanasia lobby group Exit International is warning its members off a scam website, based in the Ukraine, which is fleecingthe elderly by selling the popular and costly suicide drug Nembutal, which never arrives.

Those falling for the scam are mostly elderly people, many in poor health and with little internet savvy.

They are being gouged about $1100 - the price of a 25gm dose of the drug - and are too frightened to go to the authorities to complain about buying an illegal substance.

GLENN CAMPBELL

Exit International founder Philip Nitschke says scam sites claiming to sell Nembutal are on the rise as the elderly increasingly look for end of life choices.

Exit founder Philip Nitschke said about three of its members were in contact every week about the ripoff as the market for the lethal Class C controlled drug, used in assisted suicide, grows worldwide.

READ MORE: * Jury trial over assisted suicide case to proceed in Wellington for Susan Austen * Elderly importers of lethal drug used in assisted suicide are getting pinged by Customs * Wellington woman Annemarie Treadwell's death trigger for Police euthanasia furore * We know where you've been, police tell 76-year-old who attended euthanasia meeting

The Painless Path website uses aStuffpicture of supporters protesting outside the assisted suicide trial of Wellington euthanasia advocate Susan Austen.

STUFF

Susan Austen leaving Wellington District Court after an appearance in May.

Austen, 66, a Lower Hutt teacher, was charged in October2016with having twice imported pentobarbitone, more commonly known by its trade name Nembutal. In high doses, it causes death by respiratory arrest.

Nitschke was gobsmacked the site offered cheaper rates for teenagers and said the use of a news photo featuring euthanasia lobbyists in genuine protest was perfect for a scam site as it appeared credible and featured people from an older demographic.

Exit's handbook lists a handful of legitimate sites in Mexico, Peru, Venezuela and China but Nitschke says there are nearly 100 scam sites, a number that is growing in parallel with the rising global demand for the drug as an end-of-life option.

ROSS GIBLIN/STUFF

The original Dominion Post photo of supporters of Susan Austen outside the Wellington District Court used by the bogus Ukrainian website Painless Path.

"Luckilythey don't sell anything, just take your money. We'll be alerting members ... the steady growth in internet scams over the past decade is an indication of the growing global market in this drug ," he said.

The handbook had been updated to list bogus sites.

Nitschke said sites like Painless Path relied on those who fell for the scam being too frightened or sick to report it to the authorities.

"This is a vulnerable group who can hardly go to authorities saying I lost money buying this illegal drug. They'd be admitting to breaking the law."

The maximum penalty for importing a Class C drug is eight years' imprisonment.

-Stuff

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Dodgy scam site uses Kiwi pro-euthanasia protest imagery to sell bogus suicide drugs - Stuff.co.nz

Euthanasia push: With the push to legalise euthanasia gaining momentum in states across Australia, its a chilling end-of-life strategy, with grave implications according to Catholic ethicists. Photo: CNS

IT happened in our midst an apparent planned and researched triple suicide on the Gold Coast.

With the push to legalise euthanasia gaining momentum in states across Australia, its a chilling end-of-life strategy, with grave implications according to Catholic ethicists.

To choose to limit ones life to choose to miss out on life with its blend of joys and sorrows this is never a reasonable choice, Queensland priest Fr Kevin McGovern, who until last year was the director of a health ethics centre in Melbourne, said.

On June 27, mother Margaret Cummins, 78, and her daughters Wynette and Heather, aged 53 and 54, took their own lives in a luxury residential apartment on Ephraim Island.

Police reported the husband of one of the daughters found the women dead after returning to the apartment.

He was understandably upset, but not surprised at the discovery.

The women were followers of controversial euthanasia advocate Dr Philip Nitschkes group Exit International, having joined the pro-euthanasia group about six months ago.

Dr Nitschke, the man known as Dr Death, confirmed from Amsterdam that he didnt know them personally, but they had subscribed to the groups online Peaceful Pill eHandbook, which provides research and information on voluntary euthanasia and assisted suicide.

The handbook includes practical information about end-of-life strategies such as over-the-counter and prescription drugs, gases and poisons.

Dr Nitschke said the triple suicide pact was unusual three members had never ended their lives at the same time before but the planning and research by the women that took place over a number of months indicated that this was a rational decision.

Each of the women involved was said to have had a diminished quality of life recently.

Wynette suffered brain cancer in the 1980s, and Margaret reportedly suffered dementia.

