Daily Archives: August 20, 2017

Nic and Trees Elderhorstknew exactly how they wanted to die.

They were both 91 years old and in declining health. Nic Elderhorst suffered a stroke in 2012 and more recently, his wife,Trees Elderhorst, wasdiagnosed with dementia, according to the Dutch newspaper,De Gelderlander.

Neither wanted to live without the other, or leave this world alone.

So the two, wholived in Didam, a town in the eastern part of the Netherlands, and had been together 65 years, shared a last word, and a kiss, then died last month hand-in-hand in a double euthanasia allowed underDutch law, according to De Gelderlander.

Dying together was their deepest wish, their daughters told the newspaper,according to an English translation.

[A terminally ill woman had one rule at her end-of-life party: No crying]

The Netherlands became the first country to legalize euthanasia in 2002, allowing physiciansto assist ailing patients in ending their lives without facing criminal prosecution.

Euthanasia, in which a physician terminates a patient'slife at his or herrequest, is legal in a few countries, including Belgium, Colombiaand Luxembourg. Physician-assisted suicide, in which a doctor prescribes lethal drugs that a patient may take to end his or her life, is permitted in a fewothers, including in certain states in the United States, according toProCon.org, a nonprofit organization that researches countries' legislation on the issue.

We are pleased that we have in the Netherlands this humane and carefully executed legislation that allows the honorable wishes of these two people whose fate was painful and hopeless,Dick Bosscher, ofthe Dutch Association for a Voluntary End ofLife (NVVE), said in a statement to The Washington Post. He said theElderhorsts belonged toNVVE, a165,000-member organization foreuthanasia and assisted suicide in the Netherlands.

,,Ze gaven elkaar een dikke kus en rustig en zelfverzekerd zijn ze hand in hand ingeslapen.Via DG Liemers

Posted by De Gelderlander onThursday, August 10, 2017

In recent years, apparent double-suicides and murder-suicides have been capturing worldwide attention amid an emotional right-to-die debate couples from Florida toParisreportedlyending their lives together.

Assisted suicide has summoned up deep religious and ethical concerns among critics.

In the United States, the subject was widely debated in 2014, when a 29-year-oldwoman who had a fatal brain tumormoved from California to Oregon, where she could legally seek medical aid to end her life. Californiahas since enacted itsEnd of Life Option Act, joining a small number of states where it is legal.

Even in the Netherlands, according to Bosscher withNVVE, theElderhorsts' case is rarein that both of them were able to meet the criteria foreuthanasia under the DutchTermination of Life on Request and Assisted Suicide (Review Procedures) Act. Euthanasiaand physician-assisted suicide can be carried out only when the patient's request is voluntary and well thought-out, the patient is in lasting and unbearable suffering and there are no other solutions, among other things.

Researchpublished this monthin the New England Journal of Medicine revealed that euthanasia and physician-assistedsuicidesaccounted for 4.5 percent of deaths in the Netherlands in 2015, up from1.7 percent in 1990, before it was legal. The 25-year review found that most patients who received assistance had serious illnesses.

It looks like patients are now more willing to ask for euthanasia and physicians are more willing to grant it, lead author Agnes Van der Heide, of Erasmus University Medical Center in Rotterdam, told the Associated Press.

However, Bosscher said that there are more than 15,000 requests foreuthanasia each year in the Netherlands and that only about 6,000 of them are granted.

The Elderhorsts discussed their options and submitted requests for euthanasia a year-long process their daughters called an intense time, according to De Gelderlander.

The couple, who had even planned their own funerals,died July 4.

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How Brittany Maynard may change the right-to-die debate

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Elderly couple got 'deepest wish' to die together in rare euthanasia case - Washington Post

The latest husband-and-wife euthanasia in the Netherlands took place on July 4. Nic and Trees Elderhorst, both 91, died in their home town of Didam, surrounded by family members. Neither was terminally ill, but both were in failing health. Nic, the husband, had a stroke five years ago, and Trees, the wife, was declining into dementia.

The couple had made advance directives in 2012 but they needed the euthanasia before Trees became unable to give her informed consent.

The couple applied to the Levenseindekliniek, a clinic which handles euthanasia requests when other doctors refuse. They gave each other a big kiss and passed away confidently holding hands, one of their daughters told a local newspaper, the Gelderlander.

Couple euthanasia is relatively common in the Netherlands, although some requests are refused because one of the partners does not fulfil the criteria. According to the Gelderlander, there are a few cases a year statistically negligible, but socially significant and no longer surprising.

