Category Archives: Euthanasia

Dear Dr. Fox: We have a 23-year-old female cocker spaniel named Ed. She was just diagnosed with very bad diabetes. It has been a heartbreaking ordeal.

The vet is still trying to determine what dose of Vetsulin to administer. She is currently refusing to eat, and has to be fed critical-care food orally by syringe. We will have to increase the feedings to give her the Vetsulin. She takes Entyce, an appetite stimulant, once per day. The vet said she may be insulin-resistant.

We have to make a decision as to what we will do, and we do not want her to suffer in any way. What advice you would give us? This is a most difficult decision to make, and our hearts are in such pain to think about seeing her go. L.P., New Rochelle, New York

Dear L.P.: Your dog has reached a remarkable age. From your account, it seems that chronic organ failure has set in, which could be partially rectified with various medications, after more tests and determining the proper dosages, but to what end?

If this were my dog, I would provide whatever she likes to eat and give her lots of tender loving care, and let her go. No more medications or tests. Whether this answer upsets or relieves you, let me know.

L.P. replied:

Dear Dr. Fox: Thank you for reaching out to me. Yesterday, we said goodbye to her, and my heart is crushed. Its so hard to lose our companions when we love them as family. Im trying to focus on believing we made the right decision in not allowing her to suffer, but its still very hard to convince myself. I have been filled with guilt and second-guessing if we decided to let her go too soon.

You have relieved me somewhat, and for that, Im grateful. Thank you for the wonderful work you do on behalf of all beloved animals.

Dear L.P.: I always hesitate to recommend euthanasia, because it is such a huge responsibility, and often a painful decision to make for a loved one. Most veterinarians feel this burden when having to euthanize terminally ill animal patients, and those whose owners cannot afford costly treatments that may or may not improve the animals quality of life. But there are some who would delay this, not necessarily just to make more money, but because they see some diseases as conditions that should always be treated. The caregiving burden and continued worry of the animals owner-clients must also be considered. Sending warm regards and my condolences.

United Feature Syndicate

Write to Dr. Fox c/o Universal Uclick, 1130 Walnut St., Kansas City, MO 64106.

See original here:

Dr. Fox: When to stop treatments and say goodbye - Winston-Salem Journal

Is Covid-19 making you push yourself too far at work? Could you be at risk of burnout?We explore what causes burnout, how to recognise and deal with it and how burnout can even become deadly.

GUESTSProfessor Michael Leiter has extensively researched the experience of burnout at work, most recently through Deakin University in Victoria.Dr Nadine Hamilton is a psychologist who works with veterinarians and her PhD research looked at vets lived experience of animal euthanasia.And sharing their stories of burnout, Marie Cecile Godwin UX designer and Editor of Burnout: lets reignite the flame; Alice Cooney, Law Institute of Victoria young lawyer president and vet Dr Claire Stevens.

This episode kicks off our four-part series: Performing in a Pandemic. We know that things wont snap back exactly to the way they were - so how do you prepare yourself to adjust to this new way of working? In our next episode: what to eat to optimise mental performance.

FURTHER INFORMATION:

Nadine's book is Coping with Stress and Burnout as a Veterinarian and her charity is Love Your Pet Love Your Vet.

Claire's book is Love Your Dog.

Producer: Maria Tickle

Never miss a show! Subscribe to our weekly podcast on theABC Listen app,Apple Podcasts,Google Podcastsor your favourite podcast app. (And if you enjoy the show help us out by rating us with those little stars it helps others find us.)

Producer: Maria Tickle

See more here:

"I was stuck in my bed, all I could do is cry" is COVID making you burnout at work? - ABC News

Delaware News Desk

FridayJul3,2020at6:00AM

She was saved from a high-risk shelter in Louisiana and flown to safety

Piper flew to Delaware on a plane, scared and unsure of her future.

