Aid in Dying: A Good or a Harm?
Various views on this issue at:
http://www.nytimes.com/2016/04/30/opini ... ef=opinion
Euthanasia
Canada doesn't want to be a 'suicide tourism' destination
North America’s assisted-suicide landscape changed in a profound, historic way on Friday. As NPR reported, that was when Canada’s Senate approved that nation’s new physician-assisted-suicide law. The law was initially brought about by a ruling from Canada’s Supreme Court last year that banned a law against physician-assisted suicide, but left it to the country’s legislature to regulate and determine the scope of the practice.
One interesting aspect of Canada’s version of physician-assisted suicide is that only Canadians are eligible for it. This mirrors how it’s done in the handful of U.S. states where physician-assisted suicide is already legal, which include Washington, Oregon, and Vermont (California’s state legislature approved assisted suicide there recently, but things haven’t been finalized).
......
Belgium, which enacted its euthanasia law in 2002, is seen as taking one of the most liberal approaches, which has led to some rather strange and heart-wrenching stories. “In 2013, [the famous/infamous Belgian euthanasia physician] Wim Distelmans euthanized a forty-four-year-old transgender man, Nathan Verhelst, because Verhelst was devastated by the failure of his sex-change surgeries; he said that he felt like a monster when he looked in the mirror,” wrote Rachel Aviv in her absolute must-read piece on this subject for The New Yorker a year ago. “‘Farewell, everybody,’ Verhelst said from his hospital bed, seconds before receiving a lethal injection.” More recently, the BBC reported on a Belgian man who wants to end his life because, he says, he can’t live with his pedophilia; the first step of his application was approved. As the BBC noted, “There were 1,807 confirmed cases of euthanasia in 2013, the most recent year for which figures are available.”
There are no easy or obvious answers for any of this, but if you want to know more about how physician-assisted suicide works in Europe, definitely read that New Yorker article or watch VICE’s recent mini-doc, which I mentioned in another recent post on the subject. These controversies are only going to grow more heated.
http://www.msn.com/en-ca/news/canada/ca ... lsignoutmd
North America’s assisted-suicide landscape changed in a profound, historic way on Friday. As NPR reported, that was when Canada’s Senate approved that nation’s new physician-assisted-suicide law. The law was initially brought about by a ruling from Canada’s Supreme Court last year that banned a law against physician-assisted suicide, but left it to the country’s legislature to regulate and determine the scope of the practice.
One interesting aspect of Canada’s version of physician-assisted suicide is that only Canadians are eligible for it. This mirrors how it’s done in the handful of U.S. states where physician-assisted suicide is already legal, which include Washington, Oregon, and Vermont (California’s state legislature approved assisted suicide there recently, but things haven’t been finalized).
......
Belgium, which enacted its euthanasia law in 2002, is seen as taking one of the most liberal approaches, which has led to some rather strange and heart-wrenching stories. “In 2013, [the famous/infamous Belgian euthanasia physician] Wim Distelmans euthanized a forty-four-year-old transgender man, Nathan Verhelst, because Verhelst was devastated by the failure of his sex-change surgeries; he said that he felt like a monster when he looked in the mirror,” wrote Rachel Aviv in her absolute must-read piece on this subject for The New Yorker a year ago. “‘Farewell, everybody,’ Verhelst said from his hospital bed, seconds before receiving a lethal injection.” More recently, the BBC reported on a Belgian man who wants to end his life because, he says, he can’t live with his pedophilia; the first step of his application was approved. As the BBC noted, “There were 1,807 confirmed cases of euthanasia in 2013, the most recent year for which figures are available.”
There are no easy or obvious answers for any of this, but if you want to know more about how physician-assisted suicide works in Europe, definitely read that New Yorker article or watch VICE’s recent mini-doc, which I mentioned in another recent post on the subject. These controversies are only going to grow more heated.
http://www.msn.com/en-ca/news/canada/ca ... lsignoutmd
Terminally ill woman holds party before ending her life
SAN DIEGO — In early July, Betsy Davis emailed her closest friends and relatives to invite them to a two-day party, telling them: "These circumstances are unlike any party you have attended before, requiring emotional stamina, centeredness and openness."
And just one rule: No crying in front of her.
The 41-year-old artist with ALS, or Lou Gehrig's disease, held the gathering to say goodbye before becoming one of the first Californians to take a lethal dose of drugs under the state's new doctor-assisted suicide law for the terminally ill.
"For me and everyone who was invited, it was very challenging to consider, but there was no question that we would be there for her," said Niels Alpert, a cinematographer from New York City.
"The idea to go and spend a beautiful weekend that culminates in their suicide — that is not a normal thing, not a normal, everyday occurrence. In the background of the lovely fun, smiles and laughter that we had that weekend was the knowledge of what was coming."
1/4 SLIDES © Associated Press
This July 24, 2016 photo provided by Niels Alpert, Betsy Davis, smiles during a going away party with her family and friends in California
Davis worked out a detailed schedule for the gathering on the weekend of July 23-24, including the precise hour she planned to slip into a coma, and shared her plans with her guests in the invitation.
More than 30 people came to the party at a home with a wraparound porch in the picturesque Southern California mountain town of Ojai, flying in from New York, Chicago and across California.
One woman brought a cello. A man played a harmonica. There were cocktails, pizza from her favorite local joint, and a screening in her room of one of her favorite movies, "The Dance of Reality," based on the life of a Chilean film director.
As the weekend drew to a close, her friends kissed her goodbye, gathered for a photo and left, and Davis was wheeled out to a canopy bed on a hillside, where she took a combination of morphine, pentobarbital and chloral hydrate prescribed by her doctor.
Kelly Davis said she loved her sister's idea for the gathering, which Betsy Davis referred to as a "rebirth."
"Obviously it was hard for me. It's still hard for me," said Davis, who wrote about it for the online news outlet Voice of San Diego. "The worst was needing to leave the room every now and then, because I would get choked up. But people got it. They understood how much she was suffering and that she was fine with her decision. They respected that. They knew she wanted it to be a joyous occasion."
Davis ended her life a little over a month after a California law giving the option to the terminally ill went into effect. Four other states allow doctor-assisted suicide, with Oregon the first in 1997.
Opponents of the law in lobbying against it before state legislators argued that hastening death was morally wrong, that it puts terminally ill patients at risk for coerced death by loved ones and could become a way out for people who are uninsured or fearful of high medical bills.
Marilyn Golden of the Disability Rights Education & Defense Fund, said her heart goes out to anyone dealing with a terminal illness, but "there are still millions of people in California threatened by the danger of this law."
Davis spent months planning her exit, feeling empowered after spending the last three years losing control of her body bit by bit. The painter and performance artist could no longer stand, brush her teeth or scratch an itch. Her caretakers had to translate her slurred speech for others.
"Dear rebirth participants you're all very brave for sending me off on my journey," she wrote in her invitation. "There are no rules. Wear what you want, speak your mind, dance, hop, chant, sing, pray, but do not cry in front of me. OK, one rule."
During the party, old friends reconnected and Davis rolled in and out of the rooms in her electric wheelchair and onto the porch, talking with her guests.
At one point, she invited friends to her room to try on the clothes she had picked out for them. They modeled the outfits to laughter. Guests were also invited to take a "Betsy souvenir" — a painting, beauty product or other memento. Her sister had placed sticky notes on the items, explaining each one's significance.
Wearing a Japanese kimono she bought on a bucket-list trip she took after being diagnosed in 2013, she looked out at her last sunset and took the drugs at 6:45 p.m. with her caretaker, her doctor, her massage therapist and her sister by her side. Four hours later, she died.
Friends said it was the final performance for the artist, who once drew pictures on a stage with whipped cream.
"What Betsy did gave her the most beautiful death that any person could ever wish for," Alpert said. "By taking charge, she turned her departure into a work of art."
Her guests agreed to meet again on her birthday in June to scatter her ashes.
Photo at:
http://www.msn.com/en-ca/news/world/ter ... ailsignout
SAN DIEGO — In early July, Betsy Davis emailed her closest friends and relatives to invite them to a two-day party, telling them: "These circumstances are unlike any party you have attended before, requiring emotional stamina, centeredness and openness."
And just one rule: No crying in front of her.
The 41-year-old artist with ALS, or Lou Gehrig's disease, held the gathering to say goodbye before becoming one of the first Californians to take a lethal dose of drugs under the state's new doctor-assisted suicide law for the terminally ill.
"For me and everyone who was invited, it was very challenging to consider, but there was no question that we would be there for her," said Niels Alpert, a cinematographer from New York City.
"The idea to go and spend a beautiful weekend that culminates in their suicide — that is not a normal thing, not a normal, everyday occurrence. In the background of the lovely fun, smiles and laughter that we had that weekend was the knowledge of what was coming."
1/4 SLIDES © Associated Press
This July 24, 2016 photo provided by Niels Alpert, Betsy Davis, smiles during a going away party with her family and friends in California
Davis worked out a detailed schedule for the gathering on the weekend of July 23-24, including the precise hour she planned to slip into a coma, and shared her plans with her guests in the invitation.
More than 30 people came to the party at a home with a wraparound porch in the picturesque Southern California mountain town of Ojai, flying in from New York, Chicago and across California.
One woman brought a cello. A man played a harmonica. There were cocktails, pizza from her favorite local joint, and a screening in her room of one of her favorite movies, "The Dance of Reality," based on the life of a Chilean film director.
As the weekend drew to a close, her friends kissed her goodbye, gathered for a photo and left, and Davis was wheeled out to a canopy bed on a hillside, where she took a combination of morphine, pentobarbital and chloral hydrate prescribed by her doctor.
Kelly Davis said she loved her sister's idea for the gathering, which Betsy Davis referred to as a "rebirth."
"Obviously it was hard for me. It's still hard for me," said Davis, who wrote about it for the online news outlet Voice of San Diego. "The worst was needing to leave the room every now and then, because I would get choked up. But people got it. They understood how much she was suffering and that she was fine with her decision. They respected that. They knew she wanted it to be a joyous occasion."
Davis ended her life a little over a month after a California law giving the option to the terminally ill went into effect. Four other states allow doctor-assisted suicide, with Oregon the first in 1997.
Opponents of the law in lobbying against it before state legislators argued that hastening death was morally wrong, that it puts terminally ill patients at risk for coerced death by loved ones and could become a way out for people who are uninsured or fearful of high medical bills.
Marilyn Golden of the Disability Rights Education & Defense Fund, said her heart goes out to anyone dealing with a terminal illness, but "there are still millions of people in California threatened by the danger of this law."
Davis spent months planning her exit, feeling empowered after spending the last three years losing control of her body bit by bit. The painter and performance artist could no longer stand, brush her teeth or scratch an itch. Her caretakers had to translate her slurred speech for others.
"Dear rebirth participants you're all very brave for sending me off on my journey," she wrote in her invitation. "There are no rules. Wear what you want, speak your mind, dance, hop, chant, sing, pray, but do not cry in front of me. OK, one rule."
During the party, old friends reconnected and Davis rolled in and out of the rooms in her electric wheelchair and onto the porch, talking with her guests.
At one point, she invited friends to her room to try on the clothes she had picked out for them. They modeled the outfits to laughter. Guests were also invited to take a "Betsy souvenir" — a painting, beauty product or other memento. Her sister had placed sticky notes on the items, explaining each one's significance.
Wearing a Japanese kimono she bought on a bucket-list trip she took after being diagnosed in 2013, she looked out at her last sunset and took the drugs at 6:45 p.m. with her caretaker, her doctor, her massage therapist and her sister by her side. Four hours later, she died.
Friends said it was the final performance for the artist, who once drew pictures on a stage with whipped cream.
"What Betsy did gave her the most beautiful death that any person could ever wish for," Alpert said. "By taking charge, she turned her departure into a work of art."
Her guests agreed to meet again on her birthday in June to scatter her ashes.
Photo at:
http://www.msn.com/en-ca/news/world/ter ... ailsignout
Aid in Dying Movement Advances
New York, Colorado and the District of Columbia may soon join the handful of states where doctors are allowed to help terminally ill patients die by prescribing a lethal dose of painkillers.
A proposal to allow physician-assisted dying will be on the ballot in Colorado next month. In the District of Columbia, the District Council’s Health and Human Services Committee last week approved a physician-assisted dying bill that the full council could vote on before the end of the year. New York lawmakers, meanwhile, are hopeful that support in the Legislature for aid-in-dying bills will soon overcome opposition from religious leaders and some medical groups.
Victories in the three jurisdictions would galvanize a movement that seeks to give terminally ill Americans a dignified alternative to the dismal choices they face in most of the country. In states where assisted dying is banned, some terminal patients manage to get a lethal dose of drugs from medical professionals under the table, which exposes the health care workers to prosecution. Others are advised to starve themselves to death.
More...
http://www.nytimes.com/2016/10/10/opini ... ef=opinion
New York, Colorado and the District of Columbia may soon join the handful of states where doctors are allowed to help terminally ill patients die by prescribing a lethal dose of painkillers.
A proposal to allow physician-assisted dying will be on the ballot in Colorado next month. In the District of Columbia, the District Council’s Health and Human Services Committee last week approved a physician-assisted dying bill that the full council could vote on before the end of the year. New York lawmakers, meanwhile, are hopeful that support in the Legislature for aid-in-dying bills will soon overcome opposition from religious leaders and some medical groups.
Victories in the three jurisdictions would galvanize a movement that seeks to give terminally ill Americans a dignified alternative to the dismal choices they face in most of the country. In states where assisted dying is banned, some terminal patients manage to get a lethal dose of drugs from medical professionals under the table, which exposes the health care workers to prosecution. Others are advised to starve themselves to death.
More...
http://www.nytimes.com/2016/10/10/opini ... ef=opinion
The VSED Exit: A Way to Speed Up Dying, Without Asking Permission
Del Greenfield had endured repeated bouts of cancer over four decades, yet kept working as a peace activist in Portland, Ore., into her 80s. “She was a powerful force,” said her daughter, Bonnie Reagan.
But in 2007, Ms. Greenfield was struggling. She had been her husband’s caregiver until he died that year at 97, never telling her family she was feeling miserable herself. She’d lost much of her hearing. She required supplemental oxygen.
When she fell and broke an arm, “that was the final straw,” her daughter said. “She was a real doer, and she couldn’t function the way she wanted to. Life wasn’t joyful anymore.”
At 91, Ms. Greenfield told her family she was ready to die. She wanted a prescription for lethal drugs, and because she had active cancer, she might have obtained one under Oregon’s Death with Dignity statute for people with terminal illnesses.
Then her son-in-law, a family physician who had written such prescriptions for other patients, explained the somewhat involved process: oral and written requests, a waiting period, two physicians’ assent.
“I don’t have time for that,” Ms. Greenfield objected. “I’m just going to stop eating and drinking.”
In end-of-life circles, this option is called VSED (usually pronounced VEEsed), for voluntarily stopping eating and drinking. It causes death by dehydration, usually within seven to 14 days. To people with serious illnesses who want to hasten their deaths, a small but determined group, VSED can sound like a reasonable exit strategy.
Unlike aid with dying, now legal in five states, it doesn’t require governmental action or physicians’ authorization. Patients don’t need a terminal diagnosis, and they don’t have to prove mental capacity. They do need resolve.
“It’s for strong-willed, independent people with very supportive families,” said Dr. Timothy Quill, a veteran palliative care physician at the University of Rochester Medical Center.
He was speaking at a conference on VSED, billed as the nation’s first, at Seattle University School of Law this month. It drew about 220 participants — physicians and nurses, lawyers, bioethicists, academics of various stripes, theologians, hospice staff. (Disclosure: I was also a speaker, and received an honorarium and some travel costs.)
What the gathering made clear was that much about VSED remains unclear.
Is it legal?
For a mentally competent patient, able to grasp and communicate decisions, probably so, said Thaddeus Pope, director of the Health Law Institute at Mitchell Hamline School of Law in St. Paul, Minn. His research has found no laws expressly prohibiting competent people from VSED, and the right to refuse medical and health care intervention is well established.
Still, he pointed out, “absence of prohibition is not the same as permission.” Health care professionals can be reluctant to become involved, because “they want a green light, and there isn’t one of those for VSED,” he added.
The question grows much murkier for patients with dementia or mental illness who have specified VSED under certain circumstances through advance directives. Several states, including Wisconsin and New York, forbid health care surrogates to stop food and fluids. (Oregon legislators, on the other hand, are considering drafting a bill to allow surrogates to withhold nutrition.)
The question intrigues bioethicists. Can your current competent self cut off nutrition and hydration for your future demented self? In a handful of court decisions, judges have declined to enforce such directives.
Can VSED be comfortable and provide a peaceful death?
“The start of it is generally quite comfortable,” Dr. Quill said he had found, having cared for such patients. The not-eating part comes fairly easily, health professionals say; the seriously ill often lose their appetites anyway.
Coping with thirst can be much more difficult. Yet even sips of water prolong the dying process.
“You want a medical partner to manage your symptoms,” Dr. Quill said. “It’s harder than you think.”
Keeping patients’ mouths moistened and having aggressive pain medication available make a big difference, health professionals say.
At the conference, the Dutch researcher Dr. Eva Bolt presented results from a survey of family physicians in the Netherlands, describing 99 cases of VSED. Their patients (median age: 83) had serious diseases and depended on others for everyday care; three-quarters had life expectancies of less than a year.
In their final three days, their doctors reported, 14 percent suffered pain, and smaller percentages experienced fatigue, impaired cognition, thirst or delirium.
Still, 80 percent of the physicians said the process had unfolded as the patients wanted; only 2 percent said it hadn’t. The median time from the start of their fasts until death was seven days.
Those results mirror a 2003 study of hospice nurses in Oregon who had cared for VSED patients. Rating their deaths on a scale from 0 to 9 (a very good death), the nurses assigned a median score of 8. Nearly all of the patients died within 15 days.
The slower pace of death from fasting, compared with ingesting barbiturates, gives people time to say goodbye and, for the first few days, to change their minds. Several conference speakers described patients who had fasted and stopped a few times before continuing until death.
That’s hard on families and caregivers, though. And slowness won’t benefit people who are dying with severe shortness of breath or pain. “Two weeks is a lifetime in that situation,” Dr. Quill said.
Other obstacles could restrict VSED. A quiet choice in a private home, it could be derailed in nursing homes and assisted living facilities where administrators fear lawsuits or regulatory sanctions. Physicians might decline to participate; home care aides might quit.
Moreover, major religious groups have yet to declare whether they consider VSED an acceptable act of self-determination or a suicide, anathema in most faiths.
Phyllis Shacter and her husband, Alan Alberts, a computer scientist who received a Alzheimer’s disease diagnosis in 2011, had few doubts, however. VSED allowed him to escape the disease that had slowly killed his mother.
No state allows a person with dementia to use a “death with dignity” law, but with support from his wife, doctor and two caregivers, Mr. Alberts, 76, died peacefully at home in 2013 after a nine-day fast.
“I’m glad my husband fulfilled his desire not to live into the final stages of Alzheimer’s,” Ms. Shacter said.
On the other hand, Judith Schwarz, clinical coordinator of End of Life Choices New York, told of an 81-year-old attempting VSED with inadequate pain medication, crying out to his wife at night, “I’m dying of thirst.”
“And of course, he was, but slowly,” Dr. Schwarz said. “This was a horror show.”
Del Greenfield fared better. “She didn’t use any medicines, just some oxygen,” her daughter said. Ms. Greenfield’s children, grandchildren and great-grandchildren came to see her, and “she was completely peaceful, chatting and joking and telling people she loved them.”
She announced that she had one regret. “We all leaned in,” Bonnie Reagan said. “And she said, ‘I wish I’d seen the Rolling Stones the last time they came to Portland.’”
On the fifth day of fasting, “she just fell asleep,” and died about 36 hours later.
http://www.nytimes.com/2016/10/25/healt ... dline&te=1
Del Greenfield had endured repeated bouts of cancer over four decades, yet kept working as a peace activist in Portland, Ore., into her 80s. “She was a powerful force,” said her daughter, Bonnie Reagan.
But in 2007, Ms. Greenfield was struggling. She had been her husband’s caregiver until he died that year at 97, never telling her family she was feeling miserable herself. She’d lost much of her hearing. She required supplemental oxygen.
When she fell and broke an arm, “that was the final straw,” her daughter said. “She was a real doer, and she couldn’t function the way she wanted to. Life wasn’t joyful anymore.”
At 91, Ms. Greenfield told her family she was ready to die. She wanted a prescription for lethal drugs, and because she had active cancer, she might have obtained one under Oregon’s Death with Dignity statute for people with terminal illnesses.
Then her son-in-law, a family physician who had written such prescriptions for other patients, explained the somewhat involved process: oral and written requests, a waiting period, two physicians’ assent.
“I don’t have time for that,” Ms. Greenfield objected. “I’m just going to stop eating and drinking.”
In end-of-life circles, this option is called VSED (usually pronounced VEEsed), for voluntarily stopping eating and drinking. It causes death by dehydration, usually within seven to 14 days. To people with serious illnesses who want to hasten their deaths, a small but determined group, VSED can sound like a reasonable exit strategy.
Unlike aid with dying, now legal in five states, it doesn’t require governmental action or physicians’ authorization. Patients don’t need a terminal diagnosis, and they don’t have to prove mental capacity. They do need resolve.
“It’s for strong-willed, independent people with very supportive families,” said Dr. Timothy Quill, a veteran palliative care physician at the University of Rochester Medical Center.
He was speaking at a conference on VSED, billed as the nation’s first, at Seattle University School of Law this month. It drew about 220 participants — physicians and nurses, lawyers, bioethicists, academics of various stripes, theologians, hospice staff. (Disclosure: I was also a speaker, and received an honorarium and some travel costs.)
What the gathering made clear was that much about VSED remains unclear.
Is it legal?
For a mentally competent patient, able to grasp and communicate decisions, probably so, said Thaddeus Pope, director of the Health Law Institute at Mitchell Hamline School of Law in St. Paul, Minn. His research has found no laws expressly prohibiting competent people from VSED, and the right to refuse medical and health care intervention is well established.
Still, he pointed out, “absence of prohibition is not the same as permission.” Health care professionals can be reluctant to become involved, because “they want a green light, and there isn’t one of those for VSED,” he added.
The question grows much murkier for patients with dementia or mental illness who have specified VSED under certain circumstances through advance directives. Several states, including Wisconsin and New York, forbid health care surrogates to stop food and fluids. (Oregon legislators, on the other hand, are considering drafting a bill to allow surrogates to withhold nutrition.)
The question intrigues bioethicists. Can your current competent self cut off nutrition and hydration for your future demented self? In a handful of court decisions, judges have declined to enforce such directives.
Can VSED be comfortable and provide a peaceful death?
“The start of it is generally quite comfortable,” Dr. Quill said he had found, having cared for such patients. The not-eating part comes fairly easily, health professionals say; the seriously ill often lose their appetites anyway.
Coping with thirst can be much more difficult. Yet even sips of water prolong the dying process.