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BioEdge: Dutch couple choose euthanasia together - BioEdge

Ninety-one-year-old lovebirds Nic and Trees Elderhorst kissed each other goodbye and, while still holding hands, died together in a rare double euthanasia, a Dutch newspaper Algemeen Dagblad reported last week.

The couple, who hailed from the town of Didam in the Netherlands, died on their own terms on June 4, their daughter told the paper.

Nic Elderhorsts health had been on the decline since he suffered from a stroke five years ago, reported the Dutch paper. His wife, Trees, was diagnosed with dementia earlier this year.

To qualify for assisted suicide in the Netherlands, which in 2001 became the first country in the world to legalize euthanasia, doctors must deem a patient to be under unbearable and hopeless suffering.

Double euthanasia is thus a very rare occurrence, said Dick Bosscher of the Dutch Association of Voluntarily Life Ending, according to The Telegraph.It is factually a coincidence when both people meet the demands for euthanasia at the same time.

In the case of the Elderhorsts, the couple had to wait months before their applications were approved, according to local media.

They gave each other a big kiss and passed away confidently holding hands, their daughter recalled of the couples last moments.

The Elderhorsts had been married for 65 years.

Euthanasia accounts for 4.5 percent of all deaths in the Netherlands, according to an Associated Press report from earlier this month. The vast majority of people seeking assisted suicide were individuals who had serious illnesses or health problems from old age, early-stage dementia or psychiatric problems or a combination of these illnesses, the report said.

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In Rare Double Euthanasia, 91-Year-Old Couple Died 'Confidently Holding Hands' - HuffPost

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A rally in support of North Korea's stance against the US, on Kim Il-Sung square in Pyongyang.

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Rocks from the collapsed wall of a hotel building cover a car after an earthquake outside Jiuzhaigou, Sichuan province

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People in Seoul, South Korea walk by a local news program with an image of US President Donald Trump on Wednesday 9 August. North Korea and the United States traded escalating threats, with Mr Trump threatening Pyongyang with fire and fury like the world has never seen

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A Maasai woman waits in line to vote in Lele, 130 km (80 miles) south of Nairobi, Kenya. Kenyans are going to the polls today to vote in a general election after a tightly-fought presidential race between incumbent President Uhuru Kenyatta and main opposition leader Raila Odinga

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Children pray after releasing paper lanterns on the Motoyasu river facing the Atomic Bomb Dome in remembrance of atomic bomb victims on the 72nd anniversary of the bombing of Hiroshima, western Japan.

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Russian President Vladimir Putin (L), accompanied by defence minister Sergei Shoigu, gestures as he fishes in the remote Tuva region in southern Siberia.

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A family claiming to be from Haiti drag their luggage over the US-Canada border into Canada from Champlain, New York, U.S. August 3, 2017.

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A disabled man prepares to cast his vote at a polling station in Kigali, Rwanda, August 4, 2017

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ATTENTION EDITORS -People carry the body of Yawar Nissar, a suspected militant, who according to local media was killed during a gun battle with Indian security forces at Herpora village, during his funeral in south Kashmir's Anantnag district August 4, 2017.

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A general view shows a flooded area in Sakon Nakhon province, Thailand August 4, 2017.

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A plane landed in Sao Joao Beach, killing two people, in Costa da Caparica, Portugal August 2, 2017

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Hermitage Capital CEO William Browder waits to testify before a continuation of Senate Judiciary Committee hearing on alleged Russian meddling in the 2016 presidential election on Capitol Hill in Washington, U.S., July 27, 2017

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Two children hold a placard picturing a plane as they take part in a demonstration in central Athens outside the German embassy with others refugees and migrants to protest against the limitation of reunification of families in Germany, on August 2, 2017.

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- Incumbent Rwandan President Paul Kagame gestures as he arrives for the closing rally of the presidential campaign in Kigali, on August 2, 2017 while supporters greet him. Rwandans go the polls on August 4, 2017 in a presidential election in which strongman Paul Kagame is widely expected to cruise to a third term in office.

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Soldiers of China's People's Liberation Army (PLA) get ready for the military parade to commemorate the 90th anniversary of the foundation of the army at Zhurihe military training base in Inner Mongolia Autonomous Region, China.

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Israeli border guards keep watch as Palestinian Muslim worshippers pray outside Jerusalem's old city overlooking the Al-Aqsa mosque compound

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The Soyuz MS-05 spacecraft for the next International Space Station (ISS) crew of Paolo Nespoli of Italy, Sergey Ryazanskiy of Russia, and Randy Bresnik of the U.S., is transported from an assembling hangar to the launchpad ahead of its upcoming launch, at the Baikonur Cosmodrome in Baikonur, Kazakhstan

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Elderly Dutch couple die together in rare case of double euthanasia - The Independent

In 2002, the Netherlands was the first country in the world to legalize euthanasia. Today, Dutch euthanasia is moving away from straightforward cases where a patient has a terminal illness like cancerand into more oblique territory.