What she didnt understand was that her chances of getting adopted in Louisiana were not good. In fact, Louisiana has the fifth highest euthanasia rate in the country and at 10 months old, she was just enough of an adult to put her at risk of being euthanized for space. While the Brandywine Valley SPCAs priority is the pets in their own community, if there is extra room at the shelter, they take pets like Piper to give them a second chance.

The next thing Piper knew, she in Georgetown, surrounded by new friends who were excited to meet her. Being a playful, affectionate girl, she couldnt stop her tail from wagging and she cuddled with everyone who pet her.

Piper is dreaming of a home with an active and loving family. She is definitely dog-friendly! Meet her at the Brandywine Valley SPCAs Georgetown campus.

Go here to read the rest:

Piper is ready to be a Delaware dog - Smyrna-Clayton Sun Times

Animal models, especially mice, have given scientists valuable insights into the mechanisms behind countless human diseases. They have been instrumental to the discovery of drug targets, metabolic pathways, and gene function. Theyve helped to lay bare the basic biochemistry of metabolism, hunger, cognition, and aging. Because mice are, to a certain extent, miniature facsimiles of human anatomy and genetics, science has an array of tools at its disposal to manipulate and visualize their bodily processes in real time, in highly controlled settings.

But, as the recent Covid-19 pandemic has revealed, science doesnt always have the tools to minimize loss of animal life. As the pandemic took hold and academic research labs across the U.S. shuttered indefinitely, scientists were faced with an unprecedented animal care dilemma. Without the teams of veterinary nurses and technicians who usually attend to the animals daily, many labs were forced to resort to wholesale euthanasia. Some labs sacrificed hundreds of animals, and were criticized harshly for their management of their experimental colonies. Many started to consider more durable, long-term plans for preserving and storing their mouse lines.

In the lab where I work at the University of California, San Francisco, and where for the past two years Ive been the designated rodent surgeon, we were asked to euthanize all but our most irreplaceable mice. As new animal researchers, we are trained to sacrifice our mice humanely to give them a dignified death. Returning to lab after the shutdown to find rows of empty racks that once held cages of mice we had worked with for months was a shock, and it was hard to conjure dignity in that moment.

That experience led me to reflect on how we as a research community use animal models in biomedical research, and how we might better use them in the future. And Ive become increasingly convinced that the animal model of the future will live not in a cage but in a computer chip: By simulating biological systems rather than experimenting with them, we can make drug development and biomedical research safer, more efficient, and more effective.

This is not to say that researchers treatment of animals has been haphazard. Research in animal models is highly regulated. These regulations vary in austerity from country to country and institution to institution, but they revolve around a common set of principles known as the three Rs: Replace the use of animals when possible, reduce the number of animals used per experiment, and refine methods to minimize suffering and improve welfare.

As the recent Covid-19 pandemic has revealed, science doesnt always have the tools to minimize loss of animal life.

A few years ago, when I was a new mouse surgeon, the three Rs were the guiding tenets of a week-long course I took at the Ren Remie Surgical Skills Center in Almere, Netherlands. The centers founder, Ren Remie, advocated for meticulous surgical technique, held to the same standards of sterility and post-operative care as any human surgical procedure. But he was also a proponent of the thinking that longer-term strategies can hasten recovery time from infection and surgical procedures. For instance, Remie and other researchers advocate whats called environmental enrichment, a method that helps animals cope with the inherent stress of being isolated after a surgical procedure or during an experiment. The researchers place toys, nesting material, or other inanimate objects in the cage that allow the mouse to engage with its surroundings, similar to the way it would in the wild. Studies suggest that environmental enrichment may even promote wound healing in rats.