“You want a medical partner to manage your symptoms,” Dr. Quill said. “It’s harder than you think.”
Keeping patients’ mouths moistened and having aggressive pain medication available make a big difference, health professionals say.
At the conference, the Dutch researcher Dr. Eva Bolt presented results from a survey of family physicians in the Netherlands, describing 99 cases of VSED. Their patients (median age: 83) had serious diseases and depended on others for everyday care; three-quarters had life expectancies of less than a year.
In their final three days, their doctors reported, 14 percent suffered pain, and smaller percentages experienced fatigue, impaired cognition, thirst or delirium.
Still, 80 percent of the physicians said the process had unfolded as the patients wanted; only 2 percent said it hadn’t. The median time from the start of their fasts until death was seven days.
Those results mirror a 2003 study of hospice nurses in Oregon who had cared for VSED patients. Rating their deaths on a scale from 0 to 9 (a very good death), the nurses assigned a median score of 8. Nearly all of the patients died within 15 days.
The slower pace of death from fasting, compared with ingesting barbiturates, gives people time to say goodbye and, for the first few days, to change their minds. Several conference speakers described patients who had fasted and stopped a few times before continuing until death.
That’s hard on families and caregivers, though. And slowness won’t benefit people who are dying with severe shortness of breath or pain. “Two weeks is a lifetime in that situation,” Dr. Quill said.
Other obstacles could restrict VSED. A quiet choice in a private home, it could be derailed in nursing homes and assisted living facilities where administrators fear lawsuits or regulatory sanctions. Physicians might decline to participate; home care aides might quit.
Moreover, major religious groups have yet to declare whether they consider VSED an acceptable act of self-determination or a suicide, anathema in most faiths.
Phyllis Shacter and her husband, Alan Alberts, a computer scientist who received a Alzheimer’s disease diagnosis in 2011, had few doubts, however. VSED allowed him to escape the disease that had slowly killed his mother.
No state allows a person with dementia to use a “death with dignity” law, but with support from his wife, doctor and two caregivers, Mr. Alberts, 76, died peacefully at home in 2013 after a nine-day fast.
“I’m glad my husband fulfilled his desire not to live into the final stages of Alzheimer’s,” Ms. Shacter said.
On the other hand, Judith Schwarz, clinical coordinator of End of Life Choices New York, told of an 81-year-old attempting VSED with inadequate pain medication, crying out to his wife at night, “I’m dying of thirst.”
“And of course, he was, but slowly,” Dr. Schwarz said. “This was a horror show.”
Del Greenfield fared better. “She didn’t use any medicines, just some oxygen,” her daughter said. Ms. Greenfield’s children, grandchildren and great-grandchildren came to see her, and “she was completely peaceful, chatting and joking and telling people she loved them.”
She announced that she had one regret. “We all leaned in,” Bonnie Reagan said. “And she said, ‘I wish I’d seen the Rolling Stones the last time they came to Portland.’”
On the fifth day of fasting, “she just fell asleep,” and died about 36 hours later.
http://www.nytimes.com/2016/10/25/healt ... dline&te=1
On Assisted Suicide, Going Beyond ‘Do No Harm’
DURHAM, N.C. — Out of nowhere, a patient I recently met in my clinic told me, “If my heart stops, doctor, just let me go.”
“Why?” I asked him.
Without hesitating, he replied, “Because there are worse states than death.”
Advances in medical therapies, in addition to their immense benefits, have changed death to dying — from an instantaneous event to a long, drawn-out process. Death is preceded by years of disability, countless procedures and powerful medications. Only one in five patients is able to die at home. These days many patients fear what it takes to live more than death itself.
That may explain why this year, behind the noise of the presidential campaign, the right-to-die movement has made several big legislative advances. In June, California became the fifth and largest state to put an assisted suicide law into effect; this week the District of Columbia Council passed a similar law. And on Tuesday voters in Colorado will decide whether to allow physician-assisted suicide in their state as well.
Yet even as assisted suicide has generated broader support, the group most vehemently opposed to it hasn’t budged: doctors.
That resistance is traditionally couched in doctors’ adherence to our understanding of the Hippocratic oath. But it’s becoming harder for us to know what is meant by “do no harm.” With the amount of respirators and other apparatus at our disposal, it is almost impossible for most patients to die unless doctors’ or patients’ families end life support. The withdrawal of treatment, therefore, is now perhaps the most common way critically ill patients die in the hospital.
While “withdrawal” implies a passive act, terminating artificial support feels decidedly active. Unlike assisted suicide, which requires patients to be screened for depression, patients can ask for treatment withdrawal even if they have major depression or are suicidal. Furthermore, withdrawal decisions are usually made for patients who are so sick that they frequently have no voice in the matter.
Some doctors skirt the question of assisted suicide through opiate prescriptions, which are almost universally prescribed for patients nearing death. Even though these medications can slow down breathing to the point of stoppage, doctors and nurses are very comfortable giving them, knowing that they might hasten a “natural” death.
In extreme cases, when even morphine isn’t enough, patients are given anesthesia to ease their deaths. The last time I administered what is called terminal sedation, another accepted strategy, was in the case of a patient with abdominal cancer whose intestines were perforated and for whom surgery was not an option. The patient, who had been writhing uncontrollably in pain, was finally comfortable. Yet terminal sedation, necessary as it was, felt closer to active euthanasia than assisted suicide would have.
While the way people die has changed, the arguments made against assisted suicide have not. We are warned of a slippery slope, implying that legalization of assisted suicide would eventually lead to eugenic sterilization reminiscent of Nazi Germany. But no such drift has been observed in any of the countries where it has been legalized.
We are cautioned that legalization would put vulnerable populations like the uninsured and the disabled at risk; however, years of data from Oregon demonstrate that the vast majority of patients who opt for it are white, affluent and highly educated.
We are also told that assisted suicide laws will allow doctors and nurses to avoid providing high-quality palliative care to patients, but the data suggests the opposite: A strong argument for legalization is that it sensitizes doctors about ensuring the comfort of patients with terminal illnesses; if suicide is an option, they’ll do what they can to preclude it.
And, again, we are counseled that physicians should do no harm. But medical harm is already one of the leading causes of death — and in any case, isn’t preventing patients from dying on their terms its own form of medical harm?
With the right safeguards in place, assisted suicide can help give terminally ill patients a semblance of control over their lives as disease, disability and the medical machine tries to wrest it away from them. In Oregon, of the exceedingly few patients who have requested a lethal prescription — 1,545 in 18 years — about 35 percent never uses it; for them, it is merely a means to self-affirmation, a reassuring option.
Instead of using our energies to obfuscate and obstruct how patients might want to end their lives when faced with life-limiting disease, we physicians need to reassess how we can help patients achieve their goals when the end is near. We need to be able to offer an option for those who desire assisted suicide, so that they can openly take control of their death.
Instead of seeking guidance from ancient edicts, we need to re-evaluate just what patients face in modern times. Even if it is a course we personally wouldn’t recommend, we should consider allowing it for patients suffering from debilitating disease. How we die has changed tremendously over the past few decades — and so must we.
Haider Javed Warraich, a fellow in cardiovascular medicine at Duke University Medical Center, is the author of the forthcoming book “Modern Death: How Medicine Changed the End of Life.”
http://www.nytimes.com/2016/11/05/opini ... inion&_r=1
DURHAM, N.C. — Out of nowhere, a patient I recently met in my clinic told me, “If my heart stops, doctor, just let me go.”
“Why?” I asked him.
Without hesitating, he replied, “Because there are worse states than death.”
Advances in medical therapies, in addition to their immense benefits, have changed death to dying — from an instantaneous event to a long, drawn-out process. Death is preceded by years of disability, countless procedures and powerful medications. Only one in five patients is able to die at home. These days many patients fear what it takes to live more than death itself.
That may explain why this year, behind the noise of the presidential campaign, the right-to-die movement has made several big legislative advances. In June, California became the fifth and largest state to put an assisted suicide law into effect; this week the District of Columbia Council passed a similar law. And on Tuesday voters in Colorado will decide whether to allow physician-assisted suicide in their state as well.
Yet even as assisted suicide has generated broader support, the group most vehemently opposed to it hasn’t budged: doctors.
That resistance is traditionally couched in doctors’ adherence to our understanding of the Hippocratic oath. But it’s becoming harder for us to know what is meant by “do no harm.” With the amount of respirators and other apparatus at our disposal, it is almost impossible for most patients to die unless doctors’ or patients’ families end life support. The withdrawal of treatment, therefore, is now perhaps the most common way critically ill patients die in the hospital.
While “withdrawal” implies a passive act, terminating artificial support feels decidedly active. Unlike assisted suicide, which requires patients to be screened for depression, patients can ask for treatment withdrawal even if they have major depression or are suicidal. Furthermore, withdrawal decisions are usually made for patients who are so sick that they frequently have no voice in the matter.
Some doctors skirt the question of assisted suicide through opiate prescriptions, which are almost universally prescribed for patients nearing death. Even though these medications can slow down breathing to the point of stoppage, doctors and nurses are very comfortable giving them, knowing that they might hasten a “natural” death.
In extreme cases, when even morphine isn’t enough, patients are given anesthesia to ease their deaths. The last time I administered what is called terminal sedation, another accepted strategy, was in the case of a patient with abdominal cancer whose intestines were perforated and for whom surgery was not an option. The patient, who had been writhing uncontrollably in pain, was finally comfortable. Yet terminal sedation, necessary as it was, felt closer to active euthanasia than assisted suicide would have.
While the way people die has changed, the arguments made against assisted suicide have not. We are warned of a slippery slope, implying that legalization of assisted suicide would eventually lead to eugenic sterilization reminiscent of Nazi Germany. But no such drift has been observed in any of the countries where it has been legalized.
We are cautioned that legalization would put vulnerable populations like the uninsured and the disabled at risk; however, years of data from Oregon demonstrate that the vast majority of patients who opt for it are white, affluent and highly educated.
We are also told that assisted suicide laws will allow doctors and nurses to avoid providing high-quality palliative care to patients, but the data suggests the opposite: A strong argument for legalization is that it sensitizes doctors about ensuring the comfort of patients with terminal illnesses; if suicide is an option, they’ll do what they can to preclude it.
And, again, we are counseled that physicians should do no harm. But medical harm is already one of the leading causes of death — and in any case, isn’t preventing patients from dying on their terms its own form of medical harm?
With the right safeguards in place, assisted suicide can help give terminally ill patients a semblance of control over their lives as disease, disability and the medical machine tries to wrest it away from them. In Oregon, of the exceedingly few patients who have requested a lethal prescription — 1,545 in 18 years — about 35 percent never uses it; for them, it is merely a means to self-affirmation, a reassuring option.
Instead of using our energies to obfuscate and obstruct how patients might want to end their lives when faced with life-limiting disease, we physicians need to reassess how we can help patients achieve their goals when the end is near. We need to be able to offer an option for those who desire assisted suicide, so that they can openly take control of their death.
Instead of seeking guidance from ancient edicts, we need to re-evaluate just what patients face in modern times. Even if it is a course we personally wouldn’t recommend, we should consider allowing it for patients suffering from debilitating disease. How we die has changed tremendously over the past few decades — and so must we.
Haider Javed Warraich, a fellow in cardiovascular medicine at Duke University Medical Center, is the author of the forthcoming book “Modern Death: How Medicine Changed the End of Life.”
http://www.nytimes.com/2016/11/05/opini ... inion&_r=1
Physician Aid in Dying Gains Acceptance in the U.S.
Extract:
In recent months, this option has become available to a growing number of Americans. Last June, aid-in-dying legislation took effect in California, the most populous state. In November, Colorado voters approved a ballot measure by nearly a two-thirds majority. The District of Columbia Council has passed a similar law, and the mayor quietly signed it last month.
Aid in dying was already legal in Washington, Vermont, Montana and Oregon. So even if the District of Columbia’s law is blocked, as a prominent Republican representative has threatened to do, the country has arrived at a remarkable moment: Close to 20 percent of Americans live in jurisdictions where adults can legally end their lives if they are terminally ill and meet eligibility requirements.
More..
https://www.nytimes.com/2017/01/16/heal ... 05309&_r=0[/b]
Extract:
In recent months, this option has become available to a growing number of Americans. Last June, aid-in-dying legislation took effect in California, the most populous state. In November, Colorado voters approved a ballot measure by nearly a two-thirds majority. The District of Columbia Council has passed a similar law, and the mayor quietly signed it last month.
Aid in dying was already legal in Washington, Vermont, Montana and Oregon. So even if the District of Columbia’s law is blocked, as a prominent Republican representative has threatened to do, the country has arrived at a remarkable moment: Close to 20 percent of Americans live in jurisdictions where adults can legally end their lives if they are terminally ill and meet eligibility requirements.
More..
https://www.nytimes.com/2017/01/16/heal ... 05309&_r=0[/b]
1,300 Canadians have died with medical assistance since legalization — here's one man's story
'I just told him I loved him, held him,' man's husband tells CBC about medically assisted death
On Friday Jan. 6, Rob Rollins and his husband John MacTavish woke up just as they would any other morning. John got his brother Bobby MacTavish, who is unable to speak or walk, ready to go to his day program. But this time, before he left, Bobby spent about an hour with Rollins in his bedroom. The two were saying goodbye.
One of the couple's closest friends, Claire Cowley, soon arrived and sat in the living room with Rollins and MacTavish. The three were chatting "like it was any other morning," MacTavish says. "Which was weird, because I kept looking at the clock, knowing that, you know, the doctor was going to drive in that driveway."
Before the doctor arrived, Rollins, 56, wanted to make sure some practical things were in order.
"[He] tidied up his desk, made sure I knew where things were and gave me the passwords," MacTavish, 54, says. "You know, made sure that I knew how to run the dishwasher."
A nurse from their rural village of Delta, northeast of Kingston, Ont., who had cared for Rollins as he battled throat and neck cancer, arrived at about 10 a.m. and inserted an IV tube into his arm. His family doctor also came, although he wasn't required to, and the group kept chatting.
MacTavish says when the local doctor who would do the final procedure arrived at the house "he talked to Rob to make sure that Rob knew what was happening and still agreeable."
The couple walked down the hallway of their small house and Rollins had a cigarette, while MacTavish held his hand. Then, they came back to the living room.
"He said goodbye to Claire, who's his best friend, to the doctors and the nurse," MacTavish remembers. "We went into the bedroom, he got into bed. I covered him up with his quilt. I laid down beside him. The doctor came in and asked if there was anything we needed to say to each other."
Then, he administered the lethal dose of medication through Rollins's IV tube.
"I just told him I loved him, held him," MacTavish says through tears. "And it was over in about five minutes. Very peaceful."
More..
http://www.cbc.ca/beta/news/health/medi ... -1.4056700
'I just told him I loved him, held him,' man's husband tells CBC about medically assisted death
On Friday Jan. 6, Rob Rollins and his husband John MacTavish woke up just as they would any other morning. John got his brother Bobby MacTavish, who is unable to speak or walk, ready to go to his day program. But this time, before he left, Bobby spent about an hour with Rollins in his bedroom. The two were saying goodbye.
One of the couple's closest friends, Claire Cowley, soon arrived and sat in the living room with Rollins and MacTavish. The three were chatting "like it was any other morning," MacTavish says. "Which was weird, because I kept looking at the clock, knowing that, you know, the doctor was going to drive in that driveway."
Before the doctor arrived, Rollins, 56, wanted to make sure some practical things were in order.
"[He] tidied up his desk, made sure I knew where things were and gave me the passwords," MacTavish, 54, says. "You know, made sure that I knew how to run the dishwasher."
A nurse from their rural village of Delta, northeast of Kingston, Ont., who had cared for Rollins as he battled throat and neck cancer, arrived at about 10 a.m. and inserted an IV tube into his arm. His family doctor also came, although he wasn't required to, and the group kept chatting.
MacTavish says when the local doctor who would do the final procedure arrived at the house "he talked to Rob to make sure that Rob knew what was happening and still agreeable."
The couple walked down the hallway of their small house and Rollins had a cigarette, while MacTavish held his hand. Then, they came back to the living room.
"He said goodbye to Claire, who's his best friend, to the doctors and the nurse," MacTavish remembers. "We went into the bedroom, he got into bed. I covered him up with his quilt. I laid down beside him. The doctor came in and asked if there was anything we needed to say to each other."
Then, he administered the lethal dose of medication through Rollins's IV tube.
"I just told him I loved him, held him," MacTavish says through tears. "And it was over in about five minutes. Very peaceful."
More..
http://www.cbc.ca/beta/news/health/medi ... -1.4056700
Should I Help My Patients Die?
OAKLAND, Calif. — I WAS leafing through a patient’s chart last year when a colleague tapped me on the shoulder. “I have a patient who is asking about the End of Life Option Act,” he said in a low voice. “Can we even do that here?”
I practice both critical and palliative care medicine at a public hospital in Oakland. In June 2016, our state became the fourth in the nation to allow medical aid in dying for patients suffering from terminal illness. Oregon was the pioneer 20 years ago. Washington and Vermont followed suit more recently. (Colorado voters passed a similar law in November.) Now, five months after the law took effect here in California, I was facing my first request for assistance to shorten the life of a patient.
That week, I was the attending physician on the palliative care service. Since palliative care medicine focuses on the treatment of all forms of suffering in serious illness, my colleague assumed that I would know what to do with this request. I didn’t.
I could see my own discomfort mirrored in his face. “Can you help us with it?” he asked me. “Of course,” I said. Then I felt my stomach lurch.
California’s law permits physicians to prescribe a lethal cocktail to patients who request it and meet certain criteria: They must be adults expected to die within six months who are able to self-administer the drug and retain the mental capacity to make a decision like this.
But that is where the law leaves off. The details of patient selection and protocol, even the composition of the lethal compound, are left to the individual doctor or hospital policy. Our hospital, like many others at that time, was still in the early stages of creating a policy and procedure. To me and many of my colleagues in California, it felt as if the law had passed so quickly that we weren’t fully prepared to deal with it.
More...
https://www.nytimes.com/2017/08/05/opin ... inion&_r=0
OAKLAND, Calif. — I WAS leafing through a patient’s chart last year when a colleague tapped me on the shoulder. “I have a patient who is asking about the End of Life Option Act,” he said in a low voice. “Can we even do that here?”
I practice both critical and palliative care medicine at a public hospital in Oakland. In June 2016, our state became the fourth in the nation to allow medical aid in dying for patients suffering from terminal illness. Oregon was the pioneer 20 years ago. Washington and Vermont followed suit more recently. (Colorado voters passed a similar law in November.) Now, five months after the law took effect here in California, I was facing my first request for assistance to shorten the life of a patient.
That week, I was the attending physician on the palliative care service. Since palliative care medicine focuses on the treatment of all forms of suffering in serious illness, my colleague assumed that I would know what to do with this request. I didn’t.
I could see my own discomfort mirrored in his face. “Can you help us with it?” he asked me. “Of course,” I said. Then I felt my stomach lurch.
California’s law permits physicians to prescribe a lethal cocktail to patients who request it and meet certain criteria: They must be adults expected to die within six months who are able to self-administer the drug and retain the mental capacity to make a decision like this.
But that is where the law leaves off. The details of patient selection and protocol, even the composition of the lethal compound, are left to the individual doctor or hospital policy. Our hospital, like many others at that time, was still in the early stages of creating a policy and procedure. To me and many of my colleagues in California, it felt as if the law had passed so quickly that we weren’t fully prepared to deal with it.
More...
https://www.nytimes.com/2017/08/05/opin ... inion&_r=0
A sombre success
The Australian state of Victoria legalises assisted dying
Some 50 bills have been introduced in different Australian states. This is the first to pass
THE quest has failed many times. The past 20 years have seen around 50 attempts to pass laws in different Australian states to allow doctors to help terminally ill people end their lives. All have suffered defeat. But on November 29th Victoria finally made history, when its parliament passed Australia’s first state law to legalise doctor-assisted dying.
The law, which will take effect in 2019, allows people with an advanced, incurable illness to request “assisted dying” if their suffering cannot be relieved “in a manner that the person considers tolerable”. Patients must make three successive requests for such help; doctors are banned from initiating discussion of it as an option. The original bill had proposed limiting eligibility to those who were expected to live no more than a year. Victoria’s lawmakers reduced that to six months, with a few exceptions.
Most earlier attempts to legalise assisted dying were private members’ bills, but the state government proposed this one. Brian Owler, a neurosurgeon advising the government, believes this was crucial to its success. Daniel Andrews, Victoria’s premier, and Jill Hennessy, its health minister, both said that seeing a parent suffer from a debilitating illness had led them to support the law.
Assisted dying is legal only in Colombia, Canada, a few European countries and some American states. Mr Andrews says the new law is the most conservative in the world. Yet it has rankled some other members of his party, Labor. Paul Keating, a former Labor prime minister, says it “stands for everything a truly civil society should stand against”.
It has divided doctors, too. Michael Gannon, head of the Australian Medical Association, a lobby group, says Victoria’s parliament has “changed one of the fundamentals of medical ethics”. Doctors are “concerned about where it might lead”. Mr Owler retorts: “It’s not about doctors. It’s about people who are suffering and dying.” Andrew McGee, a health-law specialist at Queensland University of Technology, thinks Victoria’s law prevailed because the government had embarked earlier on a “thorough” public inquiry that reassured people “this type of regime can succeed.”
Australia has six states and two self-governing territories. The Northern Territory legalised assisted dying 21 years ago. But the national government can overturn territorial legislation, and did so on that occasion within a year. It has no such power over state laws, however. Malcolm Turnbull, Australia’s prime minister, who leads the right-wing Liberal Party, says he would not have voted for Victoria’s law. But Mr Owler is confident it will become a “blueprint” for change elsewhere in Australia.
https://www.economist.com/news/asia/217 ... lydispatch
The Australian state of Victoria legalises assisted dying
Some 50 bills have been introduced in different Australian states. This is the first to pass
THE quest has failed many times. The past 20 years have seen around 50 attempts to pass laws in different Australian states to allow doctors to help terminally ill people end their lives. All have suffered defeat. But on November 29th Victoria finally made history, when its parliament passed Australia’s first state law to legalise doctor-assisted dying.
The law, which will take effect in 2019, allows people with an advanced, incurable illness to request “assisted dying” if their suffering cannot be relieved “in a manner that the person considers tolerable”. Patients must make three successive requests for such help; doctors are banned from initiating discussion of it as an option. The original bill had proposed limiting eligibility to those who were expected to live no more than a year. Victoria’s lawmakers reduced that to six months, with a few exceptions.
Most earlier attempts to legalise assisted dying were private members’ bills, but the state government proposed this one. Brian Owler, a neurosurgeon advising the government, believes this was crucial to its success. Daniel Andrews, Victoria’s premier, and Jill Hennessy, its health minister, both said that seeing a parent suffer from a debilitating illness had led them to support the law.