They chose to electively access a peaceful means to end their lives and obviously carried it out very effectively, Dr Nitschke said.

Respecting a persons rational decision to end their life is fundamental.

Fr McGovern fundamentally disagrees.

In Victoria, euthanasia advocates want assistance in dying for those with a terminal condition who are in the last few months or years of life, he said.

This sad story reveals that if euthanasia is ever introduced, it will not remain limited to a small and narrowly defined group.

None of these women were terminal. Yet euthanasia advocates support their choice.

Paul Russell, a Catholic and the executive director of HOPE: Preventing euthanasia and assisted suicide described it as a marketing ploy for Dr Nitschke and others to say that people commit suicide rationally.

Whereas suicide is generally understood to be characterised by anguish, mental health, loss etcetera, Nitschkes claims are a dangerous and entirely erroneous ploy for legitimacy, he said.

He said Dr Nitschke would have us believe that changing the law to allow assisted suicide or euthanasia was not so much about pain, but autonomy and self-determination.

Fr Kevin McGovern: If we take this big step, there will be many little steps which will extend this assistance to more and more people.

Just days after the Gold Coast triple suicide, University of Notre Dame Australia bioethics professor Margaret Somerville, delivered an address entitled End of Life Choices in which she tackled the same issue, but from the opposite pole, describing euthanasia as an inevitable and perilous slippery slope.

She set out the alternatives facing society in simple, stark terms debate on physician-assisted suicide and euthanasia, or PAS-E, involving a conflict between respect for individual autonomy and respect for human life.

Pro-PAS-E advocates give priority to autonomy; anti-PAS-E adherents to respect for life, she said.

Pro PAS-E argue it is an issue of medical treatments, extensions of palliative care.

Anti PAS-E consider doctors killing patients or helping them kill themselves as a disruption of our societal values.

In the Netherlands, psychiatrist Boudewijn Chabot, a PAS-E advocate, now expresses horror at what is happening in his country.

Chabot has written that legal safeguards for euthanasia are slowly eroding away and that the law no longer protects people with psychiatric conditions and dementia.

He recognises we are dealing with a morally problematic act how do you kill someone who does not understand that he will be killed?

We should think of that in relation to vulnerable Australians. The Australian Law Reform Commission has warned that 4 to14 per cent of elderly Australians are abused.

Financial abuse takes the form of early inheritance syndrome the old person lets another person, often their child, handle their financial assets and they use it for themselves.

Imagine early death syndrome added to that.

Professor Somerville described an extreme example of the logical slippery slope unfolding in Canadas Quebec province.

Dr Yves Robert, registrar of the College of Physicians and Surgeons of Quebec (the medical licensing authority), was an instigator of the movement to legalise euthanasia, she said.

He regarded it as good palliative care a continuum of good end-of-life care, which included euthanasia.

As in the Australian debate, pro-euthanasia advocates claimed it would be rarely used and estimated about 100 cases a year in Quebec.

In the first year, there were more than 400 cases in Quebec and almost 1500 in Canada.

Some Quebec cases breached the legal requirements in one, the patient probably had just a urinary infection.

But none of this seemed to raise any questions for the College or, I assume, Robert, about whether legalising euthanasia had been a good idea.

Heres what has done so for him. There are now calls to have death on demand declared a constitutional right.

The argument is that if I want to be dead thats my right and having to fulfil certain conditions to access euthanasia breaches my right and is legally actionable discrimination.

Considering this example, does the latest Gold Coast suicide represent a step towards Death a la carte; that is, theres a menu of options for choosing how to die?

Dr Nitschke rejects this latest case was one of death on demand, but rather, acknowledged the womens wisdom in researching the issue so that they could achieved their desired outcome a peaceful, reliable death.

I strongly endorse the words of philosopher Thomas Szasz who said: Suicide is a fundamental human right. That does not mean that it is morally desirable. It only means that society does not have the moral right to interfere, Dr Nitschke said.

Fr McGovern warned against Dr Nitschkes defence of suicide.

Was this choice reasonable? Certainly not, he said.

There are big steps and there are little steps. The big step is to say that its acceptable to help someone to kill themselves.

If we take this big step, there will be many little steps which will extend this assistance to more and more people.

The only way to avoid this is not to take the big step in the first place.

Euthanasia must not be legalised for any circumstance lest it eventually become legal in just about every circumstance.

Originally posted here:

Triple suicide on Gold Coast prompts euthanasia concerns - Catholic Leader