But the success of strategies like environmental enrichment highlights an inherent weakness of the animal research model: An animals behavior is often extremely sensitive to its environment, in ways that are difficult if not impossible to control. This raises a perennial issue in biomedical research of just how reliably conclusions drawn based on studies in mice can be faithfully applied to human disease treatment. For instance, rodents are housed in groups as a rule, but certain kinds of experiments and treatments require them to be isolated, triggering a stress response that could significantly affect their immune activation. Studies have shown that mice and rats who live with companions fare better against injury, stroke, and even tumor growth than their lonely counterparts. As a result, when mice studies ask questions about human diseases, the housing status of the mouse is often a confounding factor. Even slight variation in the ambient temperature of a mouses housing room can cause stress responses that affect experimental outcomes. This variability is one reason that treatments that seem promising in mice often produce underwhelming outcomes in human clinical trials.

One attractive complement to animal studies that may address some of these shortcomings is in silico, or on a chip medicine. In silico models apply computational modeling strategies to genomic data to predict physiological responses to drugs or other stimuli. Although they are far from being able to replicate the full complexity of a living, sentient being, the U.S. Food and Drug Administration has begun consider computer modeling-based strategies to update the cumbersome and costly clinical trial pipeline. Research with in vitro models, which attempt to replicate animal physiology in test-tube style experiments, have also shown promise. These efforts have given birth to projects like the Comprehensive in Vitro Proarrhythmia Assay initiative, which integrates modeling and in vitro strategies to evaluate the potential for new drugs to cause heart rate abnormalities

Likewise, in 2013, the European Commission assembled a consortium of research groups known as the Avicenna Alliance to unify academia and industry around a set of standards for computer modeling in medicine. Based in Belgium but comprised of independent organizations around the world, the goal of the Alliance is to enable virtual clinical trials whose results can be validated by the same kinds of rigorous standards that are applied to traditional clinical trials.

As the Avicenna Alliance envisions them, virtual clinical trials would be based on unique genetic models derived from individual patients, rather than on large, genetically variable sample groups. Conceivably, this could allow a researcher to simulate a patients unique response to a treatment strategy, capturing the effects of subtle variations in baseline metabolism, bodyweight, or underlying health conditions that might influence the patients treatment outcomes. It might also significantly reduce the time and expense traditionally required to usher a new drug or medical device from the lab bench to the clinic potentially lowering the barrier to care for large swaths of the population who cant afford the often-astronomical costs of life-saving medications.

In silico clinical trials, if and when they are realized, could also address the long-standing problem of sample bias in drug development. Demographically, clinical trials tend to be disproportionately White and, until recently, overwhelmingly male. They therefore dont fully capture the therapeutic value and potential risks that drugs present to the patients who eventually rely on them. If in silico strategies become widely adopted, theyll hold potential to both increase the efficacy of new drugs and expand access to treatment.

The ethical debate around the use of animals in research has roiled for hundreds of years and will likely continue to do so. But what the Covid-19 outbreak has made clear is that there are severe weaknesses in the current animal model paradigm. As experiments have come to a halt during the coronavirus lockdowns, researchers have been given time to consider new, more sustainable approaches to discovery. Hopefully, we will look beyond the short-term technical challenges that will inevitably accompany the resumption of business as usual and gaze further afield, toward more humane, more modernized approaches to doing science.

Lindsay Gray is a lab manager at the University of California, San Francisco.

Original post:

In the Future, Lab Mice Will Live in Computer Chips, Not Cages - Undark Magazine

Reader unimpressed with HSUs previous leaders

Sundays article from Rollin Richmond on the evils of drink was interesting (What research says about alcohol and you, the Times-Standard, March 29, Page A4). Carrie Nation of the Womens Christian Temperance Union would have been proud. I wish that he had exercised that same intellectual and academic prowess while leading Humboldt State University. During his tenure he hired many administrative staff while letting the number of tenured professors dwindle.He helped recruit many students from Californias urban centers while doing very little to help them adapt to a rural setting.

He was responsible for scuttling the nursing program at HSU as being too costly; you know all those labs and things.

His successor didnt fare much better. Although she did help resurrect the nursing program in partnership with College of the Redwoods, something Rolland didnt do. She was successful in eliminating the football program after allowing the coaches to recruit student-athletes in the expectation of being able to play during their academic stay at HSU. Also she pulled the plug on KHSU, the universitys popular radio station weeks after conducting one of their periodic fundraising drives. Of course no notice, no appeals to the public, just the pulling of the plug.