Assisted dying is legal only in Colombia, Canada, a few European countries and some American states. Mr Andrews says the new law is the most conservative in the world. Yet it has rankled some other members of his party, Labor. Paul Keating, a former Labor prime minister, says it “stands for everything a truly civil society should stand against”.
It has divided doctors, too. Michael Gannon, head of the Australian Medical Association, a lobby group, says Victoria’s parliament has “changed one of the fundamentals of medical ethics”. Doctors are “concerned about where it might lead”. Mr Owler retorts: “It’s not about doctors. It’s about people who are suffering and dying.” Andrew McGee, a health-law specialist at Queensland University of Technology, thinks Victoria’s law prevailed because the government had embarked earlier on a “thorough” public inquiry that reassured people “this type of regime can succeed.”
Australia has six states and two self-governing territories. The Northern Territory legalised assisted dying 21 years ago. But the national government can overturn territorial legislation, and did so on that occasion within a year. It has no such power over state laws, however. Malcolm Turnbull, Australia’s prime minister, who leads the right-wing Liberal Party, says he would not have voted for Victoria’s law. But Mr Owler is confident it will become a “blueprint” for change elsewhere in Australia.
https://www.economist.com/news/asia/217 ... lydispatch
Guernsey considers whether to legalise assisted dying
Coming out in favour could put the island on course for a constitutional clash with Britain
PEOPLE used to joke, “Welcome to Guernsey, please put your watch back 50 years,” recalls Tony Lee, who moved to the island in the 1970s to work as a doctor. The British crown dependency off the coast of France, formerly part of the ancient duchy of Normandy, is a conservative place (its politics are characterised by “inertia”, notes one politician). Only in 2015 did all shops gain the right to trade on a Sunday, for instance, and its narrow lanes are dotted with churches. All this makes it an unlikely location for the trailblazing introduction of a controversial policy.
Nevertheless, in May the island’s parliament, the States of Deliberation, will vote on whether to legalise assisted dying. If its 40 members come down in favour, a working party would examine issues like whether to restrict the right to those with terminal illnesses, and how doctors’ approval might work, before returning with a fleshed-out proposal in 18 months. Such a vote would set Guernsey on the path to becoming the first place in the British Isles to legalise assisted dying—and, in doing so, raise thorny constitutional questions.
More...
https://www.economist.com/news/britain/ ... m=20180410
Coming out in favour could put the island on course for a constitutional clash with Britain
PEOPLE used to joke, “Welcome to Guernsey, please put your watch back 50 years,” recalls Tony Lee, who moved to the island in the 1970s to work as a doctor. The British crown dependency off the coast of France, formerly part of the ancient duchy of Normandy, is a conservative place (its politics are characterised by “inertia”, notes one politician). Only in 2015 did all shops gain the right to trade on a Sunday, for instance, and its narrow lanes are dotted with churches. All this makes it an unlikely location for the trailblazing introduction of a controversial policy.
Nevertheless, in May the island’s parliament, the States of Deliberation, will vote on whether to legalise assisted dying. If its 40 members come down in favour, a working party would examine issues like whether to restrict the right to those with terminal illnesses, and how doctors’ approval might work, before returning with a fleshed-out proposal in 18 months. Such a vote would set Guernsey on the path to becoming the first place in the British Isles to legalise assisted dying—and, in doing so, raise thorny constitutional questions.
More...
https://www.economist.com/news/britain/ ... m=20180410
Why David Goodall, 104, Renowned Australian Scientist, Wants to Die
David Goodall, 104, an accomplished Australian scientist, isn’t terminally ill, but he wants to die.
Mr. Goodall says his quality of life has deteriorated so badly that he has no reason to live, and he would like to end his life through assisted suicide. But he can’t do it in his own country, where the practice is banned.
So on Wednesday, he took what was expected to be his last flight, bound for Europe, to accomplish his goal — and his quest has renewed a debate in Australia about the right to end one’s life and what role others should play.
Mr. Goodall left his home in Perth to fly to an assisted-dying agency in Basel, Switzerland, a country where assisted suicide has been allowed for decades.
Though nations like Belgium, Canada, Colombia, Luxembourg and the Netherlands (along with some American states and the District of Columbia) permit euthanasia or assisted suicide, Switzerland is the only country with centers that offer assisted-suicide services to foreigners if the person assisting acts unselfishly.
More....
https://www.nytimes.com/2018/05/03/worl ... 9877220504
David Goodall, 104, an accomplished Australian scientist, isn’t terminally ill, but he wants to die.
Mr. Goodall says his quality of life has deteriorated so badly that he has no reason to live, and he would like to end his life through assisted suicide. But he can’t do it in his own country, where the practice is banned.
So on Wednesday, he took what was expected to be his last flight, bound for Europe, to accomplish his goal — and his quest has renewed a debate in Australia about the right to end one’s life and what role others should play.
Mr. Goodall left his home in Perth to fly to an assisted-dying agency in Basel, Switzerland, a country where assisted suicide has been allowed for decades.
Though nations like Belgium, Canada, Colombia, Luxembourg and the Netherlands (along with some American states and the District of Columbia) permit euthanasia or assisted suicide, Switzerland is the only country with centers that offer assisted-suicide services to foreigners if the person assisting acts unselfishly.
More....
https://www.nytimes.com/2018/05/03/worl ... 9877220504
Was a Scientist’s Death Murder or an ‘Act of Mercy’?
Excerpt:
Then, one evening this month, Ms. White was found dead. She was 92. Several days later, her daughter was charged with murdering her.
The accusations have stunned people who knew Ms. White and her family, as well as Bundanoon, the small town where neighbors remembered an attentive daughter who would take her mother to the salon for haircuts and stop in the cafe across the street. Many insist that whatever happened must have been motivated by compassion and love.
“It would have been done as an act of mercy,” said Jenny Goldie, a friend who had known Ms. White for 30 years. “There wouldn’t have been any malice attached to it at all.”
The case has saddened and confused Ms. White’s friends. But it has also tapped into the broader debate in Australia over euthanasia and assisted dying, which has been renewed in recent weeks as Parliament considered a proposal to overturn a two-decade-old ban on the practice in the nation’s territories.
The legislation ultimately failed, but last year, the state of Victoria became the first in Australia to legalize assisted dying, allowing someone with an incurable illness and limited life expectancy to obtain a dose of a lethal drug, and other states are considering their own legislation. (The Victoria law requires that a patient be mentally sound enough to make the request on his or her own, preventing relatives or caretakers from applying on an ill person’s behalf.)
More...
https://www.nytimes.com/2018/08/28/worl ... 3053090830
Excerpt:
Then, one evening this month, Ms. White was found dead. She was 92. Several days later, her daughter was charged with murdering her.
The accusations have stunned people who knew Ms. White and her family, as well as Bundanoon, the small town where neighbors remembered an attentive daughter who would take her mother to the salon for haircuts and stop in the cafe across the street. Many insist that whatever happened must have been motivated by compassion and love.
“It would have been done as an act of mercy,” said Jenny Goldie, a friend who had known Ms. White for 30 years. “There wouldn’t have been any malice attached to it at all.”
The case has saddened and confused Ms. White’s friends. But it has also tapped into the broader debate in Australia over euthanasia and assisted dying, which has been renewed in recent weeks as Parliament considered a proposal to overturn a two-decade-old ban on the practice in the nation’s territories.
The legislation ultimately failed, but last year, the state of Victoria became the first in Australia to legalize assisted dying, allowing someone with an incurable illness and limited life expectancy to obtain a dose of a lethal drug, and other states are considering their own legislation. (The Victoria law requires that a patient be mentally sound enough to make the request on his or her own, preventing relatives or caretakers from applying on an ill person’s behalf.)
More...
https://www.nytimes.com/2018/08/28/worl ... 3053090830
Could I Kill My Mother?
I am not a doctor. I am not very brave. But I want to do what she wants.
Excerpt:
Lung cancer is a frightening illness. In its final stages, it can make you feel as though you’re drowning, or suffocating. A formidable pharmacological stew of medications can help to suppress the symptoms, but no pill can take away the pain of waking up each day and remembering all over again that you are about to die.
I know what I’m supposed to do, because she has told me many times. One of the stories passed down as gospel in our tiny family is about how my late father, a doctor, helped his own mother — my grandmother Cecilia, whom I never met — at the end of her life. Her cancer was unbearable. “So he gave her a big dose of morphine to stop the pain,” my mother has always told my brother and me, as if reaching the end of a fairy tale. “It had the side effect of stopping her heart.”
As it happens, I have a big dose of morphine right here in the house. I also have some hefty doses of codeine, Ambien, Haldol and Ativan that I’ve cunningly stockpiled from the hospice service, like a squirrel hoarding for winter. In my top drawer, next to Mom’s passport, are more than 100 micrograms worth of fentanyl patches — enough to kill her and several passers-by.
But I am not a trained assassin. I am not a doctor. I am not very brave. I’m just a person who wants to do the most important thing that her mother has ever asked of her. I’m also a resident of New York State, where assisted suicide is illegal.
More...
https://www.nytimes.com/2018/08/31/sund ... 3053090901
I am not a doctor. I am not very brave. But I want to do what she wants.
Excerpt:
Lung cancer is a frightening illness. In its final stages, it can make you feel as though you’re drowning, or suffocating. A formidable pharmacological stew of medications can help to suppress the symptoms, but no pill can take away the pain of waking up each day and remembering all over again that you are about to die.
I know what I’m supposed to do, because she has told me many times. One of the stories passed down as gospel in our tiny family is about how my late father, a doctor, helped his own mother — my grandmother Cecilia, whom I never met — at the end of her life. Her cancer was unbearable. “So he gave her a big dose of morphine to stop the pain,” my mother has always told my brother and me, as if reaching the end of a fairy tale. “It had the side effect of stopping her heart.”
As it happens, I have a big dose of morphine right here in the house. I also have some hefty doses of codeine, Ambien, Haldol and Ativan that I’ve cunningly stockpiled from the hospice service, like a squirrel hoarding for winter. In my top drawer, next to Mom’s passport, are more than 100 micrograms worth of fentanyl patches — enough to kill her and several passers-by.
But I am not a trained assassin. I am not a doctor. I am not very brave. I’m just a person who wants to do the most important thing that her mother has ever asked of her. I’m also a resident of New York State, where assisted suicide is illegal.
More...
https://www.nytimes.com/2018/08/31/sund ... 3053090901
British doctors move to end their opposition to assisted dying
But the circumstances have provoked accusations of a stitch-up
IN THE HALF-MILLENNIUM since it was founded the Royal College of Physicians has seen plenty of squabbles, including the storming of its building in the 18th century over its exclusion of non-Oxbridge graduates, and a long battle over whether to admit women (which, after four centuries, it did). The latest row is over one of the most fundamental medical questions of all: should doctors help willing patients to die?
The college is surveying its 35,000 members on whether to back changes to the law on assisted dying, which is illegal in Britain. Five years ago 44% of them voted against and 25% in favour (the rest were neutral). Under the rules then, the plurality of votes against changing the law was enough to carry the day. This time, the college has decided that a supermajority of 60% is needed for either side to win. Since neither the pro nor anti doctors are expected to reach this threshold, the organisation looks likely to default to a neutral stance.
More...
https://www.economist.com/britain/2019/ ... sted-dying
But the circumstances have provoked accusations of a stitch-up
IN THE HALF-MILLENNIUM since it was founded the Royal College of Physicians has seen plenty of squabbles, including the storming of its building in the 18th century over its exclusion of non-Oxbridge graduates, and a long battle over whether to admit women (which, after four centuries, it did). The latest row is over one of the most fundamental medical questions of all: should doctors help willing patients to die?
The college is surveying its 35,000 members on whether to back changes to the law on assisted dying, which is illegal in Britain. Five years ago 44% of them voted against and 25% in favour (the rest were neutral). Under the rules then, the plurality of votes against changing the law was enough to carry the day. This time, the college has decided that a supermajority of 60% is needed for either side to win. Since neither the pro nor anti doctors are expected to reach this threshold, the organisation looks likely to default to a neutral stance.
More...
https://www.economist.com/britain/2019/ ... sted-dying
Aid in Dying Soon Will be Available to More Americans. Few Will Choose It.
By October, more than one in five U.S. adults will be able to obtain lethal prescriptions if terminally ill. But for those who try, obstacles remain.
On Aug. 1, New Jersey will become the eighth state to allow doctors to prescribe lethal medication to terminally ill patients who want to end their lives. On Sept. 15, Maine will become the ninth.
So by October, 22 percent of Americans will live in places where residents with six months or less to live can, in theory, exercise some control over the time and manner of their deaths. (The others: Oregon, Washington, Vermont, Montana, California, Colorado and Hawaii, as well as the District of Columbia.)
But while the campaign for aid in dying continues to make gains, supporters are increasingly concerned about what happens after these laws are passed. Many force the dying to navigate an overly complicated process of requests and waiting periods, critics say.
And opt-out provisions — which allow doctors to decline to participate and health care systems to forbid their participation — are restricting access even in some places where aid in dying is legal.
More....
https://www.nytimes.com/2019/07/08/heal ... 3053090709
By October, more than one in five U.S. adults will be able to obtain lethal prescriptions if terminally ill. But for those who try, obstacles remain.
On Aug. 1, New Jersey will become the eighth state to allow doctors to prescribe lethal medication to terminally ill patients who want to end their lives. On Sept. 15, Maine will become the ninth.
So by October, 22 percent of Americans will live in places where residents with six months or less to live can, in theory, exercise some control over the time and manner of their deaths. (The others: Oregon, Washington, Vermont, Montana, California, Colorado and Hawaii, as well as the District of Columbia.)
But while the campaign for aid in dying continues to make gains, supporters are increasingly concerned about what happens after these laws are passed. Many force the dying to navigate an overly complicated process of requests and waiting periods, critics say.
And opt-out provisions — which allow doctors to decline to participate and health care systems to forbid their participation — are restricting access even in some places where aid in dying is legal.
More....
https://www.nytimes.com/2019/07/08/heal ... 3053090709
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Teen Rape Survivor Who Requested Euthanasia Ends Her Life
Newser — Jenn Gidman
"After years of struggling and fighting, it's over." So reads a Dutch teen's "sad last post" Saturday on her Instagram account, noting she'd stopped eating and drinking and would soon be free from "[unbearable] suffering." The Washington Post reports on the right-to-die case of 17-year-old Noa Pothoven, who suffered from PTSD, depression, and anorexia after being sexually assaulted at age 11, then raped at 14.
Noa's sister confirmed her death Sunday, with the Australian reporting Noa died at her Arnhem home after saying goodbye to family and friends. Noa wrote that her decision wasn't "impulsive," made only "after many conversations and assessments." It's not clear whether Noa had the help of any doctors in dying.
Noa kept her sexual assaults secret for years from her parents out of "fear and shame," per an autobiography she wrote; her mom finally found out what she'd been through when she found goodbye letters Noa had written.
Noa had sought doctors' assistance last year at the Hague's end-of-life clinic, without her parents' knowledge, and was rejected. Her mom and dad had hoped she'd change her mind: Her father told a Dutch paper they wished Noa would "see bright spots [in life] again, perhaps fall in love or learn to discover that life is worth living," per the New York Post. In the Netherlands, which legalized euthanasia in 2001, kids as young as 12 can seek assisted suicide, though until they're 17 they need a parental OK and, like all euthanasia seekers, must demonstrate "hopeless and unbearable suffering." In the US, seven states and the District of Columbia permit assisted suicide, though patients have to take life-ending drugs themselves; New Jersey is set to join that list starting Aug.
This article originally appeared on Newser: Teen Rape Survivor Who Requested Euthanasia Ends Her Life
//start.att.net/news/read/article/newser-teen_rape_survivor_who_requested_euthanasia_ends_h-rnewsernor/category/news
Newser — Jenn Gidman
"After years of struggling and fighting, it's over." So reads a Dutch teen's "sad last post" Saturday on her Instagram account, noting she'd stopped eating and drinking and would soon be free from "[unbearable] suffering." The Washington Post reports on the right-to-die case of 17-year-old Noa Pothoven, who suffered from PTSD, depression, and anorexia after being sexually assaulted at age 11, then raped at 14.
Noa's sister confirmed her death Sunday, with the Australian reporting Noa died at her Arnhem home after saying goodbye to family and friends. Noa wrote that her decision wasn't "impulsive," made only "after many conversations and assessments." It's not clear whether Noa had the help of any doctors in dying.
Noa kept her sexual assaults secret for years from her parents out of "fear and shame," per an autobiography she wrote; her mom finally found out what she'd been through when she found goodbye letters Noa had written.
Noa had sought doctors' assistance last year at the Hague's end-of-life clinic, without her parents' knowledge, and was rejected. Her mom and dad had hoped she'd change her mind: Her father told a Dutch paper they wished Noa would "see bright spots [in life] again, perhaps fall in love or learn to discover that life is worth living," per the New York Post. In the Netherlands, which legalized euthanasia in 2001, kids as young as 12 can seek assisted suicide, though until they're 17 they need a parental OK and, like all euthanasia seekers, must demonstrate "hopeless and unbearable suffering." In the US, seven states and the District of Columbia permit assisted suicide, though patients have to take life-ending drugs themselves; New Jersey is set to join that list starting Aug.
This article originally appeared on Newser: Teen Rape Survivor Who Requested Euthanasia Ends Her Life
//start.att.net/news/read/article/newser-teen_rape_survivor_who_requested_euthanasia_ends_h-rnewsernor/category/news
On assisted suicide, the slope is proving every bit as slippery as feared
When, in 2015, the Supreme Court of Canada struck down the section of the Criminal Code forbidding assisting suicide, it overturned not only the law but its own previous ruling, in the celebrated 1993 case of Sue Rodriguez.
Courts are usually loath to do this: Under the legal doctrine of stare decisis, they are generally bound to follow precedent. However, the court found “the matrix of social and legislative facts” surrounding the 2015 case, known as Carter v. Canada, had changed so dramatically since the Rodriguez case as to justify it in taking the opposite approach.
For whereas the court had been persuaded, in Rodriguez, that an absolute prohibition on the practice was necessary to prevent a more general erosion of the taboo against taking human life, by 2015 it felt confident in setting aside this concern. The potential threat to vulnerable people, whether through error, coercion or systemic prejudice, could be averted by “a carefully designed and monitored system of safeguards.”
Evidence of widespread evasion of such safeguards in Belgium and the Netherlands, where assisted suicide had previously been legalized, was dismissed as “anecdotal,” while the widening of its application in those countries, from the consenting adults originally envisaged, to children and the mentally ill, was waved away as the product of a different “medico-legal culture.” In essence, the court said, it can’t happen here.
This was not just an incidental point. This was central to the court’s reasoning, the thing that allowed it to ignore the precedent set in Rodriguez. Legalizing assisted suicide, relaxing the prohibition in place for centuries in virtually all Western countries, need not open the floodgates, as feared. It could be limited to consenting adults, of sound mind, in the last agonizing stages of a terminal illness – the sorts of people who had come before the court in Carter and Rodriguez, the sorts of cases that had moved the public to support their cause.
Yet here we are, in 2020, considering whether to legalize assisted suicide for non-terminal cases, for the mentally ill, even for children – sorry, “mature minors.” The government has launched a two-week public consultation exercise on these and other issues, with legislation likely to follow later in the year. The slope has in fact proved every bit as slippery as the critics had warned.
Indeed, the court itself began the process. All of the evidence before it had concerned those in unbearable physical pain – and not only pain but incapacity, such as to require the assistance of another to end their lives. The court noted the “cruel choice” faced by those who, while still physically capable of killing themselves at present, might not be so in future, as the disease progressed. Assisted suicide was thus presented as, oddly, a way of prolonging life, rather than shortening it, allowing patients to have others do later what they would otherwise be forced to do themselves, earlier.
And yet in its decision, the court opened the doors to assisted suicide, not merely in cases of physical but also psychological pain. There was no necessity that the illness be terminal, or incapacitating: only that it be a “grievous and irremediable medical condition” that imposed suffering that was “intolerable to the individual.”
Hardly had the decision been issued, moreover, when the clamour went up to further loosen the law. Federal legislation, drafted in response, that included a requirement that the patient’s “natural death has become reasonably foreseeable,” was assailed as unconstitutional, as a Quebec court eventually ruled – the ostensible reason for the current exercise.
But it was always clear that this was just the start: Even as it was presenting the legislation, the Trudeau government signalled its openness to further liberalization. Which is why the coming review will embrace much more than whether the right to assisted suicide should be restricted to the terminally ill.
STORY CONTINUES BELOW ADVERTISEMENT
It could not be otherwise. Once you have accepted the logic of legalization – that death is no longer to be viewed as a terrible tragedy, something we should wish if possible to prevent, but as a blessing, a release from suffering we should wish to assist – all else follows.
The notion underlying the court’s ruling, that we could erase or elide certain important moral distinctions – between killing yourself, say, and enlisting others to kill you, or between death by natural causes and death by human intervention – while insisting on a host of others, appealing to the unlimited personal autonomy to decide one’s fate on the one hand while hedging it about with all manner of limits on the other, was always bound to collapse on itself.
Was it really to be imagined that we would extend the right to free themselves, or rather have others free them, from intolerable suffering to adults, but would condemn children to years of unendurable pain? Did we honestly think the courts would continue to restrict assisted suicide to those capable of “consenting” to it – as if mere mental incapacity should be any more of a barrier to those in need of its relief than physical?
We may not have fully realized it at the time, but what we were entertaining when we took our first steps down this road was not the legalization of a previously prohibited practice, but the normalization of it. Which is how assisted suicide passed, almost instantaneously, from criminal, to legal, to mandatory – with doctors and hospitals ordered to provide the “service,” or refer patients to others who will, and at public expense.
Which raises a peculiar irony. If the fundamental premise underlying the court’s ruling in Carter, that the fears to which it had deferred in Rodriguez had proved unfounded, has itself proved unfounded; if the limited, exceptional cases it foresaw have already become widespread and unexceptional (more than 4,000 cases of assisted suicide, 1.1 per cent of all deaths, were reported across Canada in 2018, up from roughly 2,500 the previous year), with whatever limits remain likely to be removed; has the “matrix of social and legislative facts” not changed again? Is there not ample cause for the court to revisit Carter, as earlier it revisited Rodriguez?
https://www.theglobeandmail.com/opinion ... VgMaFxFnIY
When, in 2015, the Supreme Court of Canada struck down the section of the Criminal Code forbidding assisting suicide, it overturned not only the law but its own previous ruling, in the celebrated 1993 case of Sue Rodriguez.
Courts are usually loath to do this: Under the legal doctrine of stare decisis, they are generally bound to follow precedent. However, the court found “the matrix of social and legislative facts” surrounding the 2015 case, known as Carter v. Canada, had changed so dramatically since the Rodriguez case as to justify it in taking the opposite approach.
For whereas the court had been persuaded, in Rodriguez, that an absolute prohibition on the practice was necessary to prevent a more general erosion of the taboo against taking human life, by 2015 it felt confident in setting aside this concern. The potential threat to vulnerable people, whether through error, coercion or systemic prejudice, could be averted by “a carefully designed and monitored system of safeguards.”