Since 2009, there has been a significant increase in euthanasia for patients with dementia and psychiatric illness. Doctors are also more open to euthanizing elderly patients who have an accumulation of old-age complaints rather than an actual terminal illness.

At the forefront of these developments is the Life Ends Clinic, based in The Hague. The clinic employs 40 doctors who provide euthanasia to patients whose own GPs refuse to assist. In 2016, there were 60 reported instances of euthanasia for patients with psychiatric illness. Of those, 46 were administered by Lifes End Clinic doctors. They were responsible for 40 percent of all instances of euthanasia for dementia patients. For patients with an accumulation of old-age complaints, nearly 50 percent of instances of euthanasia were administered by Lifes End Clinic doctors.

The clinic describes itself as an expertise center for complex euthanasia requests. Their doctors admit their decision to grant a request, when a patients own doctor has refused, can be subjective at times.

This was illustrated in the controversial 2016 documentary Lifes End Clinic (Levenseindekliniek) which aired on Dutch public television. The filmmakers interviewed Ans Dijkstra, who was 100 years old and requested euthanasia even though she does not have a terminal illness. She described her suffering thus: Its the one-dimensionality and the pain. All my fingers are stiff. I drop everything. I do nothing right. I think, What am I still living for? My arm hurts in the night. I have trouble getting up in the morning.

She was ultimately euthanized by a Lifes End Clinic doctor. He said, I have the feeling that Mrs. Dijkstras case completely fits within the law. But also within my own boundaries. Given Mrs. Dijkstras situation, I understand her request very well. Its relatable. So my feelings tell me to say not no, but yes. And perhaps the feelings of her GP told him the exact opposite.

Euthanasia for patients with physical terminal illnesses is widely accepted by the Dutch people. But the new developments are controversial. The Lifes End Clinic documentary provoked a national debate. Viewers were particularly troubled by the case of dementia patient Hannie Goudriaan, 68. Some wondered if her husband was the one pushing for her death. In the documentary, he says, If [the euthanasia] doesnt go through then Hannie will soon have to go to a care home. If she goes to a care home, I wont visit her anymore because I wont go visit an empty person. If Hannie doesnt see me for a month then she wont recognize me anymore and then I wont feel like visiting her anymore.

Moments before she received the fatal injection, Mrs. Goudriaan indicated she would like it to happen in another roompossibly to get away from the television camera. Her husband told her to stay seated where she was.

To become eligible for euthanasia, Dutch law says a patient must have unbearable suffering with no treatment alternatives. The day before her death, Mrs. Goudriaan is still driving her car. Her husband calls this autopilot. She drives them both to a cafe where they share a drink with friends. She then drives them to a speed-skating competition. Afterward, she dances along to the music of a brass band.

Some Dutch viewers were outraged. Victor Lamme, a professor of cognitive neuroscience at the University of Amsterdam, wrote an op-ed saying Mrs. Goudriaans death is proof that Dutch euthanasia is on a slippery slope and is being used to solve very different problems than unbearable suffering.

Surprisingly, some of the Netherlands most prominent euthanasia supporters have joined in the criticism. In June, psychiatrist Boudewijn Chabot published an op-ed in a major Dutch newspaper arguing that the current euthanasia law does not offer sufficient protection to patients with dementia or psychiatric illness. His op-ed is remarkable because he played a critical role in making euthanasia available to psychiatric patients. In 1991, he euthanized a 50-year-old woman with severe depression but no terminal illness. He was convicted but received no sentence and kept his medical license. The Dutch Supreme Court reviewed his case and ruled that psychological suffering can be considered the same as physical suffering.

Chabot directs much of his ire at the Lifes End Clinic. He is horrified that their psychiatrists do not have a long-term treatment relationship with a patient yet are legally permitted to euthanize them. Without a treatment relationship, most psychiatrists cannot reliably determine if the desire to die is the patients most important, long-term wish. Thats difficult even within a treatment relationship. But a psychiatrist from the Lifes End Clinic can determine this in fewer than 10 in-depth conversations?

Dutch law permits an elderly person who is still compos mentis to write a legal declaration requesting euthanasia once they develop advanced dementia. This declaration is then treated the same way a verbal request from a terminal cancer patient would be. Chabot thinks that is absurd. If dementia patients are going to be euthanized, they need a special set of legal guidelines.