In education parlance I would give Rollin and Lisa A+ for their personal retirement enrichment (you know, five years and out) and an Incomplete in their leadership.

John Kulstad, McKinleyville

Most medical experts agree it will take a number of months of limited social interaction to gain control over the COVID-19 virus. But President Trump sees this cure as more of a curse. For the sake of the U.S. economy, hed like to loosen things up in several weeks just in time for Easter.

The Republican Lt. Gov. Dan Patrick of Texas also wants the country to get back to business in weeks, not months. He says vulnerable seniors should understand we cant afford to sacrifice the countrys future because of the virus. In other words, if more seniors die its OK because the economy may not otherwise be strong enough to survive for younger generations.

I find his an interesting concept. In a sense Patrick is implying that seniors should agree to euthanasia to relieve pain, but not their own pain. Rather the pain that the economy is going through. In the U.S. today, in most states euthanasia is either illegal, or if legal, requires difficult steps to achieve. Here the Lt. Governor is approving euthanasia for all seniors a priori because he says it will benefit Americas future.

When I examine the two arguments above I find them both quite flawed. They both place the economy ahead of the health of U.S. citizens which I think is immoral by its very nature. And I also think both are examples of fake logic, which is sadly par for the course in the age of Trump.

Sherman Schapiro, Eureka

More:

Letters to the editor (March 31, 2020) - Eureka Times-Standard

People are doing what they can to stay healthy, but what about their pets?

Dr. Phyllis Sill is a veterinarian at Roscoe Veterinary Clinic. She says if you want to keep your dogs safe, there are certain things you shouldn't do:

"Dont let your dog suddenly go on a long run or a long walk if it hasntbeen conditioned to do so," she said. "They are probably going to end up with lameness issues or injuries." She continued, "Dont get a group of dogs together, they might fight."

Sill said it is important to think about things your dog can eat or swallow, like chocolate or the sugar substitute xylitol. "Try to keep them up and away," she warned, "because if dogs get into sugar-free gum, it can kill them."

The Roscoe Veterinary Clinic is considered an essential business; therefore it remains open amid Governor J.B. Pritzker's "stay-at-home" order. But, Sill said, even though they are open, they are only admitting patients with serious conditions.

"We are looking at patients who have growths or tumors that need to be removed," she said. "We are doing dentistries where our patients have uncomfortable mouths and maybe have teeth that need to be removed in order for them to eat better and do better," she added. "We are continuing to take X-rays and diagnose things that are going on orthopedically."

Sill gave examples of services they are not providing right now:

"We're trying to not have patients come in for things like a toenail trim," she said, "or vaccines that are maybe just coming due. We're trying not to have grooming type appointments except if the dog has a history of anal gland issues and we know the dog is going to be uncomfortable."

Sill said the practice now only allows one animal at a time in the building and staff are practicing curbside service with strict social distance guidelines. "We get as much of a history over the phone as we can," she said, "before we have a technician go out to the car. Then the technician brings the animal into the building."

Sill said clients aren't allowed inside the clinic unless it's for euthanasia. "Euthanasia is an extremely, extremely important part of [our] practice," she said. "People need to know that their animals went peacefully and the animals need to know that they were loved all the way until the end."

But other than that, clients may not enter the clinic. Sill said this act of social distancing helps keep the staff, public, and animals healthy. "It's nothing personal," she said. "We can't make an exception. If one person gets sick on our staff, we have to close our clinic."

Sill said most people understand why they are not allowed inside with their pets, but some do not. "They think we are being ridiculous," she said. "And that's just the one thing people have to understand -- that we want this to go away. We want to be done with it. This is not the way we want to process long term."