Evidence of widespread evasion of such safeguards in Belgium and the Netherlands, where assisted suicide had previously been legalized, was dismissed as “anecdotal,” while the widening of its application in those countries, from the consenting adults originally envisaged, to children and the mentally ill, was waved away as the product of a different “medico-legal culture.” In essence, the court said, it can’t happen here.
This was not just an incidental point. This was central to the court’s reasoning, the thing that allowed it to ignore the precedent set in Rodriguez. Legalizing assisted suicide, relaxing the prohibition in place for centuries in virtually all Western countries, need not open the floodgates, as feared. It could be limited to consenting adults, of sound mind, in the last agonizing stages of a terminal illness – the sorts of people who had come before the court in Carter and Rodriguez, the sorts of cases that had moved the public to support their cause.
Yet here we are, in 2020, considering whether to legalize assisted suicide for non-terminal cases, for the mentally ill, even for children – sorry, “mature minors.” The government has launched a two-week public consultation exercise on these and other issues, with legislation likely to follow later in the year. The slope has in fact proved every bit as slippery as the critics had warned.
Indeed, the court itself began the process. All of the evidence before it had concerned those in unbearable physical pain – and not only pain but incapacity, such as to require the assistance of another to end their lives. The court noted the “cruel choice” faced by those who, while still physically capable of killing themselves at present, might not be so in future, as the disease progressed. Assisted suicide was thus presented as, oddly, a way of prolonging life, rather than shortening it, allowing patients to have others do later what they would otherwise be forced to do themselves, earlier.
And yet in its decision, the court opened the doors to assisted suicide, not merely in cases of physical but also psychological pain. There was no necessity that the illness be terminal, or incapacitating: only that it be a “grievous and irremediable medical condition” that imposed suffering that was “intolerable to the individual.”
Hardly had the decision been issued, moreover, when the clamour went up to further loosen the law. Federal legislation, drafted in response, that included a requirement that the patient’s “natural death has become reasonably foreseeable,” was assailed as unconstitutional, as a Quebec court eventually ruled – the ostensible reason for the current exercise.
But it was always clear that this was just the start: Even as it was presenting the legislation, the Trudeau government signalled its openness to further liberalization. Which is why the coming review will embrace much more than whether the right to assisted suicide should be restricted to the terminally ill.
STORY CONTINUES BELOW ADVERTISEMENT
It could not be otherwise. Once you have accepted the logic of legalization – that death is no longer to be viewed as a terrible tragedy, something we should wish if possible to prevent, but as a blessing, a release from suffering we should wish to assist – all else follows.
The notion underlying the court’s ruling, that we could erase or elide certain important moral distinctions – between killing yourself, say, and enlisting others to kill you, or between death by natural causes and death by human intervention – while insisting on a host of others, appealing to the unlimited personal autonomy to decide one’s fate on the one hand while hedging it about with all manner of limits on the other, was always bound to collapse on itself.
Was it really to be imagined that we would extend the right to free themselves, or rather have others free them, from intolerable suffering to adults, but would condemn children to years of unendurable pain? Did we honestly think the courts would continue to restrict assisted suicide to those capable of “consenting” to it – as if mere mental incapacity should be any more of a barrier to those in need of its relief than physical?
We may not have fully realized it at the time, but what we were entertaining when we took our first steps down this road was not the legalization of a previously prohibited practice, but the normalization of it. Which is how assisted suicide passed, almost instantaneously, from criminal, to legal, to mandatory – with doctors and hospitals ordered to provide the “service,” or refer patients to others who will, and at public expense.
Which raises a peculiar irony. If the fundamental premise underlying the court’s ruling in Carter, that the fears to which it had deferred in Rodriguez had proved unfounded, has itself proved unfounded; if the limited, exceptional cases it foresaw have already become widespread and unexceptional (more than 4,000 cases of assisted suicide, 1.1 per cent of all deaths, were reported across Canada in 2018, up from roughly 2,500 the previous year), with whatever limits remain likely to be removed; has the “matrix of social and legislative facts” not changed again? Is there not ample cause for the court to revisit Carter, as earlier it revisited Rodriguez?
https://www.theglobeandmail.com/opinion ... VgMaFxFnIY
The fight over medical assistance in dying in one B.C. community is getting ugly
A couple of months ago, Angelina Ireland was invited to speak at the Bringing America Back to Life conference in Cleveland.
It’s billed as one of the largest gatherings of the Christian right in the world. Ms. Ireland, from Delta, B.C., was asked to recount her experiences as the president of a hospice society that has gained notoriety in this country for its efforts to ban medical assistance in dying (MAID) from taking place in its facility.
Ms. Ireland told her mainly U.S. audience that she was arriving with a warning: What was happening in Canada would soon be showing up in their country. “It’s like a contagion.” But first she wanted to clarify her bona fides. “I’m a wife, I’m a mother, I’m a Catholic, I’m pro-life, I’m pro-family and I’m pro-gun.”
A resumé that won a healthy round of applause from the crowd.
I recently watched her nearly hour-long appearance in mid-March on YouTube. It was quite a performance. The picture she painted of life in this country since the government decriminalized medical assistance in dying in 2016 was frightening. Among the things she declared:
That the legislation has ushered in the “dawn of the death industry.” Ms. Ireland defended her stance against MAID by saying she is president of the “Delta Hospice Society, not the Delta Auschwitz Society.” When the B.C. government threatened to strip the society’s funding if it didn’t offer MAID services, she said, it was effectively an order: “Kill or be killed.”
Ms. Ireland also cautioned her audience that this is coming to the U.S., and they need to start developing strategies to fight it “before they compel you to kill your neighbours and your family – because that’s where we are.”
She said there was legislation being drafted that will make MAID available to not just the elderly, but to the disabled, the mentally challenged and children. She offered up the scenario of parents getting a call from a distraught teenager who’d just broken up with her boyfriend wanting to take advantage of MAID. “This is what’s happening now [in Canada],” said Ms. Ireland, who was an unsuccessful candidate for Maxime Bernier’s People’s Party of Canada in the last election. She characterized what was taking place here as “stone-cold communism” and “cultural Marxism.”
When she was asked by someone in the audience what they could do to help, Ms. Ireland said, “The best thing you could do is vote President Trump back in the next election.”
As we say, Ms. Ireland is at the centre of a debate in Delta over a hospice’s right to deny MAID services. She has organized a special meeting of the society next week in the hopes of altering the organization’s constitution to establish it as a Christian-based body. It would have the rejection of MAID entrenched in its bylaws.
Under the language being proposed, any attempt to overturn that bylaw, once passed, would require consent by 100 per cent of the members – a near impossibility as long as the organization has a prominent base of people supporting the mandate being propagated by Ms. Ireland.
Recently, there have been allegations that the current board has been stacking the membership with supporters ahead of the critical June 15 meeting - while denying membership to others who disagree with the direction the society is taking. Ms. Ireland denies this.
What is taking place at the hospice society is simply wrong. The fact is, while it may be a private institution, it was built with money raised from the broader community. It was always intended to meet the needs of those contributors as well. I doubt many donated hoping that one day the society would be taken over by a closed-minded religious element that imposed its Christian canon on the operation.
The province has promised to cut off the $1.5-million in operating funds that go to the Delta Hospice every year if it doesn’t comply with government policy to offer the services of MAID. If the society persists on its present course, the government could move in and close the facility down — it owns the land on which the facility was built.
In some respects, the province must own part of this dispute. The government has offered MAID exemptions to faith-based facilities. This exemption has been linked to the exclusion offered under the federal legislation to doctors who have a “conscientious objection” to participating in the MAID program.
The B.C. government should rethink this policy. It’s one thing to absolve an individual whose conscience won’t allow them to perform a certain procedure. It’s another to give the same pass to a facility that is supposed to serve a broad, polylithic community.
https://www.theglobeandmail.com/opinion ... VgMaFxFnIY
A couple of months ago, Angelina Ireland was invited to speak at the Bringing America Back to Life conference in Cleveland.
It’s billed as one of the largest gatherings of the Christian right in the world. Ms. Ireland, from Delta, B.C., was asked to recount her experiences as the president of a hospice society that has gained notoriety in this country for its efforts to ban medical assistance in dying (MAID) from taking place in its facility.
Ms. Ireland told her mainly U.S. audience that she was arriving with a warning: What was happening in Canada would soon be showing up in their country. “It’s like a contagion.” But first she wanted to clarify her bona fides. “I’m a wife, I’m a mother, I’m a Catholic, I’m pro-life, I’m pro-family and I’m pro-gun.”
A resumé that won a healthy round of applause from the crowd.
I recently watched her nearly hour-long appearance in mid-March on YouTube. It was quite a performance. The picture she painted of life in this country since the government decriminalized medical assistance in dying in 2016 was frightening. Among the things she declared:
That the legislation has ushered in the “dawn of the death industry.” Ms. Ireland defended her stance against MAID by saying she is president of the “Delta Hospice Society, not the Delta Auschwitz Society.” When the B.C. government threatened to strip the society’s funding if it didn’t offer MAID services, she said, it was effectively an order: “Kill or be killed.”
Ms. Ireland also cautioned her audience that this is coming to the U.S., and they need to start developing strategies to fight it “before they compel you to kill your neighbours and your family – because that’s where we are.”
She said there was legislation being drafted that will make MAID available to not just the elderly, but to the disabled, the mentally challenged and children. She offered up the scenario of parents getting a call from a distraught teenager who’d just broken up with her boyfriend wanting to take advantage of MAID. “This is what’s happening now [in Canada],” said Ms. Ireland, who was an unsuccessful candidate for Maxime Bernier’s People’s Party of Canada in the last election. She characterized what was taking place here as “stone-cold communism” and “cultural Marxism.”
When she was asked by someone in the audience what they could do to help, Ms. Ireland said, “The best thing you could do is vote President Trump back in the next election.”
As we say, Ms. Ireland is at the centre of a debate in Delta over a hospice’s right to deny MAID services. She has organized a special meeting of the society next week in the hopes of altering the organization’s constitution to establish it as a Christian-based body. It would have the rejection of MAID entrenched in its bylaws.
Under the language being proposed, any attempt to overturn that bylaw, once passed, would require consent by 100 per cent of the members – a near impossibility as long as the organization has a prominent base of people supporting the mandate being propagated by Ms. Ireland.
Recently, there have been allegations that the current board has been stacking the membership with supporters ahead of the critical June 15 meeting - while denying membership to others who disagree with the direction the society is taking. Ms. Ireland denies this.
What is taking place at the hospice society is simply wrong. The fact is, while it may be a private institution, it was built with money raised from the broader community. It was always intended to meet the needs of those contributors as well. I doubt many donated hoping that one day the society would be taken over by a closed-minded religious element that imposed its Christian canon on the operation.
The province has promised to cut off the $1.5-million in operating funds that go to the Delta Hospice every year if it doesn’t comply with government policy to offer the services of MAID. If the society persists on its present course, the government could move in and close the facility down — it owns the land on which the facility was built.
In some respects, the province must own part of this dispute. The government has offered MAID exemptions to faith-based facilities. This exemption has been linked to the exclusion offered under the federal legislation to doctors who have a “conscientious objection” to participating in the MAID program.
The B.C. government should rethink this policy. It’s one thing to absolve an individual whose conscience won’t allow them to perform a certain procedure. It’s another to give the same pass to a facility that is supposed to serve a broad, polylithic community.
https://www.theglobeandmail.com/opinion ... VgMaFxFnIY
Assisted dying is a matter of conscience – and so our lawmakers must be allowed to vote on the issue freely
For the second time in just four years, Parliament is poised to expand the conditions by which it is lawful for doctors in Canada to end the lives of their patients. The federal government recently tabled legislation that would expand assisted death to persons who are not close to death but are intolerably suffering from serious and incurable physical illnesses. Persons suffering solely from mental illness would remain ineligible for assisted death under the proposed legislation, but it remains to be seen if that line will hold.
This legislation, Bill C-7, would build on Canada’s existing assisted death law enacted in 2016; that law currently requires that death be “reasonably foreseeable” before a patient’s life is ended. Persons whose deaths are not near, but who might be suffering terribly, are ineligible for assisted death.
But last year, a court in Quebec determined that the foreseeability of death requirement violates the Charter. More specifically, the requirement discriminates against disabled persons who are far from death and also violates their right to life, liberty, and security of the person.
In 2016, all federal parties allowed their caucuses to vote freely on assisted death. But on Bill C-7, only the leader of the Conservatives, Erin O’Toole, has said that his caucus would be able to vote freely and vote their conscience. The other party leaders have not yet indicated where they stand on a free vote.
This is not acceptable. If there is any topic that merits freedom from party discipline, this is it.
The question of when it is legal or illegal for persons to end the lives of others is – regardless of partisan allegiance – a matter that touches on the moral fabric of a society. This is not merely a question of public policy; it is a matter of life and death, and a change to the law on this issue, no matter how small, represents a structural change for our society. For good or ill, depending on your viewpoint, the legalization of assisted death has transformed the work of Canadian doctors, nurses, pharmacists and other health care professionals, who spent their careers operating under the centuries-old belief that the intentional termination of life to stop suffering was antithetical to the medical profession. The same kind of radical change will happen again if Bill C-7 passes. Assisted death would no longer be restricted to the dying.
Indeed, how a society deals with assisted death will deeply and inevitably affect how we attribute value to human life – that of ourselves, family members, friends, colleagues, and others. As assisted death expands, the message that life is an asset that can depreciate, that life has a “best before” date, gains traction. This message is sent regardless of one’s position on assisted death. It should not surprise us that once the door to assisted death is cracked open, as it was in 2016, it is difficult to stop it from being opened further. Bill C-7 confirms, four short years later, that with respect to assisted death, the slippery slope or the path of progress – again, depending on how you view the direction of the slide – is real.
The two sides of the debate agree on little; supporters of assisted death say that it is a human right, ends suffering, and ensures a dignified death, while critics say that palliative care is sorely lacking in Canada, human life is never robbed of its basic dignity, and intentional termination of life is effectively a killing. But in their passion is one common belief: that assisted death is a matter of crucial importance to Canada’s future, that this issue will leave a lasting mark on who we are and what we stand for as a society, and that it represents a turning point for our country.
This shared belief shows how imperative it is that Bill C-7 receives a free vote, across party lines, when it comes up in the House of Commons. When our elected representatives vote on assisted death, they should have the freedom that all of us would legitimately seek if we were in their position – the ability to decide, with their own conscience, a matter of conscience for Canada.
https://www.theglobeandmail.com/opinion ... VgMaFxFnIY
For the second time in just four years, Parliament is poised to expand the conditions by which it is lawful for doctors in Canada to end the lives of their patients. The federal government recently tabled legislation that would expand assisted death to persons who are not close to death but are intolerably suffering from serious and incurable physical illnesses. Persons suffering solely from mental illness would remain ineligible for assisted death under the proposed legislation, but it remains to be seen if that line will hold.
This legislation, Bill C-7, would build on Canada’s existing assisted death law enacted in 2016; that law currently requires that death be “reasonably foreseeable” before a patient’s life is ended. Persons whose deaths are not near, but who might be suffering terribly, are ineligible for assisted death.
But last year, a court in Quebec determined that the foreseeability of death requirement violates the Charter. More specifically, the requirement discriminates against disabled persons who are far from death and also violates their right to life, liberty, and security of the person.
In 2016, all federal parties allowed their caucuses to vote freely on assisted death. But on Bill C-7, only the leader of the Conservatives, Erin O’Toole, has said that his caucus would be able to vote freely and vote their conscience. The other party leaders have not yet indicated where they stand on a free vote.
This is not acceptable. If there is any topic that merits freedom from party discipline, this is it.
The question of when it is legal or illegal for persons to end the lives of others is – regardless of partisan allegiance – a matter that touches on the moral fabric of a society. This is not merely a question of public policy; it is a matter of life and death, and a change to the law on this issue, no matter how small, represents a structural change for our society. For good or ill, depending on your viewpoint, the legalization of assisted death has transformed the work of Canadian doctors, nurses, pharmacists and other health care professionals, who spent their careers operating under the centuries-old belief that the intentional termination of life to stop suffering was antithetical to the medical profession. The same kind of radical change will happen again if Bill C-7 passes. Assisted death would no longer be restricted to the dying.
Indeed, how a society deals with assisted death will deeply and inevitably affect how we attribute value to human life – that of ourselves, family members, friends, colleagues, and others. As assisted death expands, the message that life is an asset that can depreciate, that life has a “best before” date, gains traction. This message is sent regardless of one’s position on assisted death. It should not surprise us that once the door to assisted death is cracked open, as it was in 2016, it is difficult to stop it from being opened further. Bill C-7 confirms, four short years later, that with respect to assisted death, the slippery slope or the path of progress – again, depending on how you view the direction of the slide – is real.
The two sides of the debate agree on little; supporters of assisted death say that it is a human right, ends suffering, and ensures a dignified death, while critics say that palliative care is sorely lacking in Canada, human life is never robbed of its basic dignity, and intentional termination of life is effectively a killing. But in their passion is one common belief: that assisted death is a matter of crucial importance to Canada’s future, that this issue will leave a lasting mark on who we are and what we stand for as a society, and that it represents a turning point for our country.
This shared belief shows how imperative it is that Bill C-7 receives a free vote, across party lines, when it comes up in the House of Commons. When our elected representatives vote on assisted death, they should have the freedom that all of us would legitimately seek if we were in their position – the ability to decide, with their own conscience, a matter of conscience for Canada.
https://www.theglobeandmail.com/opinion ... VgMaFxFnIY
Canadians not near death gain access to assisted dying as Senate passes Bill C-7
OTTAWA — Intolerably suffering Canadians who are not near the natural end of their lives now have the right to seek medical assistance in dying.
And that will eventually include people suffering solely from grievous and irremediable mental illnesses.
The expansion of Canada's assisted dying regime went into effect Wednesday night after the Senate accepted a revised version of Bill C-7.
The bill received royal assent a few hours later — just over a week ahead of a final March 26 deadline imposed by the court, which had granted four extensions to bring the law into compliance with a 2019 Quebec Superior Court ruling.
With royal assent granted, intolerably suffering Canadians who aren't near death immediately gained the right to seek medical assistance in dying.
People suffering solely from mental illnesses will have to wait two years to gain the same right.
The government had originally intended to impose a blanket ban on assisted dying for people suffering solely from mental illnesses. But, under pressure from senators who believed that exclusion was unconstitutional, it subsequently put a two-year time limit on it.
In the meantime, the government committed to setting up an expert panel to advise on the safeguards and protocols that should apply to people with mental illnesses.
The government rejected a Senate amendment to allow people who fear losing mental competence to make advance requests for an assisted death.
But it committed to launching within 30 days a joint parliamentary committee to review that issue and other unresolved matters, including whether mature minors should have access to the procedure.
"For Canadians who are suffering intolerably, this process has taken too long, but their wait is now over," Justice Minister David Lametti tweeted shortly after the bill received royal assent.
"This is an important milestone but there is more work to do."
The bill was triggered by two Quebecers with severe disabilities who went to court to successfully fight for their right to choose an assisted death even though their natural deaths were not "reasonably foreseeable."
But disability rights groups have strenuously opposed the bill, arguing it devalues the lives of people with disabilities, particularly those who are Black, racialized, Indigenous or otherwise already marginalized and face discrimination in the health system. They fear such vulnerable people will be pressured — either directly or indirectly through societal attitudes and lack of support services — to end their lives prematurely.
Many mental health advocates have also weighed in against the eventual inclusion of people suffering solely from mental illnesses. They argue that it's harder to predict the outcomes of mental illnesses, many of which can be treated, and point out that a wish to die is often a symptom of these illnesses.
But Sen. Stan Kutcher, a psychiatrist and member of the Independent Senators Group who first proposed a time limit on the mental illness exclusion, argued that all competent Canadians suffering from irremediable and grievous illnesses, physical or mental, deserve the right to make their own choice.
"It is not for us to decide if a person's suffering is intolerable to them," he told the Senate shortly before the vote.
Dying with Dignity Canada welcomed the Senate's sign-off on the bill, calling it "a momentous day for end-of-life rights in Canada."
All 20 Conservative senators voted against the bill, several because they believed it didn't go far enough but most were fundamentally opposed to expanding the assisted dying regime, particularly to those with mental illnesses.
In an emotional speech just before the vote, Conservative Senate leader Don Plett pleaded with his colleagues to reject the bill.
"If there was ever a time to exercise sober second thought, it is now," he told the Senate.
"It is not often that we can truly say that with this vote we have the opportunity to save lives, to prevent the unnecessary premature death of the vulnerable, to offer hope to those who have lost it. But today we do."
For people who are near the natural end of life, the bill relaxes some of the rules for getting an assisted death.
It drops the requirement that a person must be able to give final consent immediately before the procedure is performed. That's intended to ensure that someone who has been approved for the procedure won't be denied if they lose mental capacity before it can be carried out.
It also drops the requirement that a person must wait 10 days after being approved for an assisted death before receiving the procedure. And it reduces the number of witnesses required to one from two.
People not near death will face higher hurdles.
Among other things, they'll face a minimum 90-day period for assessments of their requests for an assisted death. They'll have to be made aware of all alternatives, including counselling and they'll have to be able to give final consent immediately before receiving the procedure.
This report by The Canadian Press was first published March 17, 2021.
Joan Bryden, The Canadian Press
https://www.msn.com/en-ca/news/canada/c ... li=AAggNb9
OTTAWA — Intolerably suffering Canadians who are not near the natural end of their lives now have the right to seek medical assistance in dying.
And that will eventually include people suffering solely from grievous and irremediable mental illnesses.
The expansion of Canada's assisted dying regime went into effect Wednesday night after the Senate accepted a revised version of Bill C-7.
The bill received royal assent a few hours later — just over a week ahead of a final March 26 deadline imposed by the court, which had granted four extensions to bring the law into compliance with a 2019 Quebec Superior Court ruling.
With royal assent granted, intolerably suffering Canadians who aren't near death immediately gained the right to seek medical assistance in dying.
People suffering solely from mental illnesses will have to wait two years to gain the same right.
The government had originally intended to impose a blanket ban on assisted dying for people suffering solely from mental illnesses. But, under pressure from senators who believed that exclusion was unconstitutional, it subsequently put a two-year time limit on it.
In the meantime, the government committed to setting up an expert panel to advise on the safeguards and protocols that should apply to people with mental illnesses.
The government rejected a Senate amendment to allow people who fear losing mental competence to make advance requests for an assisted death.
But it committed to launching within 30 days a joint parliamentary committee to review that issue and other unresolved matters, including whether mature minors should have access to the procedure.
"For Canadians who are suffering intolerably, this process has taken too long, but their wait is now over," Justice Minister David Lametti tweeted shortly after the bill received royal assent.
"This is an important milestone but there is more work to do."
The bill was triggered by two Quebecers with severe disabilities who went to court to successfully fight for their right to choose an assisted death even though their natural deaths were not "reasonably foreseeable."
