Monthly Archives: January 2021

Theres a 7-fold unexplained variation in rates of euthanasia across The Netherlands, reveals an analysis of health insurance claims data, published online in the journalBMJ Supportive & Palliative Care.

Its not clear if these differences relate to underuse, overuse, or even misuse, say the researchers.

The Netherlands was the first country in the world to legalize euthanasia and physician-assisted suicide, introducing preliminary legislation in 1994, followed by a fully fledged law in 2002. The practice has been tolerated, however, since 1985.

Official data show that the number of euthanasia cases has risen more or less continuously since 2006, reaching 6361 in 2019. These cases make up just a small proportion of all deaths, but they have doubled from just under 2% in 2002 to just over 4% in 2019.

And its not clear if there are regional patterns across the country, and what factors might be driving any such differences.

To explore this further, the researchers analyzed national insurance data, covering all healthcare claims for the 12 months preceding the deaths of Dutch residents between 2013 and 2017.

They focused on euthanasia carried out by family doctors, which comprised 85% of all euthanasia cases, to calculate rates for 90 regions, 388 municipalities, and 196 districts in the three largest Dutch cities: Amsterdam; Rotterdam; and The Hague.

They also retrieved information from national datasets to tease out the potential association between any regional differences and demographic, socioeconomic, personal preferences, such as religious beliefs and political affiliations, and health factors.

Some 25,979 claims for euthanasia were made between 2013 and 2017, with slightly more men than women opting for the procedure every year. The average age increased from 71 in 2013 to 73 in 2017.

The number of procedures varied widely across the country. The regions with the highest proportion of euthanasia cases as a proportion of all deaths, referred to as the euthanasia ratio, had roughly five times more euthanasia deaths than in the regions with the lowest.

While this ratio fell over the five years, this was mainly due to a sharper increase in the ratio in areas with relatively low rates of euthanasia than in regions with higher rates.

In municipalities with at least 100 deaths and at least one euthanasia case a year, the differences are much greater, varying by a factor of between 27 and 17 throughout the 5-year period.

There were also striking differences between the three largest cities in the Netherlands.

In Amsterdam, in the three districts with highest rates of euthanasia, the proportion of these deaths was between nearly 12% and around 14.5% higher than in Rotterdam, where the proportion remained more or less static at around 6%.

In The Hague the rate of euthanasia in the three districts with the highest rates of euthanasia, the proportion of these deaths rose from nearly 7.5% to more than 11%.

Throughout the five years, the rate in the top three municipalities was 25 times higher than that of the bottom three.

Age, church attendance, political orientation, income, subjectively assessed health, and availability of community volunteers all emerged as potentially influential factors.

For example, in regions with relatively high numbers of 45-64 year olds, people were more likely to opt for euthanasia while in regions with a high proportion of churchgoers, they were less likely to do so.

Similarly, progressive political views were associated with higher rates of euthanasia while a higher percentage of community volunteers was linked to lower rates.

Higher rates of euthanasia were also associated with higher household income and good self-reported mental and physical health, possibly because the well off and the healthy may be more inclined to ask for assistance in dying when they do suffer, suggest the researchers.

After accounting for these factors, there was still a 7-fold geographical difference in rates of euthanasia across the country, for which there was no obvious explanation.

The unexplained part of the variation may include the possibility that part of the euthanasia practice may have to be understood in terms of underuse, overuse or misuse, suggest the researchers.

This is an observational study and reliant on billing data supplied by family doctors, so it excludes potentially relevant information on underlying health conditions and euthanasia procedures carried out by specialists.

Nevertheless, the researchers say: We think our findings have potential relevance for countries that have already legalized assisted dying Belgium, Luxembourg, Columbia, Canada, Western Australia and 10 US states and for countries currently considering legalizing it, such as Spain, New Zealand, Germany and Portugal.

Reference: Euthanasia in the Netherlands: a claims data cross-sectional study of geographical variation by A Stef Groenewoud, Femke Atsma, Mina Arvin, Gert P Westert and Theo A Boer, 14 January 2021, BMJ Supportive & Palliative Care.DOI: 10.1136/bmjspcare-2020-002573

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Huge Unexplained Variation in Euthanasia Rates Across the Netherlands - SciTechDaily

Sharon Cramp-Oliver has boxes full of her mum's old diaries.

In them, 77-year-old Liz Holmes wrote about the adventures of her three children, what made the nightly news and in the years leading up to her death the unbearable pain she experienced and detailed plans to end her own life.

WARNING: This story contains content that some readers may find distressing.

Liz spent 12 years battling breast cancer, had a broken back and suffered through two painful hip replacements, one of which dislocated itself in early 2017.

"This is hell on earth," she wrote, just months before she took her own life in September, 2017.

"I have nothing to look forward to, just pain and indignity," a later entry read.

Liz also wrote that if she could have accessed voluntary euthanasia, she would have.

But Liz lived in New South Wales, one of the six Australian states and territories that do not allow assisted dying.

Liz's daughter Sharon, who lives in the Northern Territory, said if voluntary euthanasia was permitted in the NT, she would have brought her mum up to die surrounded by people who loved her.