Sill said there are things people can do to eliminate human contact. Rather than hand a credit card to a technician, make the payment over the phone. "Think of all the times a technician has to either glove, de-glove, or just scrub in between each transaction," she said. "I promise you there is no identity theft whatsoever. We are just trying to do a transaction without touching cash or checks." She said over-the-phone payments will also speed up the process because it means less before and after santitizing.

Another thing people can do is not engage in a conversation during curbside pickup. "I don't want my technician talking through a rolled down window," she said. "It offers no protection whatsoever. So please, please, please, talk to us on the phone."

Looking ahead, Sill said, "I think this will be an unusual summer. I don't think this is going to easily and quickly go away. I think we're going to be dealing with this for months on end."

Even so, she said there isn't any need to panic. "We're going to get through this. I think everybody is trying to do what they're supposed to do."

And, Sill said, the main goal for animals remains the same as it is for other family members: Stay out of the emergency room.

The rest is here:

Veterinary Clinic Keeps Pets (& Their Humans) Safe Amid COVID-19 - WNIJ and WNIU

Reading Time: 8 minutesCaring for our elderly and terminally ill is expensive. But it is also a non-negotiable, fundamental duty of government.

It can be unethical to withdraw artificial hydration and nutrition and doing so can constitute a form of euthanasia that is, when its withdrawn with a primary intention to cause death. But withdrawal is not always unethical. Just as there are situations where it is justified to turn off a ventilator, so too there can be situations where it is justified to withdraw artificial hydration and nutrition.

Australias ABC networkrecently reported a storyof an elderly South Australian woman with dementia and breast cancer, who was not mentally competent and was being given hydration and nutrition through a nasogastric tube.

The tube fell out and the Public Advocate, who was the legal guardian of the patient and decision maker for her, determined that it should not be replaced. The reasons given included that the tube was burdensome, that it was prolonging suffering, and that replacing it would be contrary to the presumed wishes of the patient which is to say, if she were able to decide for herself, she would refuse replacement.

Two of the patients daughters, a Catholic bishop and the patients Catholic priest all disagreed with the Public Advocates decision and sought to change it. The daughters argued that the patient would want to live as long as possible and that replacing the tube was consistent with her Catholic faith.

The tube was not replaced, and the patient died five weeks later.

Now, despite being a truism, a very important principle in applied ethics is that good facts are essential for good ethics. The story as reported does not provide sufficient facts to judge whether or not the cessation of artificial feeding by means of a nasogastric tube was an ethically acceptable decision.

Its worth noting that hydration wasnotwithdrawn, but was delivered by intravenous line. So a pertinent question is: what justification was there for withdrawing nutrition, but not hydration? Either both hydration and nutrition were ethically appropriate life-prolonging treatment, or neither were.

One reason for the different approach to hydration as compared with nutrition could be that delivering total parenteral nutrition is a far more invasive procedure and more burdensome for the patient than, as occurred in this case, delivering hydration by way of an intravenous drip. The hydration might also have been continued as comfort care rather than life-prolonging treatment.

I was once consulted on a comparable case.

A young woman, who was diabetic and on haemodialysis for kidney failure, had a sudden cardiac arrest. She was revived and placed on a ventilator, but several days later, when she was due for dialysis, was diagnosed as being in a deep and irreversible coma.

Her parents decided that she should not receive dialysis, but they did not want the ventilator to be removed. We complied with their wishes in order to avoid further sufferingto them, not because we believed it was necessary treatment for the young woman. We explained in the case notes that was the reason the ventilator was continued. The young woman died a natural death from renal failure, at which time the ventilator was stopped.

What often causes great emotional trauma for a patients family, as was true in the South Australian case, is the thought of starving and dehydrating the patient to death in withdrawing artificial hydration and nutrition. There is, however, research that shows the hunger and thirst mechanisms in our brains shut down when we are dying.

The reflections of the Catholic Church on medical ethics are a frequently used reference point for bioethicists around the world. Even if they reject them, bioethicists respond to its concerns. This is especially true in a case such as the one we are considering, in which the patient and her carers are of that faith.