Chabot also criticises the Dutch committee that oversees euthanasia. He believes they give doctors far too much leeway. He also says their reports exclude information that might stoke controversy, such as the fact that doctors sometimes secretly slip a sedative into a dementia patients food before administering the fatal injection.

Interestingly, the committee itself is also unhappy with its work. Each year, they find a couple cases where a doctor acted negligently. Under Dutch law, these doctors should be prosecuted but this has never happened. Starting in the 1970s, a series of court cases paved the way for the legalization of euthanasia in 2002. But since then, the courts have been completely absent. Doctors themselves are determining the boundaries.

Earlier this year, the head of the oversight committee, Jacob Kohnstamm, went to Parliament to plead for some actual judicial oversight. I think lawmakers intended for a jurisprudence to be developed, he told MPs. He asked for a legal mechanism whereby his committee could send ground-breaking new cases to the Supreme Court for review.

Ethicist Theo Boer, a former member of the oversight committee, told Dutch media that such judicial reviews would have lifted a burden off his shoulders. There were some cases that just crossed your pain threshold. You can accept the euthanization that took place but you ask yourself if its desirable for this category of patients to receive euthanasia, he said.

Lifes End Clinic doctors are regularly among those found to be negligent. But the absence of legal consequences has taught them to take it in stride. We always have an internal discussion about what went wrong, says Gerty Casteelen, a psychiatrist, in the documentary Lifes End Clinic. We learn a great deal from that, but weve also learned to relativize the negligent ruling. Seven out of nine matters went right and two didnt go completely right. You didnt totally fail but you also didnt get an A+.

Despite the controversy surrounding the new developments in euthanasia, Dutch left-wing political party D66 recently proposed the Completed Life Bill. It would legalize euthanasia for any person age 75 or over who decides their life is complete. Pia Dijkstra, an MP with D66, drafted the bill. She was asked on Dutch news why she chose 75 as the minimum age. She shrugged and said, Of course its always difficult to set an age limit. We have age limits for many questions, like when can you vote.

D66 played a critical role in the original legalization of euthanasia in 2002. They openly acknowledge their goal is to eventually legalize euthanasia for any adult who wishes to die. In March, D66 leader Alexander Pechtold said on a political talk show, I hope that in the future our civilization will have reached a point where if you wish [to die] with full comprehension, without external pressure, and over the long-term then we can make that a possibility. He sees the Completed Life Bill as an important step in that direction.

The Completed Life Bill enjoys support from a wide variety of parties across the political spectrum. Thierry Baudet, leader of the small, far-right party Forum for Democracy, said, We support the initiative. Its a conflict of two values. The first is self-determination. The second is the legitimate threat that your kids or grandkids will come to you and say, Its time for you to leave. The current protections we have in the lawtwo medical doctors have to take a lookare sufficient protection against this type of abuse.

Dutch political parties are currently negotiating to form a new governing coalition. This process involves setting Parliaments legislative agenda. The Completed Life Bill is the political hot potato of the negotiations. D66 is part of the proposed coalition, but so are two Christian parties who are opposed to the bill. If the coalition goes ahead, the Completed Life Bill will likely be shelved for the time being. However, that may not make much difference. As Ans Dijkstra illustrated in Lifes End Clinic, seniors without a terminal illness are already being euthanized under existing law.

Its fair to say that euthanasia in the Netherlands has reached a crossroads. The Dutch are fully aware that they are entering new territory. Will they plunge in further or will they decide to take a step back?

Emma Elliott Freire is freelance writer living in South Africa. She has also been published in Chronicles and The Federalist.

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Death on Demand? Dutch Euthanasia Moves in Disturbing Direction ... - The American Conservative

As euthanasia rates increase in the Canadian province of Ontario, pressure is mounting on Catholic Healthcare providers to abandon their blanket opposition to Medical Assistance in Dying (MAiD).

Over 630 Ontarians have received MAiD since the procedure was legalised in Canada in 2015, according to data from the provincial coroner, yet none of these cases has taken place in a Catholic healthcare facility.

Lobby groups are now calling for sanctions on Catholic healthcare providers, particularly in light of the public funding these providers receive.

Dying With Dignity Canada CEO Shanaaz Gokool told CBA News that her organisation is considering a legal challenge of Catholic hospitals right to conscientiously object to participation in euthanasia.

Gokool says that the Catholic healthcare policy of transferring MAiD patients to secular facilities places an undue burden on patients. "It really depends on how precarious their physical medical condition is," she said. "And if they are in a precarious state physically, then that can cause them more trauma."