She decided to share her mother's story for the first time in the hope it may spark a new conversation about assisted dying.

"Wouldn't it have been nice for her to have gone to sleep with her family around her, rather than do that by herself?" Sharon said.

In 1995, the Northern Territory became the first place in the world to legalise voluntary euthanasia.

It was a private bill put forward by then-chief minister Marshall Perron, which came into effect in 1996.

"I had just always felt that a person who was was close to dying and suffering terribly ought to have the opportunity to advance their death, if that was their wish, to end suffering," Mr Perron said.

In the nine months voluntary euthanasia was legal in the Northern Territory, four terminally ill people used it to die: one Territorian and three others who travelled up to the NT to end their lives.

But in 1996, federal Liberal MP Kevin Andrews put forward a different bill passed by the Commonwealth in 1997 which overrode the right of the Northern Territory and Australian Capital Territory to legalise assisted dying.

Mr Andrews argued in Parliament that legalising voluntary euthanasia sent a "powerful message" to the Australian community that vulnerable people were "expendable" and not valued, and the law could expose patients to "pressure, abuse and a loss of autonomy".

Australian Medical Association NT branch president Robert Parker said while he wanted the NT to have the power to make its own laws on assisted dying, the AMA believed doctors should not be involved in interventions which had the "primary intention" of ending someone's life.

In its position paper on the subject, the AMA calls on governments to invest in and adequately resource palliative care facilities to improve the end of life care for Australians, no matter where they live.

"The AMA as it currently stands, cannot support physician-assisted suicide and it says it is an issue for populations and governments," Dr Parker said.

In the 23 years since the Andrews Bill was passed, there have been several highly publicised movements to allow the ACT and NT to regain control of euthanasia laws.

And this year, with Queensland and Tasmania set to debate similar laws and a bill on voluntary assisted dying tabled in SA Parliament, the Northern Territory's Federal Labor Member for Solomon, Luke Gosling, says his office has been discussing a bill to "restore the rights of Territorians to legislate on euthanasia" with his counterparts in the ACT.

NT Country Liberal Party Senator Sam McMahon has backed the call to allow the Territory to make its own laws about assisted dying, and said given the right regulatory framework she was "fully supportive" of voluntary euthanasia.

But former chief minister Mr Perron said it was time for Territory leaders to stop talking about introducing a bill and start actively campaigning for the NT to be allowed to make its own laws about the issue.

"This is not a voluntary euthanasia issue, this is an issue of the equal democratic representation of Australians. We should not be discriminated on the grounds of geography," Mr Perron said.

Mr Perron said as other states legislated assisted dying, it became more "absurd" that the Northern Territory the pioneer of assisted dying laws in Australia was denied the right to decide for itself about the issue.

Both Chief Minister Michael Gunner and Opposition Leader Lia Finocchiaro agree the Northern Territory deserves the same power as states to determine laws on a range of issues, including voluntary euthanasia.

Now, Mr Gunner is calling on Territorians who agree to reach out to leaders in the nation's capital.

"I need Territorians to help me here as well. Get on the phone or write an email to politicians in Canberra and tell them we want to decide this issue for ourselves," Mr Gunner said.

"People power can make the difference."

But despite the bipartisan support in the Northern Territory, a spokesman for Federal Attorney-General Christian Porter remained firm, telling the ABC there were "no plans" to introduce legislation to repeal the Euthanasia Laws Act 1997.

Judy Dent's husband, Bob, was the first person to die from a legal, voluntary lethal injection.

Speaking from the same suburban Darwin home in which her husband ended his life, Judy said she fully supported any renewed push to allow the Territory to make its own laws about assisted dying.

"I'm hoping that when more of the states have passed their own legislation, they will say it is not right to treat the citizens of the ACT and the NT as second-class citizens," she said.

"They should restore our rights. Not restore the legislation, but restore our rights to ask for such legislation."

Bob Dent died on September 22, 1996, after a long battle with incurable prostate cancer.

Judy remembers holding his hand as he took his last breath and said the pain "just disappeared" from her husband's face in the minutes before he passed.

"I almost thought I saw him smile," Judy recalled.

"But certainly all the signs of pain just disappeared. All the frowns, it at all just disappeared. And then he stopped breathing. It was very calm, peaceful."

Bob was a "strong willed" man, Judy laughed, and when he set his mind to something, he'd do whatever it took to achieve it.

And dying on his own terms was no exception, she said.

"I didn't want him to die, but he was going to die anyway, so why not let him die on his terms, with him in control?" Judy said.

See original here:

The NT pioneered voluntary euthanasia before the law was overruled. Now there is a campaign to restore it - ABC News

A racing pigeon that survived a 13,000km Pacific Ocean crossing from the United States to Australia now faces being euthanised as a quarantine risk.

Kevin Celli-Bird said he discovered that the exhausted bird that arrived in his Melbourne backyard on Boxing Day had disappeared from a race in the US state of Oregon on 29 October.

Experts suspect the pigeon that Celli-Bird has named Joe, after the US president-elect, Joe Biden, hitched a ride on a cargo ship to cross the Pacific.