The Catholic Church teaches that food and fluids must always be offered and supplied if the person can take these orally. Pope John Paul II (now Saint Pope John Paul II) declared in a 2004 address that the same requirement of mandatory provision applies to artificial hydration and nutrition for people in a permanent vegetative state that is, hydration and nutrition not taken orally but delivered by other means.

With great respect, I believe that this statement needs to be nuanced. In that particular document its clear that the Pope wanted to protect vulnerable patients receiving artificial hydration and nutrition who are in a stable medical condition.

There are thousands of such patients in nursing homes and they have a right to humane basic care, as the Pope says. But the Pope might not have been thinking of the acceptability of withdrawal of artificial hydration and nutrition fromallpatients in a permanent vegetative state.

One problem is that if we apply this criterion to all such patients, it actually supports the euthanasia movement, as I shall explain below. But let me first attempt to make some distinctions that could help us to decide when withdrawal of artificial hydration and nutrition is ethical and when it is not.

It depends, first, on how we classify artificial hydration and nutrition: as simply food and water, or as medical treatment for a failed alimentary system (just as a ventilator is medical treatment for a failed respiratory system). If its just food and water and basic care, then ethically itmustbe provided. If it is medical treatment, that is not always the case.

I propose that, just as there are situations where it is justified to turn off a ventilator, so too there can be situations where it is justified to withdraw artificial hydration and nutrition. Both are forms of medical life-support treatment. And what if, for instance, a PEG feeding tube is painful or has become infected? What should doctors do then?

One distinction that is sometimes made in order to determine whether a given medical treatment must be offered is whether the intervention is ordinary or extraordinary medical treatment. The Catholic moral teaching is that the former must be provided, whereas the latter need not be.

Bishop Gregory OKellyis quotedas saying in his letter to the Office of the Public Advocate that, To deny food or drink, no matter how it is delivered, to such a person is to deny themordinary[emphasis added] means for sustaining life.

But this distinction betweenordinaryandextraordinarymedical treatment is not always clear cut. It can be that the patients quality of life is being judged and not the treatment. When a patient is in very fragile health in ICU, a certain treatment can be judged as extraordinary; but when the patient improves and is living in a nursing home, thesame treatmentfor the same personcan be characterised as ordinary.

In short, circumstances need to be taken into account. Moreover, whether a treatment is judged ordinary or extraordinary can be a very subjective and discretionary decision, which can leave it open to abuse.

Justifications for withdrawing life support treatment include that withdrawal is required to respect a patients right to refuse medical treatment, including through an advance directive that is, withdrawing treatment is required in order to respect a patients rights to inviolability (the right not to be touched without ones informed consent) and competent patients rights to autonomy.

Artificial hydration and nutrition would not be forcibly imposed on such a patient. Justifications also include: that the treatment is medically futile; that the burdens of continuing treatment outweigh any benefits; and that the treatment is prolonging dying, not living.

The Public Advocatedescribed the patient in questionas pre-terminal, which might or might not mean that she was dying, although her daughters denied that she was. With respect to the burden of the nasogastric tube, they are admittedly very uncomfortable, but its at least an open question whether the suffering involved for the patient could have justified not replacing it. Further questions include how the tube fell out (did the patient pull it out?) and whether, if the tube had not fallen out, its removal would have been justified?

To repeat, these decisions about providing or withdrawing artificial hydration and nutrition can be very difficult ones in relation to determining the right ethical path to take. Every case (and person) is different; assessments must be made on that basis and, importantly, in the light of all the relevant facts.

As I said, advocates of legalising euthanasia use cases such as the one describedin the ABC reportto promote their cause. They argue that withholding artificial hydration and nutritionis euthanasia often called slow euthanasia or passive euthanasia; therefore, we are already practising euthanasia and, if we are to be consistent, should recognise the legal right to do so by means of lethal injection.