Ontario health minister Eric Hoskins said that access to MAiD was not currently a problem. "We're obviously monitoring it very, very closely and currently don't have those concerns in terms of access," he told CBA News. "And about half of medical assistance in dying happens at home.

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Stand-off with Catholic hospitals as euthanasia gains traction in Canada - BioEdge

20 Aug 2017, 7:16 p.m.

The Liberals have pledged $140 million for palliative care to give dying Victorians what they say is a "genuine choice" to stay at home or remain in hospital ahead of the looming conscience vote on euthanasia.

The Liberals have pledged $140 million for palliative care to give dying Victorians what they say is a "genuine choice" to stay at home or remain in hospital ahead of the looming conscience vote on euthanasia.

The money, to be given over four years, will provide more doctors and nurses for those receiving palliative care in the community, especially in rural and regional Victoria.

It comes as the Andrews government plans to introduce a bill to legalise assisted dying in the Victorian Parliament later this year.

Victorian MPs will get a conscience vote on the proposed laws and will not vote along party lines, with the exception of the Greens who have a policy in support of assisted dying.

Some MPs against the bill have argued instead for better palliative care.

But opposition health spokeswoman Mary Wooldridge, who supports assisted dying, said the Liberals policy was not connected to the euthanasia bill.

"This is about palliative care and services and support that are needed for people in their end-of-life days, weeks and months," Ms Wooldridge said.

"So this is an announcement regardless of the outcome of the legislation."

The opposition's policy plans for an awareness campaign to help Victorians, including those from culturally diverse backgrounds and the Indigenous community, better understand palliative care.

Opposition Leader Matthew Guy said the substantial funding would help more terminally ill Victorians to return home.

"Victoria has limited resources to be able to allow people to die at home," Mr Guy said.

"Being home and surrounded by loved ones and precious memories can make a huge difference to patients and families and we want to make sure more people have that choice if they want it."

Palliative Care Victoria chief executive Odette Waander said more than half of palliative care services were unable to meet current demand.

She said the proposed increase to services would mean that up to 8000 extra people would be able to receive the care and support they needed.

"There are about at least one in four Victorians who die each year who are missing out on ... palliative care," she said.

She said the additional funding would also help provide more support on weekends, overnight, as well as respite to carers.

Fairfax Media this month asked almost 3000 Victorians via a ReachTel phone poll if they support or oppose the Andrews government's planned new assisted dying laws?

Almost two-thirds said they either supported or strongly supported the laws, which will be subject to a conscience vote among MPs.

About 15 per cent of people polled said they were opposed or strongly opposed to assisted dying.

Under the proposed Victorian model to be debated in parliament later this year, lethal medication will be available to terminally ill adults who are in pain with less than 12 months to live.

With Adam Carey

The story Liberals pledge funds to palliative care ahead of euthanasia vote first appeared on The Age.

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Liberals pledge funds to palliative care ahead of euthanasia vote - The Border Mail

The owner of four dogs involved in an attack on a young girl in June has filed a court petition to overturn a decision by Klamath County Commissioners to have the dogs put down.

On Friday, Vincent Berry filed a petition for judicial review in Klamath County Circuit Court to stay the commissioners order that the dogs, four mastiffs, be euthanized on or after Aug. 21.

The order also directed Berry to turn over one of the four dogs not yet in custody. On Saturday, Commissioner Kelley Minty Morris confirmed the fourth dog has been surrendered.

The petition will be heard by Judge Marci Adkisson and, as of Saturday, a future hearing date had yet to be published.

Commissioners voted unanimously Aug. 11 to euthanize the dogs after hearing testimony about an attack June 1 on the 3800 block of Shasta Way. The 10-year-old daughter of Berrys neighbor entered Berrys property and was mauled by the dogs, suffering injuries including a torn scalp, broken ribs and a punctured lung.

Because of the severity of the attack, the dogs were considered dangerous and officials were tasked with determining if they should be put down. Because no criminal charges were filed, authority fell to commissioners to make the decision.

After considering if Berry could safely contain the dogs in the future, among other factors, commissioners decided it was in the interest of public safety to euthanize the animals. Berrys sister and legal adviser LaTronda Darnell said Berry plans to argue during appeal that commissioners did not consider all potential options to safely contain the dogs.

During testimony last week, Berry said his plan was to move to a more rural property out of state where the dogs would be further from other people. His petition Friday indicated his current address was outside Washougal, Wash.

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Dog owner petitions euthanasia order - Herald and News