But disability rights groups have strenuously opposed the bill, arguing it devalues the lives of people with disabilities, particularly those who are Black, racialized, Indigenous or otherwise already marginalized and face discrimination in the health system. They fear such vulnerable people will be pressured — either directly or indirectly through societal attitudes and lack of support services — to end their lives prematurely.
Many mental health advocates have also weighed in against the eventual inclusion of people suffering solely from mental illnesses. They argue that it's harder to predict the outcomes of mental illnesses, many of which can be treated, and point out that a wish to die is often a symptom of these illnesses.
But Sen. Stan Kutcher, a psychiatrist and member of the Independent Senators Group who first proposed a time limit on the mental illness exclusion, argued that all competent Canadians suffering from irremediable and grievous illnesses, physical or mental, deserve the right to make their own choice.
"It is not for us to decide if a person's suffering is intolerable to them," he told the Senate shortly before the vote.
Dying with Dignity Canada welcomed the Senate's sign-off on the bill, calling it "a momentous day for end-of-life rights in Canada."
All 20 Conservative senators voted against the bill, several because they believed it didn't go far enough but most were fundamentally opposed to expanding the assisted dying regime, particularly to those with mental illnesses.
In an emotional speech just before the vote, Conservative Senate leader Don Plett pleaded with his colleagues to reject the bill.
"If there was ever a time to exercise sober second thought, it is now," he told the Senate.
"It is not often that we can truly say that with this vote we have the opportunity to save lives, to prevent the unnecessary premature death of the vulnerable, to offer hope to those who have lost it. But today we do."
For people who are near the natural end of life, the bill relaxes some of the rules for getting an assisted death.
It drops the requirement that a person must be able to give final consent immediately before the procedure is performed. That's intended to ensure that someone who has been approved for the procedure won't be denied if they lose mental capacity before it can be carried out.
It also drops the requirement that a person must wait 10 days after being approved for an assisted death before receiving the procedure. And it reduces the number of witnesses required to one from two.
People not near death will face higher hurdles.
Among other things, they'll face a minimum 90-day period for assessments of their requests for an assisted death. They'll have to be made aware of all alternatives, including counselling and they'll have to be able to give final consent immediately before receiving the procedure.
This report by The Canadian Press was first published March 17, 2021.
Joan Bryden, The Canadian Press
https://www.msn.com/en-ca/news/canada/c ... li=AAggNb9
P.E.I. couple who used medically assisted dying 'went out on their own terms,' says family
'They were both terminal — there was no coming out of the situation'
Watch video at:
https://www.cbc.ca/news/canada/prince-e ... -1.6050270
The obituary last week may have caught some people's attention: Bob Wilson, 71, and his wife Margi, 73, died on the same day, May 25, at Charlottetown's Queen Elizabeth Hospital.
They planned it that way.
"They went out on their own terms," said their son Scott Wilson, sitting beside his sister Nicolle Hogan in her sunny kitchen in Cumberland, overlooking the sparkling Northumberland Strait.
The doctors told the Wilsons' three children they would be the first couple in P.E.I. to use medical assistance in dying (MAID) at the same time.
Although their parents handled their deaths privately, Scott and Nicolle agreed to talk to CBC News about it to celebrate their parents' bravery and to try to reduce any stigma around MAID.
'Loved each other immensely'
Bob and Margi Wilson were lifelong partners, "the love of each other's life," said Scott. They met at Prince of Wales College (now Holland College) in Charlottetown and married 50 years ago.
Nicolle Hogan and Scott Wilson's parents, Bob and Margi Wilson, both used medical assistance in dying last week. (Sara Fraser/CBC)
"Just a cute, beautiful couple that loved each other immensely ... they lived a really good life," Scott said. They were never apart.
Bob was a solid, happy man, working first with his mother and then Margi at their real estate business. After Bob retired, the couple came to live with Nicolle and her family.
Margi worked alongside her husband at his business, but had suffered from the pain of multiple sclerosis for the last 30 years. Early on, it put her in a wheelchair, but when her grandchildren were born, she rallied and became very active, even walking several half-marathons.
In August 2019, Bob was diagnosed with Stage 4 kidney cancer that had spread to his lungs.
Bob was determined to fight it and stick around as long as possible. He tried many different therapies, and he'd actually had some positive news that his cancer had stopped growing when Margi's MS flared up and put her in the hospital this past February. She didn't come home after that.
The Wilsons on their wedding day. The family says the couple was the first in P.E.I. to receive medical assistance in dying together. (Submitted by Nicolle Hogan)
Mutual care
The couple had been trying to look after one another, but they became run down and frail. They weren't able to winter in Alabama the last two years because of Bob's illness. The warm climate had helped Margi feel better.
In hospital, Margi continued to go downhill. She didn't feel like eating or drinking much, and her weight plummeted. In mid-March, Margi told her family she was ready to die, and would do so naturally — and that they shouldn't to try to revive her if the time came.
"She was just sick and tired of being sick and tired," Scott said. "It's a big shock to be told, 'I don't want to live anymore because my life is so miserable.'"
The family decided they needed to support their mother in her decision.
"You might not personally like the decision, but from us it's a selfish side that you don't want them to go and leave," Scott said.
"It wasn't about us anymore," said Nicolle.
Their father was also shocked, they said.
"I just remember seeing his face. When he heard the news, his heart — it was broken," Scott said. "The love of his life was giving up."
CBC EXPLAINS Here's the latest on the review of Canada's assisted dying law
Delta hospice reopens after bitter fight over medically assisted death
'He wanted to go with his love'
At the hospital, as the family was talking about options including nursing care, Nicolle heard about MAID. She mentioned it to her mother.
In April, the couple celebrated their 50th wedding anniversary at the Queen Elizabeth Hospital in Charlottetown. (Submitted by Nicolle Hogan)
"We are definitely a family that is always about looking at, what are all of our options? Let's explore all of our options," Nicolle said.
Margi told the family she'd like to choose assisted dying. Bob got all the assessments he needed if he also decided to choose assisted dying, but he didn't make a decision until May 7.
He'd become increasingly frail, unsteady on his feet and lacked an appetite. His pain was unbearable. He decided he and Margi would take their final milestone as a couple: an assisted death, together.
As they did in life, they would do this final step together.
— Scott Wilson
"He wanted to go with his love," Scott said. "The pain of not going with her would have broken him."
The hospital bed next to Margi was available, so it became Bob's. Scott and Nicolle's brother Tony was permitted to travel from his home in Brooklyn, N.Y., to P.E.I. on compassionate grounds.
Scott and Nicolle said doctors checked in with the couple often to make sure they hadn't changed their minds.
In the last weeks, the grandchildren gathered in their grandparents' room to keep them company, doing crafts and playing music. They reminisced about fun times the close-knit family had spent together. Nothing went unsaid.
"It was bittersweet," Scott said of the scene.
"I joked with my mom, I said it's almost Romeo and Juliet without the poison," Scott said. "We use humour in our family as a coping mechanism. In a way, there was somewhat of a relief that a decision had been made, because it was very up and down."
Watching the clock
The Wilsons were the love of each other's lives, their children say. (Submitted by Nicolle Hogan)
Margi lost consciousness in the days before, and the family thought she might die naturally before the agreed-upon date. They kept a vigil around the clock, with one or more of the three children always in the room with Bob and Margi for the week before they died.
Nicolle and Tony stayed awake most of the night on May 24 and into the early hours of the next day, watching the clock and counting down the hours they had left with their parents. "We were just left with our own thoughts and emotions," she said.
At 7 a.m. on May 25, doctors came into the room for a final check. They took the family to a different room, away from their parents, and briefed them on the procedure.
Even though Margi wasn't able to verbally consent, recent changes to the assisted dying law made it possible for doctors to carry out her wishes. Bob indicated to the doctors that he wanted to go through with it, too.
"He was committed that, as they did in life, they would do this final step together," Scott said. "They were both terminal — there was no coming out of the situation."
They pushed the couple's beds together so they could be close.
Nicolle held her father's hand and they said "I love you" to one another.
First, doctors gave the couple injections that put them to sleep. After Bob was snoring peacefully, doctors gave them both a series of further injections over about 10 minutes.
They died together, peacefully.
"You could just see the weight of all the pain and the suffering was gone," said Scott.
LISTENPsychiatrists divided over Canada's new medical assistance in dying law
Do changes to assisted dying in Canada help the most vulnerable or endanger them? Advocates are divided
'Really proud of my parents'
Nicolle said she wants people who are terminally ill to be aware that "options do exist" and they should be informed of all choices available to them.
In the weeks leading up to the chosen day, there was always plenty of family in the couple's hospital room. (Submitted by Nicolle Hogan)
"Know that the option is available, if you so choose," she said. "My message is — really look at the quality of life and remember those happy times and think of what's right for you as an individual rather than everybody else around you.
"There shouldn't be any judgment," she added.
Scott said he wanted to share his parents' journey because he is immensely proud of them.
"I'm really proud of my parents and the hard decision they had to make — that takes a lot of guts," he said.
The family is still in mourning and say they will have to adjust to all the "firsts" without their parents.
Nicolle's house is quiet without Bob and Margi living downstairs. Nicolle grips the crocheted heart her father held as he died tightly.
"I do sleep with it sometimes," she said. "It's comfort."
https://www.cbc.ca/news/canada/prince-e ... -1.6050270
'They were both terminal — there was no coming out of the situation'
Watch video at:
https://www.cbc.ca/news/canada/prince-e ... -1.6050270
The obituary last week may have caught some people's attention: Bob Wilson, 71, and his wife Margi, 73, died on the same day, May 25, at Charlottetown's Queen Elizabeth Hospital.
They planned it that way.
"They went out on their own terms," said their son Scott Wilson, sitting beside his sister Nicolle Hogan in her sunny kitchen in Cumberland, overlooking the sparkling Northumberland Strait.
The doctors told the Wilsons' three children they would be the first couple in P.E.I. to use medical assistance in dying (MAID) at the same time.
Although their parents handled their deaths privately, Scott and Nicolle agreed to talk to CBC News about it to celebrate their parents' bravery and to try to reduce any stigma around MAID.
'Loved each other immensely'
Bob and Margi Wilson were lifelong partners, "the love of each other's life," said Scott. They met at Prince of Wales College (now Holland College) in Charlottetown and married 50 years ago.
Nicolle Hogan and Scott Wilson's parents, Bob and Margi Wilson, both used medical assistance in dying last week. (Sara Fraser/CBC)
"Just a cute, beautiful couple that loved each other immensely ... they lived a really good life," Scott said. They were never apart.
Bob was a solid, happy man, working first with his mother and then Margi at their real estate business. After Bob retired, the couple came to live with Nicolle and her family.
Margi worked alongside her husband at his business, but had suffered from the pain of multiple sclerosis for the last 30 years. Early on, it put her in a wheelchair, but when her grandchildren were born, she rallied and became very active, even walking several half-marathons.
In August 2019, Bob was diagnosed with Stage 4 kidney cancer that had spread to his lungs.
Bob was determined to fight it and stick around as long as possible. He tried many different therapies, and he'd actually had some positive news that his cancer had stopped growing when Margi's MS flared up and put her in the hospital this past February. She didn't come home after that.
The Wilsons on their wedding day. The family says the couple was the first in P.E.I. to receive medical assistance in dying together. (Submitted by Nicolle Hogan)
Mutual care
The couple had been trying to look after one another, but they became run down and frail. They weren't able to winter in Alabama the last two years because of Bob's illness. The warm climate had helped Margi feel better.
In hospital, Margi continued to go downhill. She didn't feel like eating or drinking much, and her weight plummeted. In mid-March, Margi told her family she was ready to die, and would do so naturally — and that they shouldn't to try to revive her if the time came.
"She was just sick and tired of being sick and tired," Scott said. "It's a big shock to be told, 'I don't want to live anymore because my life is so miserable.'"
The family decided they needed to support their mother in her decision.
"You might not personally like the decision, but from us it's a selfish side that you don't want them to go and leave," Scott said.
"It wasn't about us anymore," said Nicolle.
Their father was also shocked, they said.
"I just remember seeing his face. When he heard the news, his heart — it was broken," Scott said. "The love of his life was giving up."
CBC EXPLAINS Here's the latest on the review of Canada's assisted dying law
Delta hospice reopens after bitter fight over medically assisted death
'He wanted to go with his love'
At the hospital, as the family was talking about options including nursing care, Nicolle heard about MAID. She mentioned it to her mother.
In April, the couple celebrated their 50th wedding anniversary at the Queen Elizabeth Hospital in Charlottetown. (Submitted by Nicolle Hogan)
"We are definitely a family that is always about looking at, what are all of our options? Let's explore all of our options," Nicolle said.
Margi told the family she'd like to choose assisted dying. Bob got all the assessments he needed if he also decided to choose assisted dying, but he didn't make a decision until May 7.
He'd become increasingly frail, unsteady on his feet and lacked an appetite. His pain was unbearable. He decided he and Margi would take their final milestone as a couple: an assisted death, together.
As they did in life, they would do this final step together.
— Scott Wilson
"He wanted to go with his love," Scott said. "The pain of not going with her would have broken him."
The hospital bed next to Margi was available, so it became Bob's. Scott and Nicolle's brother Tony was permitted to travel from his home in Brooklyn, N.Y., to P.E.I. on compassionate grounds.
Scott and Nicolle said doctors checked in with the couple often to make sure they hadn't changed their minds.
In the last weeks, the grandchildren gathered in their grandparents' room to keep them company, doing crafts and playing music. They reminisced about fun times the close-knit family had spent together. Nothing went unsaid.
"It was bittersweet," Scott said of the scene.
"I joked with my mom, I said it's almost Romeo and Juliet without the poison," Scott said. "We use humour in our family as a coping mechanism. In a way, there was somewhat of a relief that a decision had been made, because it was very up and down."
Watching the clock
The Wilsons were the love of each other's lives, their children say. (Submitted by Nicolle Hogan)
Margi lost consciousness in the days before, and the family thought she might die naturally before the agreed-upon date. They kept a vigil around the clock, with one or more of the three children always in the room with Bob and Margi for the week before they died.
Nicolle and Tony stayed awake most of the night on May 24 and into the early hours of the next day, watching the clock and counting down the hours they had left with their parents. "We were just left with our own thoughts and emotions," she said.
At 7 a.m. on May 25, doctors came into the room for a final check. They took the family to a different room, away from their parents, and briefed them on the procedure.
Even though Margi wasn't able to verbally consent, recent changes to the assisted dying law made it possible for doctors to carry out her wishes. Bob indicated to the doctors that he wanted to go through with it, too.
"He was committed that, as they did in life, they would do this final step together," Scott said. "They were both terminal — there was no coming out of the situation."
They pushed the couple's beds together so they could be close.
Nicolle held her father's hand and they said "I love you" to one another.
First, doctors gave the couple injections that put them to sleep. After Bob was snoring peacefully, doctors gave them both a series of further injections over about 10 minutes.
They died together, peacefully.
"You could just see the weight of all the pain and the suffering was gone," said Scott.
LISTENPsychiatrists divided over Canada's new medical assistance in dying law
Do changes to assisted dying in Canada help the most vulnerable or endanger them? Advocates are divided
'Really proud of my parents'
Nicolle said she wants people who are terminally ill to be aware that "options do exist" and they should be informed of all choices available to them.
In the weeks leading up to the chosen day, there was always plenty of family in the couple's hospital room. (Submitted by Nicolle Hogan)
"Know that the option is available, if you so choose," she said. "My message is — really look at the quality of life and remember those happy times and think of what's right for you as an individual rather than everybody else around you.
"There shouldn't be any judgment," she added.
Scott said he wanted to share his parents' journey because he is immensely proud of them.
"I'm really proud of my parents and the hard decision they had to make — that takes a lot of guts," he said.
The family is still in mourning and say they will have to adjust to all the "firsts" without their parents.
Nicolle's house is quiet without Bob and Margi living downstairs. Nicolle grips the crocheted heart her father held as he died tightly.
"I do sleep with it sometimes," she said. "It's comfort."
https://www.cbc.ca/news/canada/prince-e ... -1.6050270
For Terminal Patients, the Barrier to Aid in Dying Can Be a State Line
Complex restrictions are preventing patients from accessing medical aid in dying, even in states where it is allowed. New legal and legislative efforts are pushing to change that.
Five years ago, Dr. Nicholas Gideonse spoke with an older man who had received a terminal cancer diagnosis and was hoping to use Oregon’s medical aid-in-dying law.
Oregon’s Death With Dignity Act, in effect since 1997, permits doctors, after a complex process of requests and waiting periods, to prescribe lethal medication for dying patients to self-ingest.
The nonprofit group End of Life Choices Oregon had referred the man to Dr. Gideonse, a primary care doctor at Oregon Health & Science University and a hospice medical director, who had already helped many patients use the law.
But this time he could not. “I’m really sorry,” he told the man on the phone. “I’m not going to be able to help you with this.” Oregon’s law — and all the laws that permit medical aid in dying in 10 states and in Washington, D.C. — has residency requirements. This man would have qualified — except for that fact he lived in nearby Washington State.
The patient’s response, Dr. Gideonse recalled, was “stunned silence, deep disappointment.” A number of Dr. Gideonse’s primary care patients drive 20 to 30 minutes across the Washington border to his office in Portland. There, he can offer them any medical service he is qualified to provide — except that one — without proof of residency. And although Washington has its own aid-in-dying law, its southwestern region has few providers who can help patients use it.
Last month Dr. Gideonse, backed by pro bono lawyers and Compassion & Choices, an advocacy group for expanding end-of-life options, filed a federal lawsuit claiming that the residency requirement for Oregon’s aid-in-dying law is unconstitutional. “I realized how important this could be for patients seeking access,” he said.
The lawsuit is one of several legal and legislative efforts around the country to reduce the requirements that patients must contend with in order to receive aid in dying. In some states, lawmakers have already broadened the types of health care providers that can participate, or have shortened waiting periods or allowed waivers.
“I think of it as MAID 2.0,” said Thaddeus Pope, an end-of-life bioethicist at Mitchell Hamline School of Law who tracks such actions, referring to the acronym for medical aid in dying. “We found out there’s an access problem.” He added, “We set all these safeguards and eligibility requirements and they locked a lot of people out.”
Oregon led the shift in easing access, amending its law in 2019. The state previously required patients to make two verbal requests for life-ending medication, at least 15 days apart, to ensure that they had not changed their minds. Now, if the patient is unlikely to survive that long, their doctor can waive the 15-day waiting period.
“Fifteen days is everything when you are suffering,” said Kim Callinan, the president and chief executive of Compassion & Choices, which supported the change. “People who are eligible for the law are hitting roadblocks and barriers.”
In 2016, for example, Youssef Cohen, a political scientist at New York University, took the extraordinary step of moving across the country to use the Oregon law as he was dying of mesothelioma at 68. “He wanted the option to determine the end of his life,” said his wife, Lindsay Wright, who is an associate dean at the university.
To establish residency, the couple had to hurriedly sign an apartment lease, obtain an ID from the state motor vehicle agency, transfer medical records and arrange an immediate appointment with a Portland doctor to qualify for medical aid in dying. Dr. Cohen then faced the 15-day waiting period.
“He didn’t make it,” Dr. Wright said. “He died six days after we arrived. And he suffered.”
A 2018 study from the Kaiser Permanente health system in Southern California showed that about one-third of qualifying patients died before they could complete the process.
New Mexico, which in June became the most recent state to legalize medical aid in dying, has adopted a markedly less restrictive approach than other states. The largely rural state is the first to allow not only doctors but advanced practice registered nurses and physician assistants to help determine eligibility and write prescriptions for lethal medication. “In some communities, they’re the only providers,” said Representative Deborah Armstrong, a Democrat and the bill’s primary sponsor.
Although a doctor must also affirm that a patient is terminally ill, New Mexico patients can skip that step if they have already enrolled in hospice, as most do. The patient need only make one written request, rather than two or more requests, as other states require. A 48-hour waiting period between when the prescription is written and when it is filled can be waived. “People walk up and tell me how thankful they are to have this option if they need it,” Ms. Armstrong said.
California has simplified its 2016 law as well. In October, Gov. Gavin Newsom signed legislation that, starting in January, reduces the 15-day wait between verbal requests to 48 hours and eliminates the requirement for a third written “attestation.”
Similar bills died during the most recent legislative sessions in Hawaii, Washington and Vermont, but will be reintroduced, Ms. Callinan said. And in many states — including Delaware, Indiana, North Carolina, Virginia, Pennsylvania and Arizona — new aid-in-dying bills, if passed, will ease requirements for patients or expand the kinds of providers who may participate.
On the legal front, the Oregon lawsuit filed by Dr. Gideonse argues that residency requirements for aid in dying violate two sections of the U.S. Constitution, one barring state laws that limit the ability of a nonresident to access medical care and one prohibiting state laws that burden interstate commerce. The state must respond by Dec. 27.
“This is the only medical procedure we can think of that is limited by someone’s ZIP code,” said Kevin Diaz, the chief legal advocacy officer at Compassion & Choices.
A separate federal class action suit claims that California’s law, which like the others requires patients to self-administer the drugs that end their lives, discriminates against patients dying of neurodegenerative diseases that make it physically impossible to take medication without assistance.
The plaintiffs, charging violation of the Americans With Disabilities Act and California law, include patients with multiple sclerosis and A.L.S., also known as Lou Gehrig’s disease, and their doctors. (In denying a request for a preliminary injunction, a judge ruled in September that the plaintiffs were asking California “to cross the line to euthanasia.”)
Catholic organizations, anti-abortion advocates and some disability groups continue to oppose aid in dying. The California Catholic Conference, the church’s public policy organization, for example, argued in June that liberalizing the state’s law “puts patients at risk of abuse and the early and unwillful termination of life.”
But polls regularly report broad public support. Last year, Gallup found that 74 percent of respondents agreed that doctors should be allowed to end patients’ lives “by some painless means” if they and their families request it.
Liberalizing the laws will likely increase participation, the bioethicist Dr. Pope predicts. “We know from evidence around the world that if you reduce the waiting period, or allow waivers in certain cases, it materially expands access,” he said.
Experts do not expect a major surge, however. Even in states where the practice has been legal for years, aid in dying accounts for very few deaths, a fraction of one percent. Of those who successfully navigate the process, moreover, about one-third do not use the drugs and instead die of their diseases.
Still, should Dr. Gideonse prevail in his lawsuit and a likely appeal, residency requirements in other regions might also start to fall. That could allow New York or Pennsylvania patients to use New Jersey’s aid-in-dying law, for instance, or Maryland and Virginia residents to seek providers in Washington, D.C.
It is an outcome that would please Dr. Gideonse. “This is an action in support of a needed and very important service,” he said. “I’m optimistic.”
https://www.nytimes.com/2021/11/13/heal ... 778d3e6de3
Complex restrictions are preventing patients from accessing medical aid in dying, even in states where it is allowed. New legal and legislative efforts are pushing to change that.