Consequently, people who oppose the withdrawal of artificial hydration and nutrition when this withdrawal could be justified, and object to such a withdrawal on the grounds that it would be euthanasia, sadly help the pro-euthanasia cause.

Moreover, when members of the public think euthanasia isanyfailure to useallpossible means to prolong life and believe thatallrefusals of medical treatment that could prolong life are euthanasia, they respond positively to survey questions that ask, Do you agree with legalising euthanasia? because they want to have the right to refuse treatment. The publics responses are even more compromised when asked, If someone is in terrible pain and suffering should they be able to consent to euthanasia?

The option of saying yes to fully adequate pain and suffering management and no to euthanasia adopting a position that we must kill the pain and suffering, but not the personwiththe pain and suffering is often not possible in surveys. They tend to pose conjunctive questions (rather than two disjunctive ones)that is, do you agree with fully adequate pain and suffering managementandas a separate question, do you agree with euthanasia?.

It bears always keeping clearly in mind when discussing withdrawal of artificial hydration and nutrition that it can be employed unethically, when it does become a form of euthanasia that is, when its used with a primary intention to cause death.

This is most likely to occur when it is paired with an unwarranted use of palliative sedation, where the patient is unjustifiably deeply sedated until they die. Such a use is better called terminal sedation to differentiate it from the ethical use of palliative sedation, that is, when sedation is necessary and used appropriately to relieve a patients pain and suffering and not to hasten their death.

Margaret Somervilleis Professor of Bioethics in theSchool of Medicine and the Institute for Society and Ethics at the University of Notre Dame Australia.

This article was originally published at Mercatornet.com.

Related articles:

Sisters struggle reveals risk to disabled elderlyACSJC head backs aged care crackdown

Originally posted here:

Margaret Somerville: Withdrawing artificial hydration and nutrition - The Catholic Weekly

LISBON, Portugal Portugals parliament voted Thursday in favor of allowing euthanasia and physician-assisted suicide for terminally ill people.

The landmark vote left Portugal poised to become one of the few countries in the world permitting the procedures. However, the country's president could still attempt to block the legislation.

The 230-seat Republican Assembly, Portugal's parliament, approved five right-to-die bills, each by a comfortable margin. Left-of-center parties introduced the bills, which had no substantial differences.

Before lawmakers voted, hundreds of people outside parliament building protested the measures. One banner said, Euthanasia doesn't end suffering, it ends life. Some protesters chanted Sim a vida! ("Yes to life!") and others held up crucifixes and religious effigies.

Inside the parliament building, underlining the historical weight of the moment, each lawmaker was called, in alphabetical order, to state their vote on each bill, instead of voting electronically. Such a lengthy method is usually used only for landmark votes, such as a declaration of war or impeachment.

After the five bills passed, some lawmakers took photographs with their smartphone of the electronic screen on the wall announcing the results. The bills were approved by margins of between 28 and 41 votes.

President Marcelo Rebelo de Sousa, who is known to be reluctant about euthanasia, could veto the new law, but parliament can override his veto by voting a second time for approval. The Portuguese president doesn't have executive powers.

The head of state also could ask the Constitutional Court to review the legislation; Portugal's Constitution states that human life is "sacrosanct," though abortion has been legal in the country since 2007.

Euthanasia when a doctor directly administers fatal drugs to a patient is legal in Belgium, Canada, Colombia, Luxembourg, the Netherlands and Switzerland. In some U.S. states, medically-assisted suicide where patients administer the lethal drug themselves, under medical supervision is permitted.

Ana Figueiredo, a math teacher, became a supporter of euthanasia after her 70-year-old father with terminal cancer killed himself with a gun almost six years ago.

He was conscious, in deep pain and ... he went on begging his doctors to take his pain away because he was in such a terminal state, Figueiredo said. It was very sad to see him begging for a dignified death without pain.

The Catholic church in Portugal has led opposition to the procedures, which currently are illegal and carry prison sentences of up to three years. Church leaders have urged lawmakers in vain to hold a referendum on the issue.