Celli-Bird said the Australian Quarantine and Inspection Service called him on Thursday to ask him to catch the bird, after its arrival was reported in the media.

They say if it is from America, then theyre concerned about bird diseases, Celli-Bird said. They wanted to know if I could help them out. I said, To be honest, I cant catch it. I can get within 500mm of it and then it moves.

He said quarantine authorities were now considering contracting a professional bird catcher.

The quarantine service did not immediately respond to a request for comment.

In 2015, the government threatened to euthanise two Yorkshire terriers, Pistol and Boo, after they were smuggled into the country by Hollywood star Johnny Depp and his ex-wife Amber Heard. Faced with a 50-hour deadline to leave Australia, the dogs made it out in a chartered jet.

Pigeons are an unusual sight in Celli-Birds backyard in suburban Officer, where Australian native doves are much more common.

It rocked up at our place on Boxing Day. Ive got a fountain in the backyard and it was having a drink and a wash. He was pretty emaciated so I crushed up a dry biscuit and left it out there for him, Celli-Bird said.

Next day, he rocked back up at our water feature, so I wandered out to have a look at him because he was fairly weak and he didnt seem that afraid of me and I saw he had a blue band on his leg. Obviously he belongs to someone, so I managed to catch him, he said.

Celli-Bird, who said he had no interest in birds apart from my last name, said he could no longer catch the pigeon with his bare hands since it had regained its strength.

He said the Oklahoma-based American Pigeon Union had confirmed that Joe was registered to an owner in Montgomery, Alabama.

Celli-Bird said he had attempted to contact the owner, but had so far been unable to get through.

The bird spends every day in the backyard, sometimes sitting side-by-side with a native dove on a pergola. Celli-Bird has been feeding it since it arrived.

I think that he just decided that since Ive given him some food and hes got a spot to drink, thats home, he said.

Australian National Pigeon Association secretary Brad Turner said he had heard of cases of Chinese racing pigeons reaching the Australian west coast aboard cargo ships, a much shorter voyage.

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Racing pigeon that survived 13,000km journey from US to Australia now faces euthanasia - The Guardian

A hospital in Winnipeg, Manitoba, Canada, November 2, 2020(Shannon VanRaes/Reuters)

I have written here before about Delta Hospice in British Columbia, which has been under unremitting pressure by the government of the province including a funding cutoff only because it refuses to participate in euthanasia. It is now being forced to lay off clinical workers and faces eviction. From the press release:

The board of DHS deeply regrets being compelled to take this action. Tragically, as the video and the attached background document make clear, we have been left no other choice due to the Fraser Health Authority canceling our service agreement and 35-year lease. Fraser Health is about to evict us and expropriate approximately $15 million of our assets simply because we decline to euthanize our patients at our 10-bed Irene Thomas Hospice in Ladner, B.C.

To be clear, we accept that the provision of MAiD is an elective, legal service across Canada.Nothing in Canadian law, however, requires medically assisted death to be made available everywhere, at all times, to everyone. The Constitution of our private Society and our commitment to palliative care, bars us from offering it. Neither the board of the DHS, nor the vast majority of our patients and members want to change that.

Euthanasia killing patients is directly antithetical to the hospice philosophy as established by the modern movements founder, the late Dame Cecily Saunders. Indeed, when I interviewed her for my book, Culture of Death, she told me that assisted suicide denies the intrinsic equal dignity of terminally ill patients.

Not only that, but there is a hospital directly next door to Delta where patients can go to be lethally injected, so it isnt as if suicidal patients wont be able to obtain their desire to be made dead.

But that isnt the problem. Deltas stand sends the moral message that human life has intrinsic value and that medicalized killing is wrong. We cant have that. The culture of death brooks no dissent.

Link:

Canadian Hospice to Be Shuttered for Refusing Euthanasia - National Review

yes.

Aw! Canines in dog wheelchairs have fun in the snow

Updated: 8:38 PM EST Jan 14, 2021

These adorable dogs will brighten your day.Paraplegic canines with dog wheelchairs played in a snowy fenced-in area in Minnesota at Home for Life, an animal sanctuary for animals with special needs."All of our animals even our paraplegic dogs appreciate fresh air and sunshine even in the winter months," the sanctuary said in a Tuesday post.The sanctuary doesn't put animals up for adoptions but instead helps serve as a way to avoid euthanasia by giving them a permanent home.The sanctuary said the dogs include Goofy, Program, White, Zavier, Mana, Noori, Soosan, and Beninabucket.Tap the video above to see the dogs having fun.

These adorable dogs will brighten your day.

Paraplegic canines with dog wheelchairs played in a snowy fenced-in area in Minnesota at Home for Life, an animal sanctuary for animals with special needs.

"All of our animals even our paraplegic dogs appreciate fresh air and sunshine even in the winter months," the sanctuary said in a Tuesday post.

The sanctuary doesn't put animals up for adoptions but instead helps serve as a way to avoid euthanasia by giving them a permanent home.

The sanctuary said the dogs include Goofy, Program, White, Zavier, Mana, Noori, Soosan, and Beninabucket.

Tap the video above to see the dogs having fun.

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Aw! Canines in dog wheelchairs have fun in the snow - WXII The Triad