Five years ago, Dr. Nicholas Gideonse spoke with an older man who had received a terminal cancer diagnosis and was hoping to use Oregon’s medical aid-in-dying law.
Oregon’s Death With Dignity Act, in effect since 1997, permits doctors, after a complex process of requests and waiting periods, to prescribe lethal medication for dying patients to self-ingest.
The nonprofit group End of Life Choices Oregon had referred the man to Dr. Gideonse, a primary care doctor at Oregon Health & Science University and a hospice medical director, who had already helped many patients use the law.
But this time he could not. “I’m really sorry,” he told the man on the phone. “I’m not going to be able to help you with this.” Oregon’s law — and all the laws that permit medical aid in dying in 10 states and in Washington, D.C. — has residency requirements. This man would have qualified — except for that fact he lived in nearby Washington State.
The patient’s response, Dr. Gideonse recalled, was “stunned silence, deep disappointment.” A number of Dr. Gideonse’s primary care patients drive 20 to 30 minutes across the Washington border to his office in Portland. There, he can offer them any medical service he is qualified to provide — except that one — without proof of residency. And although Washington has its own aid-in-dying law, its southwestern region has few providers who can help patients use it.
Last month Dr. Gideonse, backed by pro bono lawyers and Compassion & Choices, an advocacy group for expanding end-of-life options, filed a federal lawsuit claiming that the residency requirement for Oregon’s aid-in-dying law is unconstitutional. “I realized how important this could be for patients seeking access,” he said.
The lawsuit is one of several legal and legislative efforts around the country to reduce the requirements that patients must contend with in order to receive aid in dying. In some states, lawmakers have already broadened the types of health care providers that can participate, or have shortened waiting periods or allowed waivers.
“I think of it as MAID 2.0,” said Thaddeus Pope, an end-of-life bioethicist at Mitchell Hamline School of Law who tracks such actions, referring to the acronym for medical aid in dying. “We found out there’s an access problem.” He added, “We set all these safeguards and eligibility requirements and they locked a lot of people out.”
Oregon led the shift in easing access, amending its law in 2019. The state previously required patients to make two verbal requests for life-ending medication, at least 15 days apart, to ensure that they had not changed their minds. Now, if the patient is unlikely to survive that long, their doctor can waive the 15-day waiting period.
“Fifteen days is everything when you are suffering,” said Kim Callinan, the president and chief executive of Compassion & Choices, which supported the change. “People who are eligible for the law are hitting roadblocks and barriers.”
In 2016, for example, Youssef Cohen, a political scientist at New York University, took the extraordinary step of moving across the country to use the Oregon law as he was dying of mesothelioma at 68. “He wanted the option to determine the end of his life,” said his wife, Lindsay Wright, who is an associate dean at the university.
To establish residency, the couple had to hurriedly sign an apartment lease, obtain an ID from the state motor vehicle agency, transfer medical records and arrange an immediate appointment with a Portland doctor to qualify for medical aid in dying. Dr. Cohen then faced the 15-day waiting period.
“He didn’t make it,” Dr. Wright said. “He died six days after we arrived. And he suffered.”
A 2018 study from the Kaiser Permanente health system in Southern California showed that about one-third of qualifying patients died before they could complete the process.
New Mexico, which in June became the most recent state to legalize medical aid in dying, has adopted a markedly less restrictive approach than other states. The largely rural state is the first to allow not only doctors but advanced practice registered nurses and physician assistants to help determine eligibility and write prescriptions for lethal medication. “In some communities, they’re the only providers,” said Representative Deborah Armstrong, a Democrat and the bill’s primary sponsor.
Although a doctor must also affirm that a patient is terminally ill, New Mexico patients can skip that step if they have already enrolled in hospice, as most do. The patient need only make one written request, rather than two or more requests, as other states require. A 48-hour waiting period between when the prescription is written and when it is filled can be waived. “People walk up and tell me how thankful they are to have this option if they need it,” Ms. Armstrong said.
California has simplified its 2016 law as well. In October, Gov. Gavin Newsom signed legislation that, starting in January, reduces the 15-day wait between verbal requests to 48 hours and eliminates the requirement for a third written “attestation.”
Similar bills died during the most recent legislative sessions in Hawaii, Washington and Vermont, but will be reintroduced, Ms. Callinan said. And in many states — including Delaware, Indiana, North Carolina, Virginia, Pennsylvania and Arizona — new aid-in-dying bills, if passed, will ease requirements for patients or expand the kinds of providers who may participate.
On the legal front, the Oregon lawsuit filed by Dr. Gideonse argues that residency requirements for aid in dying violate two sections of the U.S. Constitution, one barring state laws that limit the ability of a nonresident to access medical care and one prohibiting state laws that burden interstate commerce. The state must respond by Dec. 27.
“This is the only medical procedure we can think of that is limited by someone’s ZIP code,” said Kevin Diaz, the chief legal advocacy officer at Compassion & Choices.
A separate federal class action suit claims that California’s law, which like the others requires patients to self-administer the drugs that end their lives, discriminates against patients dying of neurodegenerative diseases that make it physically impossible to take medication without assistance.
The plaintiffs, charging violation of the Americans With Disabilities Act and California law, include patients with multiple sclerosis and A.L.S., also known as Lou Gehrig’s disease, and their doctors. (In denying a request for a preliminary injunction, a judge ruled in September that the plaintiffs were asking California “to cross the line to euthanasia.”)
Catholic organizations, anti-abortion advocates and some disability groups continue to oppose aid in dying. The California Catholic Conference, the church’s public policy organization, for example, argued in June that liberalizing the state’s law “puts patients at risk of abuse and the early and unwillful termination of life.”
But polls regularly report broad public support. Last year, Gallup found that 74 percent of respondents agreed that doctors should be allowed to end patients’ lives “by some painless means” if they and their families request it.
Liberalizing the laws will likely increase participation, the bioethicist Dr. Pope predicts. “We know from evidence around the world that if you reduce the waiting period, or allow waivers in certain cases, it materially expands access,” he said.
Experts do not expect a major surge, however. Even in states where the practice has been legal for years, aid in dying accounts for very few deaths, a fraction of one percent. Of those who successfully navigate the process, moreover, about one-third do not use the drugs and instead die of their diseases.
Still, should Dr. Gideonse prevail in his lawsuit and a likely appeal, residency requirements in other regions might also start to fall. That could allow New York or Pennsylvania patients to use New Jersey’s aid-in-dying law, for instance, or Maryland and Virginia residents to seek providers in Washington, D.C.
It is an outcome that would please Dr. Gideonse. “This is an action in support of a needed and very important service,” he said. “I’m optimistic.”
https://www.nytimes.com/2021/11/13/heal ... 778d3e6de3
Re: Euthanasia
Canadians need to get better at talking about death, says pioneer in medically assisted dying
Most people have not had the opportunity to openly discuss their end-of-life options, says Dr. Stefanie Green
Stefanie Green, B.C.-based physician who offers medical assistance in death. (Jacob Green)
When Dr. Stefanie Green meets a patient to discuss medical assistance in dying (MAID), she's upfront about the conversation they're about to have.
"We're going to talk about death today. We're going to talk about dying," she tells them. "We're going to talk about your death. And we're going to talk about assisted dying."
"People thank me at that moment," often because they have not yet had an open conversation about their death, or end-of-life options, said Green, a physician based in Victoria, B.C.
Green was one of the first doctors to offer MAID after it was legalized in 2016. The law offers the procedure to Canadians suffering grievous and irremediable conditions, provided they have the capacity to understand the choice, as well as their own health issues, and any potential treatment or palliative care options. Providers perform checks to ensure there is no coercion involved.
Years after medical assistance in dying became legal, the debate rages on
Combining previous reports and the latest data released in January, Statistics Canada has recorded more than 21,000 medically assisted deaths between 2016 and 2020. As of last summer, there were about 1,300 providers offering MAID across the country.
Green says the decision to access MAID ultimately lies with the patient, provided they meet the necessary parameters. (Shaun Best/Reuters)
After six years working closely with people at the end of life, Green hopes to help people have easier conversations about MAID.
"We're not very good in Canada about talking about death and dying," she told The Current's Matt Galloway.
"I think we need to get better at this conversation."
Her new book, This is Assisted Dying: A Doctor's Story of Empowering Patients at the End of Life, tells the stories of people she has helped — with names and details changed for privacy — and also looks at how Canadians approach the topic.
Getting better at talking about death
Green's very first patient was a man she calls Harvey in the book. He was suffering from end-stage liver disease, and had already decided to access MAID when it became legal.
When the time came, he died surrounded by his wife and children as he'd hoped.
In her book, Green recounts a moment between Harvey and his wife: "She tells him to let go, that she's here with him. And as on most nights of his life, hers are the last words he hears, as he falls asleep."
LISTEN | Stefanie Green reads an excerpt from her book about a man receiving MAID
The Current0:47
Stefanie Green reads an excerpt from her book, This is Assisted Dying
Harvey had the support of his family, but when that's not forthcoming, Green encourages respectful dialogue, with the help of a counsellor if necessary.
The aim is for a patient to express what they want, but also why they want it. And at the same time, for loved ones to express their fears or concerns about the procedure.
"The majority of times people can come to a respectful resolution together, maybe not agreeing with each other, but agreeing to at least disagree," Green said.
I will not be bullied into not doing my job and I will not allow my patients to be bullied.
- Dr. Stefanie Green
In a minority of cases she has overseen, the family will never agree to the procedure, as happened with a woman Green calls Edna in the book, whose loved ones objected on personal moral grounds.
Fear of losing access to medical assistance in dying put 'panic' in woman with terminal cancer, says son
'A compromised life is worth living': Why Ing Wong-Ward won't choose medically assisted death
"We did have some counselling, but in the end, there was some yelling and screaming and finger pointing — that is never a pleasant situation," Green said.
But the decision ultimately lies with the patient, she said, provided they meet the eligibility, are capable of making the choice, and there is no evidence of coercion.
"I will not be bullied into not doing my job and I will not allow my patients to be bullied," she said.
"I take my direction from the patient who has the right to make this request."
Disability advocates want support to live
Last year, the federal government passed Bill C-7, which expanded access to MAID to include those whose deaths are not "reasonably foreseeable" after a 2019 court challenge by two Quebecers.
The changes included a temporary ban on accessing MAID solely on the basis of mental illness until March 2023. That delay allows the federal government's expert panel to assess how MAID in cases of mental illness can be safely provided.
WATCH | New law on medically assisted death passes
New law on medically assisted death passes
1 year ago
Duration5:27
The Senate has passed Bill C-7, which expands access to medical assistance in dying, including, eventually, to people suffering solely from mental illnesses. 5:27
Some disability advocates have said the expansion in MAID access, without additional supports to live full lives, is tantamount to discrimination against people living with disabilities.
Earlier this year, Krista Carr, executive vice-president of disability rights organization Inclusion Canada, said it poses a threat to Canadians with disabilities.
"One of the things the disability community fought really hard to do was keep [MAID] at end-of-life," she told CBC News in January.
"They don't actually want to die, they want to live. But they want to live a life on par with other people, which is entirely possible with proper support. But yet we're not prepared to provide that."
Green said debates about whether the law is "too loose or too tight" will continue for years, "but it's my job to work within that law."
Green's book tells the stories of people she has helped, with some details changed for privacy. (Simon and Schuster)
She added that as much as she may want to help people, she won't break the law to do so.
That makes telling some people they're ineligible for MAID "probably the hardest thing I do," she said.
'Cold comfort to be offered the choice to die' when not offered support to live, says disability advocate
Do changes to assisted dying in Canada help the most vulnerable or endanger them? Advocates are divided
"These are patients who've approached me, who very much believe … that they are suffering intolerably," she said.
"When I need to tell someone that they're ineligible, it's often devastating for them."
Latest figures show that three-quarters of the 12,808 requests in 2019 and 2020 were granted.
By contrast, she sees an "immediate relief" when telling patients they are eligible.
"There's an immediate sense of forgetting about how they're going to die and a grabbing on to the time that is left," she said.
'There was no hesitation': Why a couple married 73 years chose doctor-assisted death together
This family learned loved one had medically assisted death only after she was gone
Those patients focus on things like who they want to spend time with, what they want to say, and what's left on their bucket lists, she said.
"I'm always amazed at how people focus more on life and living once they know how they're going to die."
Listen to podcasts at:
https://www.cbc.ca/radio/thecurrent/the ... -1.6401496
Book:
Green's book tells the stories of people she has helped, with some details changed for privacy. (Simon and Schuster)
Most people have not had the opportunity to openly discuss their end-of-life options, says Dr. Stefanie Green
Stefanie Green, B.C.-based physician who offers medical assistance in death. (Jacob Green)
When Dr. Stefanie Green meets a patient to discuss medical assistance in dying (MAID), she's upfront about the conversation they're about to have.
"We're going to talk about death today. We're going to talk about dying," she tells them. "We're going to talk about your death. And we're going to talk about assisted dying."
"People thank me at that moment," often because they have not yet had an open conversation about their death, or end-of-life options, said Green, a physician based in Victoria, B.C.
Green was one of the first doctors to offer MAID after it was legalized in 2016. The law offers the procedure to Canadians suffering grievous and irremediable conditions, provided they have the capacity to understand the choice, as well as their own health issues, and any potential treatment or palliative care options. Providers perform checks to ensure there is no coercion involved.
Years after medical assistance in dying became legal, the debate rages on
Combining previous reports and the latest data released in January, Statistics Canada has recorded more than 21,000 medically assisted deaths between 2016 and 2020. As of last summer, there were about 1,300 providers offering MAID across the country.
Green says the decision to access MAID ultimately lies with the patient, provided they meet the necessary parameters. (Shaun Best/Reuters)
After six years working closely with people at the end of life, Green hopes to help people have easier conversations about MAID.
"We're not very good in Canada about talking about death and dying," she told The Current's Matt Galloway.
"I think we need to get better at this conversation."
Her new book, This is Assisted Dying: A Doctor's Story of Empowering Patients at the End of Life, tells the stories of people she has helped — with names and details changed for privacy — and also looks at how Canadians approach the topic.
Getting better at talking about death
Green's very first patient was a man she calls Harvey in the book. He was suffering from end-stage liver disease, and had already decided to access MAID when it became legal.
When the time came, he died surrounded by his wife and children as he'd hoped.
In her book, Green recounts a moment between Harvey and his wife: "She tells him to let go, that she's here with him. And as on most nights of his life, hers are the last words he hears, as he falls asleep."
LISTEN | Stefanie Green reads an excerpt from her book about a man receiving MAID
The Current0:47
Stefanie Green reads an excerpt from her book, This is Assisted Dying
Harvey had the support of his family, but when that's not forthcoming, Green encourages respectful dialogue, with the help of a counsellor if necessary.
The aim is for a patient to express what they want, but also why they want it. And at the same time, for loved ones to express their fears or concerns about the procedure.
"The majority of times people can come to a respectful resolution together, maybe not agreeing with each other, but agreeing to at least disagree," Green said.
I will not be bullied into not doing my job and I will not allow my patients to be bullied.
- Dr. Stefanie Green
In a minority of cases she has overseen, the family will never agree to the procedure, as happened with a woman Green calls Edna in the book, whose loved ones objected on personal moral grounds.
Fear of losing access to medical assistance in dying put 'panic' in woman with terminal cancer, says son
'A compromised life is worth living': Why Ing Wong-Ward won't choose medically assisted death
"We did have some counselling, but in the end, there was some yelling and screaming and finger pointing — that is never a pleasant situation," Green said.
But the decision ultimately lies with the patient, she said, provided they meet the eligibility, are capable of making the choice, and there is no evidence of coercion.
"I will not be bullied into not doing my job and I will not allow my patients to be bullied," she said.
"I take my direction from the patient who has the right to make this request."
Disability advocates want support to live
Last year, the federal government passed Bill C-7, which expanded access to MAID to include those whose deaths are not "reasonably foreseeable" after a 2019 court challenge by two Quebecers.
The changes included a temporary ban on accessing MAID solely on the basis of mental illness until March 2023. That delay allows the federal government's expert panel to assess how MAID in cases of mental illness can be safely provided.
WATCH | New law on medically assisted death passes
New law on medically assisted death passes
1 year ago
Duration5:27
The Senate has passed Bill C-7, which expands access to medical assistance in dying, including, eventually, to people suffering solely from mental illnesses. 5:27
Some disability advocates have said the expansion in MAID access, without additional supports to live full lives, is tantamount to discrimination against people living with disabilities.
Earlier this year, Krista Carr, executive vice-president of disability rights organization Inclusion Canada, said it poses a threat to Canadians with disabilities.
"One of the things the disability community fought really hard to do was keep [MAID] at end-of-life," she told CBC News in January.
"They don't actually want to die, they want to live. But they want to live a life on par with other people, which is entirely possible with proper support. But yet we're not prepared to provide that."
Green said debates about whether the law is "too loose or too tight" will continue for years, "but it's my job to work within that law."
Green's book tells the stories of people she has helped, with some details changed for privacy. (Simon and Schuster)
She added that as much as she may want to help people, she won't break the law to do so.
That makes telling some people they're ineligible for MAID "probably the hardest thing I do," she said.
'Cold comfort to be offered the choice to die' when not offered support to live, says disability advocate
Do changes to assisted dying in Canada help the most vulnerable or endanger them? Advocates are divided
"These are patients who've approached me, who very much believe … that they are suffering intolerably," she said.
"When I need to tell someone that they're ineligible, it's often devastating for them."
Latest figures show that three-quarters of the 12,808 requests in 2019 and 2020 were granted.
By contrast, she sees an "immediate relief" when telling patients they are eligible.
"There's an immediate sense of forgetting about how they're going to die and a grabbing on to the time that is left," she said.
'There was no hesitation': Why a couple married 73 years chose doctor-assisted death together
This family learned loved one had medically assisted death only after she was gone
Those patients focus on things like who they want to spend time with, what they want to say, and what's left on their bucket lists, she said.
"I'm always amazed at how people focus more on life and living once they know how they're going to die."
Listen to podcasts at:
https://www.cbc.ca/radio/thecurrent/the ... -1.6401496
Book:
Green's book tells the stories of people she has helped, with some details changed for privacy. (Simon and Schuster)
Is Choosing Death Too Easy in Canada?
Since the government expanded the eligibility for assisted death last year to include those with disabilities, critics have been saying there should be more checks and balances.
Cheryl Romaire, who wears a fentanyl patch for pain from a degenerative spinal condition, was recently approved for an assisted death.Credit...Ian Austen/The New York Times
CALGARY, Alberta — The first time Cheryl Romaire tried to end her life under Canada’s assisted suicide law, her application was rejected. But after a loosening of the law, she received approval to end her life — and she now intends to do just that.
“It felt like a weight had been lifted off my chest,” Ms. Romaire said recently, as one of her cats and a dog competed for her attention at her apartment in Calgary, Alberta.
Last year, Canada changed its assisted death law, permitting people with chronic, “grievous and irremediable” conditions and physical disabilities to commit suicide, even if they are not terminally ill. And so this allowed Ms. Romaire — who has undergone 41 medical procedures in 10 years for a painful and worsening spinal cord condition but had been told her death from the condition was not “reasonably foreseeable’’ — to qualify for a death on her own terms.
“You can have a good death, you can have your family there with you,” she said. “It’s traumatic still to them. But it’s not the same as the shock of suicide which people will do when they’re at pain levels where there’s no hope.”
Canada is among 12 countries and several American states where assisted death is permitted in certain circumstances. Since last year, it has been one of at least three — including Belgium and the Netherlands — that allow an assisted death if the person is suffering from a chronic painful condition, even if that condition is not terminal.
Although the Canadian law was hotly debated in 2016, when it was originally enacted, it has won broad public acceptance since then, with polls showing strong support. Through December of 2021, 31,664 Canadians have received assisted deaths. Of those, 224 who died last year were not terminally ill, taking advantage of last year’s amendment.
But the change in the law has reignited debate over the system. In March the law will expand again, to apply to people with some mental disorders. A Parliamentary committee of lawmakers is studying what standards should govern those cases; its report is expected in the fall.
Already, though, critics are saying Canada is now going too far.
Among those critics are three United Nations disability and human rights experts, who said, in a letter to the Canadian government, that in legalizing assisted suicide for disabled people who are not terminally ill, the law, as written, has devalued their lives by suggesting “that significant disability can be worse than death.”
“You can have a good death, you can have your family there with you,” said Ms. Romaire.Credit...Ian Austen/The New York Times
Some say that with the law’s expansions, Canada is turning assisted suicide into an almost routine medical option, instead of treating it as an extraordinary measure taken in limited situations.
“Canada has the least safeguards of all of countries that allow it,” said Trudo Lemmens, the chairman in health law and policy in the faculty of law at the University of Toronto, referring to the assisted suicide legislation generally, “and it has the most open-ended system.”
“It’s a state-funded, state-organized, medical system providing end of life,” he continued. “What I find particularly troublesome is that there is no other jurisdiction that treats the ending of life by a physician as a standard medical practice.”
Under the current law, people who are terminally ill when they apply for assisted death must be assessed by a physician or nurse practitioner. Applicants who have non-life threatening illnesses and disabilities must undergo assessments by two separate clinicians. They must also undergo a 90-day waiting period.
While patients have the option of swallowing prescribed medication to end their lives, the overwhelming majority elect to have a physician or nurse practitioner make a lethal injection. The clinicians are the final arbiters of whether the person qualifies for assisted death. But all requests for assisted death and the deaths themselves must be reported to the federal health department, which monitors them, as well.
Jocelyn Downie, a professor in the law and medical faculties at Dalhousie University in Halifax, Nova Scotia, said, “There’s no good evidence that the Canadian system is not working well and we do have systems in place to detect when it is not working well.”
She added, “Relative to the rest of the world, I actually think we have an excellent system.”
But a series of committee hearings, including the current parliamentary ones, have provided a public forum for the rekindled debate both about the expanded law and the country’s experience with assisted dying.
The committees have heard from people frustrated by being shut out of the process that led to the deaths of family members; the decision to choose death is, under the law, one in which family members have no say. Many characterized the amended law as a dangerous assault on people with disabilities and have raised the possibility that people facing economic or housing challenges may now simply give up and opt to die.
Others worried that including mental disorders will undermine suicide prevention efforts, or that death was being inappropriately raised as an alternative to treatment or more support.
Experts said there were often disagreements within families when someone chooses assisted suicide. But the government says there have not been documented abuses of the system.
In a statement, Health Canada said the new law introduced extra safeguards to protect people with disabilities and mental disorders as well as increased the government’s tracking of who is applying to die and of their motives. The government also said that the new law provided more oversight of doctors.
The committee that is studying how to apply the changes in the law heard hours of testimony and reviewed piles of written submissions.
Committee members wrestled with questions like whether minors should be allowed to choose assisted death and, if so, how, and whether healthy Canadians should be able to choose an assisted death before they develop dementia or any other condition that would prevent them from making a valid request.