In a similar debate two years ago, lawmakers rejected euthanasia by five votes.

Most parties allowed their lawmakers to vote their conscience, with some diverging from their party line.

Socialist lawmaker Isabel Moreira said the aim of the bills was to let people make intimate choices, without breaking the law.

In recent years, the Socialist Party has also led successful efforts to permit same-sex marriages and abortion in Portugal.

Everyone can be the architect of their own destiny, as long they dont harm others, Moreira said during the debate.

Telmo Correia, a lawmaker from the conservative Popular Party, described euthanasia as a sinister step backward for civilization. He said none of the parties presenting the legalization proposals mentioned euthanasia in their platforms for Octobers general election.

The governing Socialist Party's bill, similar to the others, covers patients over 18 years of age who are "in a situation of extreme suffering, with an untreatable injury or a fatal and incurable disease."

Two doctors, at least one of them a specialist in the relevant illness, and a psychiatrist would need to sign off on the patient's request to die. The case would then go to a Verification and Evaluation Committee, which could approve or turn down the procedure.

The process is postponed if it is legally challenged, or if the patient loses consciousness, and health practitioners can refuse to perform the procedure on moral grounds. Oversight is provided by the General-Inspectorate for Health.

To discourage people from traveling to Portugal to end their life, the bills all stipulate that patients must either be Portuguese citizens or legal residents.

The Socialist-led coalition government in Portugal's neighbor Spain has also set in motion the legislative steps needed to allow euthanasia.

___

AP reporter Helena Alves contributed from Lisbon.

Originally posted here:

Amid Protests, Portugal Lawmakers Vote to Allow Euthanasia - The New York Times

Mobile vets in Bay Area offer in-home euthanasia

Walter Allen reports

LUTZ, Fla. - The worst thing about our dogs and cats is that they dont live nearly as long as wed want, wish, or hope for.There is a local organization that can step in when that time comes and make it the most peaceful and loving process all from your lap.

"I honestly wish that everyone did something that they got thanked for every day, Dr. Dani McVety told FOX 13. Very few people in this world that get thank-yous for everything that they do. Imagine if the person who bagged your groceries got a hug and a thanks.

Dr. McVety knew she wanted to be a veterinarian when she was little but it was where she found her calling was after the death of one of her dogs.

We took her to a very nice clinic, she recalled, and the euthanasia was done very well but it still wasn't what I wanted it to be. Again, even though the experience was good. It just wasn't everything it could have been.

Among other motivating factors, Dr. McVety started Lap of Loves veterinary hospice and in-home euthanasia.

The team of more than 130 vets in around 30 states will come to the home and put your animal to sleep.

"Pets navigate this world by smell more than they do by sight, McVety said. More of their brain is dedicated to that. So for them to be in their own surroundings, in their own bed, with their own smells...I just believe, and from my experience, that it keeps them much more calm.

FOX 13 was with the Villarini family the day they said their final farewell to Rocky, their Jack Russell terrier.

Its an honor to do this, McVety said. We love being a part of this memory. We love offering something that we might not be able to get anywhere else. Even if you do a peaceful euthanasia in a clinic, it might be beautiful and peaceful and great. But to have it done in the home is the most peaceful experience and the most peaceful environment that anyone including our animals can have.

For McVety, her days are filled with tissues and tears, but when her head hits the pillow every night, she knows shes making a difference.

Its the most raw thing you could ever experience that you can have as a doctor to visualize that, to witness that, and you get to see every piece of their life, she said. You witness the ending of this. Youre not only losing a pet but losing a person. To me, it is the most honorable thing I could ever do as a veterinarian.

LINK: You can learn more about the Lap of Love and the veterinary services provided by heading over to the organization's website.

See the original post:

Lap of Love veterinarians offer in-home euthanasia to give a final farewell in a place of comfort - FOX 13 Tampa Bay

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.

Originally posted here:

Euthanasia | American Medical Association