“I wish they wouldn’t speak for me,” said Ms. Romaire.Credit...Ian Austen/The New York Times
One submission came from Christopher Lyon, whose father sought an assisted death under the amended law. The father, who lived in western Canada, had a long history of depression, suicidal thoughts and threats of suicide, Mr. Lyon said. When he fell and stopped eating, his doctors ruled him terminally ill, and granted him an assisted death at age 77. The son, who has recently moved to Britain, said the process was rushed and opaque to his family.
“We still haven’t gotten the records but what we do have raises more questions than answers about the circumstances of his death and to me that’s quite alarming,” Mr. Lyon said. “The current law in Canada and the level of rigor that goes into an assessment does not seem to be strong.”
Canada’s move toward assisted suicide was driven by the courts. The original 2016 law was a response to a 2015 decision by the Supreme Court of Canada that federal criminal law prohibiting assisted death violated the country’s Charter of Rights and Freedoms. The amended law was a response to a 2019 ruling by a Quebec court that parts of the system were unconstitutional by being too restrictive.
In Calgary, Ms. Romaire, who is 46 and a divorced mother of two adult children, said the debate over the new law has at times angered her but also made her anxious that the approval she’s received for an assisted death could be taken away.
Despite wearing a fentanyl patch, Ms. Romaire said she was in constant pain. Once an avid walker and yoga practitioner, she can no longer make it to the Co-Op supermarket a block from her home.
Ms. Romaire said that she has no immediate plans to go ahead with her death, partly because she first wants to sort out things with two family members who are struggling with her decision.
Ms. Romaire said she has a message for people who want to add additional safeguards or roll back the system’s scope by arguing that it is a threat to people with disabilities.
“I wish they wouldn’t speak for me,” she said. Assisted death “is not something that somebody can be pushed into,” she said. “It’s a very difficult process to go through, it’s not as easy as people think.”
https://www.nytimes.com/2022/09/18/worl ... 778d3e6de3
Cheryl Romaire, who wears a fentanyl patch for pain from a degenerative spinal condition, was recently approved for an assisted death.Credit...Ian Austen/The New York Times
CALGARY, Alberta — The first time Cheryl Romaire tried to end her life under Canada’s assisted suicide law, her application was rejected. But after a loosening of the law, she received approval to end her life — and she now intends to do just that.
“It felt like a weight had been lifted off my chest,” Ms. Romaire said recently, as one of her cats and a dog competed for her attention at her apartment in Calgary, Alberta.
Last year, Canada changed its assisted death law, permitting people with chronic, “grievous and irremediable” conditions and physical disabilities to commit suicide, even if they are not terminally ill. And so this allowed Ms. Romaire — who has undergone 41 medical procedures in 10 years for a painful and worsening spinal cord condition but had been told her death from the condition was not “reasonably foreseeable’’ — to qualify for a death on her own terms.
“You can have a good death, you can have your family there with you,” she said. “It’s traumatic still to them. But it’s not the same as the shock of suicide which people will do when they’re at pain levels where there’s no hope.”
Canada is among 12 countries and several American states where assisted death is permitted in certain circumstances. Since last year, it has been one of at least three — including Belgium and the Netherlands — that allow an assisted death if the person is suffering from a chronic painful condition, even if that condition is not terminal.
Although the Canadian law was hotly debated in 2016, when it was originally enacted, it has won broad public acceptance since then, with polls showing strong support. Through December of 2021, 31,664 Canadians have received assisted deaths. Of those, 224 who died last year were not terminally ill, taking advantage of last year’s amendment.
But the change in the law has reignited debate over the system. In March the law will expand again, to apply to people with some mental disorders. A Parliamentary committee of lawmakers is studying what standards should govern those cases; its report is expected in the fall.
Already, though, critics are saying Canada is now going too far.
Among those critics are three United Nations disability and human rights experts, who said, in a letter to the Canadian government, that in legalizing assisted suicide for disabled people who are not terminally ill, the law, as written, has devalued their lives by suggesting “that significant disability can be worse than death.”
“You can have a good death, you can have your family there with you,” said Ms. Romaire.Credit...Ian Austen/The New York Times
Some say that with the law’s expansions, Canada is turning assisted suicide into an almost routine medical option, instead of treating it as an extraordinary measure taken in limited situations.
“Canada has the least safeguards of all of countries that allow it,” said Trudo Lemmens, the chairman in health law and policy in the faculty of law at the University of Toronto, referring to the assisted suicide legislation generally, “and it has the most open-ended system.”
“It’s a state-funded, state-organized, medical system providing end of life,” he continued. “What I find particularly troublesome is that there is no other jurisdiction that treats the ending of life by a physician as a standard medical practice.”
Under the current law, people who are terminally ill when they apply for assisted death must be assessed by a physician or nurse practitioner. Applicants who have non-life threatening illnesses and disabilities must undergo assessments by two separate clinicians. They must also undergo a 90-day waiting period.
While patients have the option of swallowing prescribed medication to end their lives, the overwhelming majority elect to have a physician or nurse practitioner make a lethal injection. The clinicians are the final arbiters of whether the person qualifies for assisted death. But all requests for assisted death and the deaths themselves must be reported to the federal health department, which monitors them, as well.
Jocelyn Downie, a professor in the law and medical faculties at Dalhousie University in Halifax, Nova Scotia, said, “There’s no good evidence that the Canadian system is not working well and we do have systems in place to detect when it is not working well.”
She added, “Relative to the rest of the world, I actually think we have an excellent system.”
But a series of committee hearings, including the current parliamentary ones, have provided a public forum for the rekindled debate both about the expanded law and the country’s experience with assisted dying.
The committees have heard from people frustrated by being shut out of the process that led to the deaths of family members; the decision to choose death is, under the law, one in which family members have no say. Many characterized the amended law as a dangerous assault on people with disabilities and have raised the possibility that people facing economic or housing challenges may now simply give up and opt to die.
Others worried that including mental disorders will undermine suicide prevention efforts, or that death was being inappropriately raised as an alternative to treatment or more support.
Experts said there were often disagreements within families when someone chooses assisted suicide. But the government says there have not been documented abuses of the system.
In a statement, Health Canada said the new law introduced extra safeguards to protect people with disabilities and mental disorders as well as increased the government’s tracking of who is applying to die and of their motives. The government also said that the new law provided more oversight of doctors.
The committee that is studying how to apply the changes in the law heard hours of testimony and reviewed piles of written submissions.
Committee members wrestled with questions like whether minors should be allowed to choose assisted death and, if so, how, and whether healthy Canadians should be able to choose an assisted death before they develop dementia or any other condition that would prevent them from making a valid request.
“I wish they wouldn’t speak for me,” said Ms. Romaire.Credit...Ian Austen/The New York Times
One submission came from Christopher Lyon, whose father sought an assisted death under the amended law. The father, who lived in western Canada, had a long history of depression, suicidal thoughts and threats of suicide, Mr. Lyon said. When he fell and stopped eating, his doctors ruled him terminally ill, and granted him an assisted death at age 77. The son, who has recently moved to Britain, said the process was rushed and opaque to his family.
“We still haven’t gotten the records but what we do have raises more questions than answers about the circumstances of his death and to me that’s quite alarming,” Mr. Lyon said. “The current law in Canada and the level of rigor that goes into an assessment does not seem to be strong.”
Canada’s move toward assisted suicide was driven by the courts. The original 2016 law was a response to a 2015 decision by the Supreme Court of Canada that federal criminal law prohibiting assisted death violated the country’s Charter of Rights and Freedoms. The amended law was a response to a 2019 ruling by a Quebec court that parts of the system were unconstitutional by being too restrictive.
In Calgary, Ms. Romaire, who is 46 and a divorced mother of two adult children, said the debate over the new law has at times angered her but also made her anxious that the approval she’s received for an assisted death could be taken away.
Despite wearing a fentanyl patch, Ms. Romaire said she was in constant pain. Once an avid walker and yoga practitioner, she can no longer make it to the Co-Op supermarket a block from her home.
Ms. Romaire said that she has no immediate plans to go ahead with her death, partly because she first wants to sort out things with two family members who are struggling with her decision.
Ms. Romaire said she has a message for people who want to add additional safeguards or roll back the system’s scope by arguing that it is a threat to people with disabilities.
“I wish they wouldn’t speak for me,” she said. Assisted death “is not something that somebody can be pushed into,” she said. “It’s a very difficult process to go through, it’s not as easy as people think.”
https://www.nytimes.com/2022/09/18/worl ... 778d3e6de3
Death by Doctor May Soon Be Available for the Mentally Ill in Canada
The country is divided over a law that would allow patients suffering from mental health illnesses to apply for assisted death.
Jason French has undergone years of treatment for his depression without any improvement. He says he wants access to assisted death so he can die on his own terms.Credit...Ian Willms for The New York Times
Canada already has one of the most liberal assisted death laws in the world, offering the practice to terminally and chronically ill Canadians.
But under a law scheduled to take effect in March assisted dying would also become accessible to people whose only medical condition is mental illness, making Canada one of about half a dozen countries to permit the procedure for that category of people.
Audio: Listen to This Article
Open this article in the New York Times Audio app on iOS.
That move has divided Canadians, some of whom view it as a sign that the country’s public health care system is not offering adequate psychiatric care, which is notoriously underfunded and in high demand.
The government of Prime Minister Justin Trudeau, which has been criticized for its rollout of the policy, has defended its actions by pointing to a 2019 court decision in Quebec that officials say mandates the expansion.
Members of the Conservative Party have accused the government of promoting a “culture of death.” There has also been opposition from politicians on the left who would like the government to focus its health policy on expanding mental health care.
Jason French is among those building a case for why a doctor should help him die.
With copies of a document describing his troubled mental health history tucked in his backpack, he attended an event in Toronto to lobby for making assisted dying available to people like him.
He has severe depression and has tried twice to end his own life, he said.
“My goal from the start was to get better,” said Mr. French, of Toronto, who agreed to share his name, but not his age because so many in his life don’t know about his illness. “Unfortunately, I’m resistant to all these treatments and the bottom line is, I can’t keep suffering. I can’t keep living my life like this.”
At His Own Wake, Celebrating Life and the Gift of Death
Tormented by an incurable disease, John Shields knew that dying openly and without fear could be his legacy, if his doctor, friends and family helped him.
May 25, 2017
But Dr. John Maher, a psychiatrist in Barrie, Ontario, who specializes in treating complex cases that often take years to improve said he was concerned that hopeless patients will opt for assisted death instead.
“I’m trying to keep my patients alive,” he said. “What does it mean for the role of the physician, as healer, as bringer of hope, to be offering death? And what does it mean in practice?”
Canada’s existing assisted death law applies only to people who are terminally ill or living with physical disabilities or chronic, incurable conditions. The country’s Supreme Court decriminalized assisted death in 2015 and ruled that forcing Canadians to cope with intolerable suffering infringes on fundamental rights to liberty and security.
About 13,200 Canadians had an assisted death last year, a 31 percent increase over 2021 according to a report by the federal health ministry. Of those, 463 people, or 3.5 percent, were not terminally ill, but had other medical conditions. Patients who are approved have the option to end their lives using lethal drugs administered by a physician or nurse, or by taking drugs prescribed to them.
There is still uncertainty and debate over whether assisted death will become available to the mentally ill early next year as scheduled. Amid concerns over how to implement it, Parliament has delayed putting it into place for the past three years and could delay it again.
Clinical guidelines were released to address those concerns last March, but some people involved in providing mental health care say they are insufficient.
ImageA person wearing a dark jacket and an orange top stands near a body of water.
Lisa Marr, a paramedic diagnosed with post-traumatic stress disorder, said the wait for the assisted dying law to take effect has been grueling.Credit...Carolina Andrade for The New York Times
The proposed change to include the mentally ill has been particularly divisive among some psychiatrists with Dr. Maher and others saying it muddles their efforts to prevent suicide.
But supporters say denying mentally ill people access to the same humane option to end their suffering amounts to discrimination.
“I have a very deep empathy for patients who suffer deeply,” said Dr. Alexandra McPherson, a psychiatry professor at the University of Alberta and assisted death provider. She said she treats a small number of patients “with severe disabling mental health disorders who suffer equally to the patients that I see in cancer care.”
Lisa Marr, a former paramedic diagnosed with post-traumatic stress disorder who lives in Nova Scotia, said she was desperate to take advantage of the new law. She has bipolar disorder, depression and excoriation disorder, or skin picking, from anxiety and has made, she estimates, 15 attempts on her life but “always managed to pull myself out.”
Image
A person covered by a blanket sits on a couch. A cat is nearby.
Ms. Marr at home with her support cat, Fig. “All the medications I take just barely keep me together,” she said.Credit...Carolina Andrade for The New York Times
“The only reason I haven’t done it yet, I think, is I’m waiting for this decision in March,” she added.
Canada amended its criminal code to legalize assisted death for the terminally ill in 2016, and in 2021, responding to the court ruling in Quebec, the country loosened the law to add other severely ill people experiencing “grievous and irremediable” conditions.
Eligible patients must wait 90 days before receiving an assisted death and be approved based on the assessments of two independent physicians. One of the assessors must be a specialist in the patient’s illness or have consulted with a specialist.
A panel of experts and a special parliamentary committee have worked to address concerns from the public and medical community, by laying out practice standards and advising clinicians and regulators.
The government has also funded the development of a training program for physicians and nurses who assess patients for assisted death.
“The work has been done,” Dr. Mona Gupta, the chair of a government-appointed expert panel — who is a psychiatrist and bioethics researcher at the University of Montreal — told a special parliamentary committee in November. “We are ready.”
Anyone in Canada seeking assisted death must be deemed by the physicians or nurse practitioners who assess them as not impulsive and not suicidal, and those who are mentally ill would need to be evaluated to show that their condition is “irremediable.”
But even some psychiatrists worry that they may not always be able to determine if someone seeking an assisted death could actually get better or not.
“The research that we have shows psychiatrists are no better at identifying who’s not going to get better,” said Dr. Maher, the psychiatrist in Ontario. “The challenge for us is it’s not a short term process. When people have been sick for years, healing takes years.”
The Centre for Addiction and Mental Health, Canada’s largest teaching hospital for psychiatric care and research, has said that clinicians need more guidance to assist them in assessing who is acutely suicidal or capable of making a rational choice to end their lives.
“We’ve been clear that we have concerns about expansion at this time,” said Dr. Sanjeev Sockalingam, chief medical officer at the center, which has convened several professional groups to assist physicians in preparing for March.
Image
A man in a suit leans against a pole looking out the window.
Dr. Sanjeev Sockalingam is the chief medical officer at the Centre for Addiction and Mental Health, Canada’s largest teaching hospital for psychiatric care and research.Credit...Ian Willms for The New York Times
Ms. Marr, the paramedic, said the wait for the law to take effect has been grueling. She takes eight psychiatric drugs every day. “All the medications I take just barely keep me together,” said Ms. Marr, who is on disability leave and spends most days in her room, leaving home only for therapy.
Her father had an assisted death after being diagnosed with prostate cancer, and her mother died shortly after, all while she was juggling her job as a paramedic.
“Then, my mental health started to rear its ugly head,” she said.
The uncertainty over whether the mentally ill would be allowed assisted death motivated Mr. French to leave his home after work, something his depression rarely allows him, to attend a screening of a documentary financed by Dying With Dignity, a charity promoting assisted death.
He went with several copies of a five-page document he created explaining his case, hoping to give it to medical experts at the screening.
Death doesn’t scare him.
“My biggest fear is surviving,” he said.
He said he’s not suicidal. But, he added, “I don’t want to have to die terrified and alone, and have someone find me somewhere. I want to do it with a doctor. I want to die within a few minutes, peacefully.”
Image
A person in a hooded sits on a bench facing a playground.
“My biggest fear is surviving,” Mr. French said.Credit...Ian Willms for The New York Times
Both Canada and the United States have a three-digit suicide and crisis hotline: 988. If you are having thoughts of suicide, call or text 988 and visit 988.ca (Canada) or 988lifeline.org (United States) for a list of additional resources. This service offers bilingual crisis support in each country, 24 hours a day, seven days a week.
https://www.nytimes.com/2023/12/27/worl ... 778d3e6de3
Jason French has undergone years of treatment for his depression without any improvement. He says he wants access to assisted death so he can die on his own terms.Credit...Ian Willms for The New York Times
Canada already has one of the most liberal assisted death laws in the world, offering the practice to terminally and chronically ill Canadians.
But under a law scheduled to take effect in March assisted dying would also become accessible to people whose only medical condition is mental illness, making Canada one of about half a dozen countries to permit the procedure for that category of people.
Audio: Listen to This Article
Open this article in the New York Times Audio app on iOS.
That move has divided Canadians, some of whom view it as a sign that the country’s public health care system is not offering adequate psychiatric care, which is notoriously underfunded and in high demand.
The government of Prime Minister Justin Trudeau, which has been criticized for its rollout of the policy, has defended its actions by pointing to a 2019 court decision in Quebec that officials say mandates the expansion.
Members of the Conservative Party have accused the government of promoting a “culture of death.” There has also been opposition from politicians on the left who would like the government to focus its health policy on expanding mental health care.
Jason French is among those building a case for why a doctor should help him die.
With copies of a document describing his troubled mental health history tucked in his backpack, he attended an event in Toronto to lobby for making assisted dying available to people like him.
He has severe depression and has tried twice to end his own life, he said.
“My goal from the start was to get better,” said Mr. French, of Toronto, who agreed to share his name, but not his age because so many in his life don’t know about his illness. “Unfortunately, I’m resistant to all these treatments and the bottom line is, I can’t keep suffering. I can’t keep living my life like this.”
At His Own Wake, Celebrating Life and the Gift of Death
Tormented by an incurable disease, John Shields knew that dying openly and without fear could be his legacy, if his doctor, friends and family helped him.
May 25, 2017
But Dr. John Maher, a psychiatrist in Barrie, Ontario, who specializes in treating complex cases that often take years to improve said he was concerned that hopeless patients will opt for assisted death instead.
“I’m trying to keep my patients alive,” he said. “What does it mean for the role of the physician, as healer, as bringer of hope, to be offering death? And what does it mean in practice?”
Canada’s existing assisted death law applies only to people who are terminally ill or living with physical disabilities or chronic, incurable conditions. The country’s Supreme Court decriminalized assisted death in 2015 and ruled that forcing Canadians to cope with intolerable suffering infringes on fundamental rights to liberty and security.
About 13,200 Canadians had an assisted death last year, a 31 percent increase over 2021 according to a report by the federal health ministry. Of those, 463 people, or 3.5 percent, were not terminally ill, but had other medical conditions. Patients who are approved have the option to end their lives using lethal drugs administered by a physician or nurse, or by taking drugs prescribed to them.
There is still uncertainty and debate over whether assisted death will become available to the mentally ill early next year as scheduled. Amid concerns over how to implement it, Parliament has delayed putting it into place for the past three years and could delay it again.
Clinical guidelines were released to address those concerns last March, but some people involved in providing mental health care say they are insufficient.
ImageA person wearing a dark jacket and an orange top stands near a body of water.
Lisa Marr, a paramedic diagnosed with post-traumatic stress disorder, said the wait for the assisted dying law to take effect has been grueling.Credit...Carolina Andrade for The New York Times
The proposed change to include the mentally ill has been particularly divisive among some psychiatrists with Dr. Maher and others saying it muddles their efforts to prevent suicide.
But supporters say denying mentally ill people access to the same humane option to end their suffering amounts to discrimination.
“I have a very deep empathy for patients who suffer deeply,” said Dr. Alexandra McPherson, a psychiatry professor at the University of Alberta and assisted death provider. She said she treats a small number of patients “with severe disabling mental health disorders who suffer equally to the patients that I see in cancer care.”
Lisa Marr, a former paramedic diagnosed with post-traumatic stress disorder who lives in Nova Scotia, said she was desperate to take advantage of the new law. She has bipolar disorder, depression and excoriation disorder, or skin picking, from anxiety and has made, she estimates, 15 attempts on her life but “always managed to pull myself out.”
Image
A person covered by a blanket sits on a couch. A cat is nearby.
Ms. Marr at home with her support cat, Fig. “All the medications I take just barely keep me together,” she said.Credit...Carolina Andrade for The New York Times
“The only reason I haven’t done it yet, I think, is I’m waiting for this decision in March,” she added.
Canada amended its criminal code to legalize assisted death for the terminally ill in 2016, and in 2021, responding to the court ruling in Quebec, the country loosened the law to add other severely ill people experiencing “grievous and irremediable” conditions.
Eligible patients must wait 90 days before receiving an assisted death and be approved based on the assessments of two independent physicians. One of the assessors must be a specialist in the patient’s illness or have consulted with a specialist.
A panel of experts and a special parliamentary committee have worked to address concerns from the public and medical community, by laying out practice standards and advising clinicians and regulators.
The government has also funded the development of a training program for physicians and nurses who assess patients for assisted death.
“The work has been done,” Dr. Mona Gupta, the chair of a government-appointed expert panel — who is a psychiatrist and bioethics researcher at the University of Montreal — told a special parliamentary committee in November. “We are ready.”
Anyone in Canada seeking assisted death must be deemed by the physicians or nurse practitioners who assess them as not impulsive and not suicidal, and those who are mentally ill would need to be evaluated to show that their condition is “irremediable.”
But even some psychiatrists worry that they may not always be able to determine if someone seeking an assisted death could actually get better or not.
“The research that we have shows psychiatrists are no better at identifying who’s not going to get better,” said Dr. Maher, the psychiatrist in Ontario. “The challenge for us is it’s not a short term process. When people have been sick for years, healing takes years.”
The Centre for Addiction and Mental Health, Canada’s largest teaching hospital for psychiatric care and research, has said that clinicians need more guidance to assist them in assessing who is acutely suicidal or capable of making a rational choice to end their lives.
“We’ve been clear that we have concerns about expansion at this time,” said Dr. Sanjeev Sockalingam, chief medical officer at the center, which has convened several professional groups to assist physicians in preparing for March.
Image
A man in a suit leans against a pole looking out the window.
Dr. Sanjeev Sockalingam is the chief medical officer at the Centre for Addiction and Mental Health, Canada’s largest teaching hospital for psychiatric care and research.Credit...Ian Willms for The New York Times
Ms. Marr, the paramedic, said the wait for the law to take effect has been grueling. She takes eight psychiatric drugs every day. “All the medications I take just barely keep me together,” said Ms. Marr, who is on disability leave and spends most days in her room, leaving home only for therapy.
Her father had an assisted death after being diagnosed with prostate cancer, and her mother died shortly after, all while she was juggling her job as a paramedic.
“Then, my mental health started to rear its ugly head,” she said.
The uncertainty over whether the mentally ill would be allowed assisted death motivated Mr. French to leave his home after work, something his depression rarely allows him, to attend a screening of a documentary financed by Dying With Dignity, a charity promoting assisted death.
He went with several copies of a five-page document he created explaining his case, hoping to give it to medical experts at the screening.
Death doesn’t scare him.
“My biggest fear is surviving,” he said.
He said he’s not suicidal. But, he added, “I don’t want to have to die terrified and alone, and have someone find me somewhere. I want to do it with a doctor. I want to die within a few minutes, peacefully.”
Image
A person in a hooded sits on a bench facing a playground.
“My biggest fear is surviving,” Mr. French said.Credit...Ian Willms for The New York Times
Both Canada and the United States have a three-digit suicide and crisis hotline: 988. If you are having thoughts of suicide, call or text 988 and visit 988.ca (Canada) or 988lifeline.org (United States) for a list of additional resources. This service offers bilingual crisis support in each country, 24 hours a day, seven days a week.
https://www.nytimes.com/2023/12/27/worl ... 778d3e6de3
Canada Delays Plan to Offer Medically Assisted Death to the Mentally Ill
A parliamentary panel concluded that there are not enough doctors, particularly psychiatrists, in the country to properly assess patients.
Jason French, a Canadian who has undergone years of treatment for depression, said he wanted access to assisted death so he could die on his own terms.Credit...Ian Willms for The New York Times
Canada is postponing a plan to offer people suffering from mental illnesses the option of a medically assisted death, two cabinet ministers said on Monday.
The announcement by Mark Holland, the health minister, and Arif Virani, the justice minister, came after a special parliamentary committee looking into the plan concluded that there are not enough doctors, particularly psychiatrists, in the country to assess patients with mental illnesses who want to end their lives and to help them do so.
“The system needs to be ready, and we need to get it right,” Mr. Holland told reporters. “It’s clear from the conversations we’ve had that the system is not ready, and we need more time.”
Neither minister offered any timeline for the latest extension. Following an earlier delay, the expansion had been scheduled to come into effect on March 17.
Canada already offers medically assisted death to terminally and chronically ill people, but the plan to extend the program to people with mental illnesses has divided Canadians.
Some critics say the plan is a consequence of the inability of Canada’s public health care system to offer adequate psychiatric care, which is chronically underfunded and facing demand that outstrips its availability.
Many psychiatrists say the plan would undermine efforts to prevent suicide, and they have expressed fear that patients with complex problems will abandon treatments that can take years to achieve results in favor of a medically assisted death.
Supporters say that denying people with mental illnesses the option to end their suffering through death is a form of discrimination.
Canada introduced medically assisted dying after its Supreme Court ruled in 2015 that requiring people to cope with intolerable suffering infringed on fundamental rights to liberty and security.
The law was expanded in 2021 after the Superior Court of Quebec struck down the government’s original assisted death law on constitutional grounds because it only applied to people whose deaths were “reasonably foreseeable.”
The 2021 law expanded eligibility to people experiencing “grievous and irremediable” conditions. Its separate provisions for people with mental illnesses, which were added to the law by Canada’s unelected Senate, were originally postponed for two years.
Members of the opposition Conservative Party have charged that the Liberal government of Prime Minister Justin Trudeau is promoting a “culture of death.” Some politicians on the left have also opposed the expansion for mental illnesses and have said they want to focus on further expanding psychiatric care.
Michael Cooper, a Conservative member of Parliament who sat on the special committee, said the government should make the postponement indefinite.
“I don’t see any indication that the fundamental issues that are at the heart — or should be at the heart — of putting a pause on this expansion will be resolved,” he said.
Dying with Dignity Canada, a group that advocates for the right to medically assisted death, said in a statement that it was “disheartened” by the latest delay.
The health and justice ministers said the new implementation date would be included in legislation, soon to be introduced, that will formally extend the delay.
About 13,200 Canadians had an assisted death last year, a 31 percent increase over 2021, according to a report by the federal health department. About 3.5 percent of those patients were not terminally ill but had other qualifying medical conditions.
Both Canada and the United States have a three-digit suicide and crisis hotline: 988. If you are having thoughts of suicide, call or text 988 and visit 988.ca (Canada) or 988lifeline.org (United States) for a list of additional resources. This service offers bilingual crisis support in each country, 24 hours a day, seven days a week.
https://www.nytimes.com/2024/01/29/worl ... 778d3e6de3
Jason French, a Canadian who has undergone years of treatment for depression, said he wanted access to assisted death so he could die on his own terms.Credit...Ian Willms for The New York Times
Canada is postponing a plan to offer people suffering from mental illnesses the option of a medically assisted death, two cabinet ministers said on Monday.
The announcement by Mark Holland, the health minister, and Arif Virani, the justice minister, came after a special parliamentary committee looking into the plan concluded that there are not enough doctors, particularly psychiatrists, in the country to assess patients with mental illnesses who want to end their lives and to help them do so.
“The system needs to be ready, and we need to get it right,” Mr. Holland told reporters. “It’s clear from the conversations we’ve had that the system is not ready, and we need more time.”
Neither minister offered any timeline for the latest extension. Following an earlier delay, the expansion had been scheduled to come into effect on March 17.
Canada already offers medically assisted death to terminally and chronically ill people, but the plan to extend the program to people with mental illnesses has divided Canadians.
Some critics say the plan is a consequence of the inability of Canada’s public health care system to offer adequate psychiatric care, which is chronically underfunded and facing demand that outstrips its availability.
Many psychiatrists say the plan would undermine efforts to prevent suicide, and they have expressed fear that patients with complex problems will abandon treatments that can take years to achieve results in favor of a medically assisted death.
Supporters say that denying people with mental illnesses the option to end their suffering through death is a form of discrimination.
Canada introduced medically assisted dying after its Supreme Court ruled in 2015 that requiring people to cope with intolerable suffering infringed on fundamental rights to liberty and security.
The law was expanded in 2021 after the Superior Court of Quebec struck down the government’s original assisted death law on constitutional grounds because it only applied to people whose deaths were “reasonably foreseeable.”
The 2021 law expanded eligibility to people experiencing “grievous and irremediable” conditions. Its separate provisions for people with mental illnesses, which were added to the law by Canada’s unelected Senate, were originally postponed for two years.
Members of the opposition Conservative Party have charged that the Liberal government of Prime Minister Justin Trudeau is promoting a “culture of death.” Some politicians on the left have also opposed the expansion for mental illnesses and have said they want to focus on further expanding psychiatric care.
Michael Cooper, a Conservative member of Parliament who sat on the special committee, said the government should make the postponement indefinite.
“I don’t see any indication that the fundamental issues that are at the heart — or should be at the heart — of putting a pause on this expansion will be resolved,” he said.
Dying with Dignity Canada, a group that advocates for the right to medically assisted death, said in a statement that it was “disheartened” by the latest delay.
The health and justice ministers said the new implementation date would be included in legislation, soon to be introduced, that will formally extend the delay.
About 13,200 Canadians had an assisted death last year, a 31 percent increase over 2021, according to a report by the federal health department. About 3.5 percent of those patients were not terminally ill but had other qualifying medical conditions.
Both Canada and the United States have a three-digit suicide and crisis hotline: 988. If you are having thoughts of suicide, call or text 988 and visit 988.ca (Canada) or 988lifeline.org (United States) for a list of additional resources. This service offers bilingual crisis support in each country, 24 hours a day, seven days a week.
https://www.nytimes.com/2024/01/29/worl ... 778d3e6de3
Re: Euthanasia
In Switzerland, Reported Use of Suicide Capsule Inflames Debate
The Swiss police said they had detained “several individuals” after a 64-year-old American woman reportedly died by suicide using the controversial device.
The Sarco capsule on display at a news conference in Zurich in July. Credit...Ennio Leanza/EPA, via Shutterstock
The authorities in northern Switzerland said they were investigating a reported assisted suicide using a controversial device that replaces oxygen with lethal nitrogen gas.
A 64-year-old American was reported to have died by assisted suicide in a remote forest in northern Switzerland with the help of two right-to-die groups that facilitated her use of a Sarco capsule, a coffin-sized, air-tight pod with a large window, according to the capsule’s inventor. The device, which can be transported to a location of a user’s choosing, has an interior button that replaces life-giving oxygen with fatal nitrogen, killing the person in minutes. The inventor of the device said it was the first time it had been used.
The capsule was used on Monday in a remote, mountainous area north of Zurich, near the German border. The woman was said to have suffered for years from an autoimmune condition, the manufacturers of the pod said.
“I monitored the first use of the device from Germany and was pleased with the peaceful, fast death that resulted when the button was pressed,” said Philip Nitschke, the inventor of the Sarco capsule and founder of Exit International, the assisted-suicide group that provided the device to a similar group in Switzerland.
Now, the authorities in the canton of Schaffhausen said they had arrested “several people” who may have helped the woman die. Among the detained were two lawyers, a photographer for the Dutch newspaper de Volkskrant, and Florian Willet, the director of the Last Resort, a group that facilitates assisted suicide in Switzerland. Mr. Willet was the only person present when the woman died, Mr. Nitschke said. He then contacted two lawyers, who informed the authorities of her death.
The authorities said they were detaining the individuals on charges of “incitement and aiding and abetting suicide.”
The episode has drawn condemnation even in Switzerland, which has such permissible laws surrounding the practice that thousands of people across the world have sought help from right-to-die organizations there in recent years.
Although advocates of the Sarco capsule say it is compliant with Swiss law — and that users must be evaluated by medical professionals before they are approved for use — some officials and experts have decried it as inhumane and said it had not been tested sufficiently. The Swiss authorities said they warned its manufacturers that using the device in the country would be illegal.
“We warned them in writing. We said that if they came to Schaffhausen and used Sarco, they would face criminal consequences,” Peter Sticher, a prosecutor in Schaffhausen, the region of Switzerland where the device was used, told the newspaper Blick.
The emergence of the Sarco capsule, which has been criticized even by staunch advocates of the right-to-die movement, has challenged Switzerland’s stance on the subject. In an address before lawmakers on Monday — the same day that, unbeknown to the authorities, the capsule was being used by the American woman — the head of the country’s home affairs department said the device was not legal. The machine, she said, violated the Chemicals Act by using gas.
Swiss law requires that those seeking to end their lives visit with a doctor, who must confirm the person is mentally competent and has not been pushed toward the decision by anyone with ulterior motive. If confirmed, the doctor will then write a prescription for sodium pentobarbital, a type of sedative.
The Sarco (short for “sarcophagus”) capsule was invented by Mr. Nitschke, an Australian doctor who is a longtime advocate of assisted-dying procedures. The capsule is billed as a drug-free way for qualified, older people of sound mind to end their own lives. Once locked inside the capsule in a chosen location, a person can choose when to press a button, which injects nitrogen gas into the chamber.
On its website, the Last Resort advertises itself as the only organization in Switzerland with access to 3D-printed Sarco capsules, which are available to “qualified users” free of cost.
The police in Switzerland said they were made aware of the woman’s death by a law firm on Monday. The firm contacted the local prosecutor’s office in Schaffhausen and said that an assisted suicide had taken place that afternoon via the Sarco capsule in a forest hut in Merishausen, a mountainous municipality near the German border.
Asked to respond to reports of Mr. Willet’s arrest, the Last Resort referred to a statement posted on its website. “The Last Resort was acting at all times on the legal advice of their lawyers,” the statement said. “Legal advice since 2021 has consistently found that the use of Sarco in Switzerland would be lawful.”
Once notified, Swiss emergency responders reportedly arrived to the capsule, removed the body of the woman, and transported it to Institute of Forensic Medicine in Zurich, where an autopsy was to be performed.
Representatives from de Volkskrant did not immediately respond to requests for comment.
A 3-D Printed Pod Inflames the Assisted Suicide Debate https://www.nytimes.com/2021/12/16/worl ... rland.html
Dec.
https://www.nytimes.com/2024/09/25/worl ... icide.html
The Swiss police said they had detained “several individuals” after a 64-year-old American woman reportedly died by suicide using the controversial device.
The Sarco capsule on display at a news conference in Zurich in July. Credit...Ennio Leanza/EPA, via Shutterstock
The authorities in northern Switzerland said they were investigating a reported assisted suicide using a controversial device that replaces oxygen with lethal nitrogen gas.
A 64-year-old American was reported to have died by assisted suicide in a remote forest in northern Switzerland with the help of two right-to-die groups that facilitated her use of a Sarco capsule, a coffin-sized, air-tight pod with a large window, according to the capsule’s inventor. The device, which can be transported to a location of a user’s choosing, has an interior button that replaces life-giving oxygen with fatal nitrogen, killing the person in minutes. The inventor of the device said it was the first time it had been used.
The capsule was used on Monday in a remote, mountainous area north of Zurich, near the German border. The woman was said to have suffered for years from an autoimmune condition, the manufacturers of the pod said.
“I monitored the first use of the device from Germany and was pleased with the peaceful, fast death that resulted when the button was pressed,” said Philip Nitschke, the inventor of the Sarco capsule and founder of Exit International, the assisted-suicide group that provided the device to a similar group in Switzerland.
Now, the authorities in the canton of Schaffhausen said they had arrested “several people” who may have helped the woman die. Among the detained were two lawyers, a photographer for the Dutch newspaper de Volkskrant, and Florian Willet, the director of the Last Resort, a group that facilitates assisted suicide in Switzerland. Mr. Willet was the only person present when the woman died, Mr. Nitschke said. He then contacted two lawyers, who informed the authorities of her death.
The authorities said they were detaining the individuals on charges of “incitement and aiding and abetting suicide.”
The episode has drawn condemnation even in Switzerland, which has such permissible laws surrounding the practice that thousands of people across the world have sought help from right-to-die organizations there in recent years.
Although advocates of the Sarco capsule say it is compliant with Swiss law — and that users must be evaluated by medical professionals before they are approved for use — some officials and experts have decried it as inhumane and said it had not been tested sufficiently. The Swiss authorities said they warned its manufacturers that using the device in the country would be illegal.
“We warned them in writing. We said that if they came to Schaffhausen and used Sarco, they would face criminal consequences,” Peter Sticher, a prosecutor in Schaffhausen, the region of Switzerland where the device was used, told the newspaper Blick.
The emergence of the Sarco capsule, which has been criticized even by staunch advocates of the right-to-die movement, has challenged Switzerland’s stance on the subject. In an address before lawmakers on Monday — the same day that, unbeknown to the authorities, the capsule was being used by the American woman — the head of the country’s home affairs department said the device was not legal. The machine, she said, violated the Chemicals Act by using gas.
Swiss law requires that those seeking to end their lives visit with a doctor, who must confirm the person is mentally competent and has not been pushed toward the decision by anyone with ulterior motive. If confirmed, the doctor will then write a prescription for sodium pentobarbital, a type of sedative.
The Sarco (short for “sarcophagus”) capsule was invented by Mr. Nitschke, an Australian doctor who is a longtime advocate of assisted-dying procedures. The capsule is billed as a drug-free way for qualified, older people of sound mind to end their own lives. Once locked inside the capsule in a chosen location, a person can choose when to press a button, which injects nitrogen gas into the chamber.
On its website, the Last Resort advertises itself as the only organization in Switzerland with access to 3D-printed Sarco capsules, which are available to “qualified users” free of cost.
The police in Switzerland said they were made aware of the woman’s death by a law firm on Monday. The firm contacted the local prosecutor’s office in Schaffhausen and said that an assisted suicide had taken place that afternoon via the Sarco capsule in a forest hut in Merishausen, a mountainous municipality near the German border.
Asked to respond to reports of Mr. Willet’s arrest, the Last Resort referred to a statement posted on its website. “The Last Resort was acting at all times on the legal advice of their lawyers,” the statement said. “Legal advice since 2021 has consistently found that the use of Sarco in Switzerland would be lawful.”
Once notified, Swiss emergency responders reportedly arrived to the capsule, removed the body of the woman, and transported it to Institute of Forensic Medicine in Zurich, where an autopsy was to be performed.
Representatives from de Volkskrant did not immediately respond to requests for comment.
A 3-D Printed Pod Inflames the Assisted Suicide Debate https://www.nytimes.com/2021/12/16/worl ... rland.html
Dec.
https://www.nytimes.com/2024/09/25/worl ... icide.html
Re: Euthanasia
The U.K. Will Debate Legalizing Assisted Dying. Here’s What to Know.
A bill introduced in the House of Commons could legalize assisted dying for the terminally ill, under strict conditions. A similar proposal was rejected in 2015.
Demonstrators rally in support of assisted dying in April outside the Houses of Parliament in London.Credit...Wiktor Szymanowicz/Future Publishing, via Getty Images
Ali Watkins
By Ali Watkins
Oct. 17, 2024
A proposal to legalize assisted dying for terminally ill patients in England and Wales was introduced this week in Britain’s House of Commons.
The bill, which has already prompted emotional public debate in Britain, is set to be debated formally in Parliament on Nov. 29, and a vote on the proposal will be held soon after. If it passes the initial vote, it would be scrutinized in committees and subject to further votes, including in the House of Lords, the upper chamber of Parliament.
It would be the first time in nearly a decade that British lawmakers vote on assisted dying, a once-taboo practice that has seen increased interest and legalization among Western countries in recent years. Here’s what to know:
What is the current law in Britain?
It is illegal to assist someone in the act of killing themselves in Britain. The proposed legislation only covers England and Wales, but a similar bill is being considered by Scotland’s Parliament.
Still, it is difficult to convict someone in these kinds of cases. According to the Crown Prosecution Service, the public prosecutor for England and Wales, 187 cases of assisted suicide have been referred to courts in the last 15 years; only four have been successfully prosecuted.
It is not legal to assist someone’s suicide in Scotland, but prosecutors there have said it is exceedingly unlikely that anyone would face charges for doing so, assuming the act was fully voluntary.
What is allowed in other countries?
Assisted dying has been legalized in many parts of Europe and North America in the 21st century. Many European countries, including Belgium, the Netherlands and Spain, permit assisted dying under certain circumstances. In the United States, assisted dying is allowed in 10 states and in the capital, Washington.
The policies vary, but most include age limits, medical exams, certain requirements for physical and health condition, and waiting periods. In U.S. states where it is legal, it is typically up to physicians to determine a prescription of drugs for a person seeking an assisted death, according to Death With Dignity, a group that advocates for more lenient laws around assisted dying.
Britain’s ban on assisted suicide has led some people to travel abroad to end their lives. Dignitas, an assisted-dying organization based in Switzerland — long considered a leader in assisted dying policies — told British lawmakers last year that it had helped 540 British citizens die within Swiss borders.
What is being debated now, and why?
The bill, introduced by Kim Leadbeater, a Labour lawmaker, would allow terminally ill patients to end their lives with medical assistance, subject to strict protocols. Although the full details of the bill have not yet been published, it is expected that it would allow assistance only for people who had been given a limited prognosis, such as up to six months to live.
Ms. Leadbeater was able to introduce the bill after she was one of a group of backbench lawmakers selected in a lottery to bring new proposals before Parliament.
The debate over assisted dying practices was reignited in December, when the celebrated British broadcaster Esther Rantzen said she would consider traveling abroad to end her life, given her diagnosis of terminal lung cancer. Prime Minister Keir Starmer has said he promised Ms. Rantzen that his government would allow a debate and a vote on the subject.
How does the public feel about the practice?
In a recent poll, two-thirds of respondents in Britain said they believed assisted dying should be allowed, under certain conditions.
Image
A group of protesters wearing white masks and medical robes stand in a line in front of the Houses of Parliament. They hold signs reading "Don't make doctors killers"
Opponents of assisted dying initiatives in front of the Houses of Parliament in April.Credit...Ben Stansall/Agence France-Presse — Getty Images
Still, critics question whether the proposed law could be used to pressure vulnerable people, including those with disabilities, to end their lives before they’re ready. The archbishop of Canterbury, the Most Rev. Justin Welby, who leads the Anglican Church, told the BBC this week that the idea of assisted dying was “dangerous,” saying he believed it could lead to people who are not terminally ill “feeling pressured to ask for it.”
Will the law pass?
The debate would be the first time British lawmakers have debated assisted dying since 2015, when members of Parliament overwhelmingly rejected a proposal to allow assisted dying. Since then, many Western nations have legalized assisted dying, and there is increased public support for such measures.
Mr. Starmer — who supported the 2015 measure — has said the government will remain neutral in the debate, allowing lawmakers to vote according to their conscience rather than along party lines. He recently told journalists he believed the law should be changed.
Doctor-Assisted Death Is Legal in 10 States. Could New York Be No. 11? https://www.nytimes.com/2024/06/01/nyre ... de-ny.html
June 1, 2024
How Aid in Dying Became Medical, Not Moral https://www.nytimes.com/2023/10/24/scie ... icide.html
Oct. 24, 2023
https://www.nytimes.com/2024/10/17/worl ... ament.html
A bill introduced in the House of Commons could legalize assisted dying for the terminally ill, under strict conditions. A similar proposal was rejected in 2015.
Demonstrators rally in support of assisted dying in April outside the Houses of Parliament in London.Credit...Wiktor Szymanowicz/Future Publishing, via Getty Images
Ali Watkins
By Ali Watkins
Oct. 17, 2024
A proposal to legalize assisted dying for terminally ill patients in England and Wales was introduced this week in Britain’s House of Commons.
The bill, which has already prompted emotional public debate in Britain, is set to be debated formally in Parliament on Nov. 29, and a vote on the proposal will be held soon after. If it passes the initial vote, it would be scrutinized in committees and subject to further votes, including in the House of Lords, the upper chamber of Parliament.
It would be the first time in nearly a decade that British lawmakers vote on assisted dying, a once-taboo practice that has seen increased interest and legalization among Western countries in recent years. Here’s what to know:
What is the current law in Britain?
It is illegal to assist someone in the act of killing themselves in Britain. The proposed legislation only covers England and Wales, but a similar bill is being considered by Scotland’s Parliament.
Still, it is difficult to convict someone in these kinds of cases. According to the Crown Prosecution Service, the public prosecutor for England and Wales, 187 cases of assisted suicide have been referred to courts in the last 15 years; only four have been successfully prosecuted.
It is not legal to assist someone’s suicide in Scotland, but prosecutors there have said it is exceedingly unlikely that anyone would face charges for doing so, assuming the act was fully voluntary.
What is allowed in other countries?
Assisted dying has been legalized in many parts of Europe and North America in the 21st century. Many European countries, including Belgium, the Netherlands and Spain, permit assisted dying under certain circumstances. In the United States, assisted dying is allowed in 10 states and in the capital, Washington.
The policies vary, but most include age limits, medical exams, certain requirements for physical and health condition, and waiting periods. In U.S. states where it is legal, it is typically up to physicians to determine a prescription of drugs for a person seeking an assisted death, according to Death With Dignity, a group that advocates for more lenient laws around assisted dying.
Britain’s ban on assisted suicide has led some people to travel abroad to end their lives. Dignitas, an assisted-dying organization based in Switzerland — long considered a leader in assisted dying policies — told British lawmakers last year that it had helped 540 British citizens die within Swiss borders.
What is being debated now, and why?
The bill, introduced by Kim Leadbeater, a Labour lawmaker, would allow terminally ill patients to end their lives with medical assistance, subject to strict protocols. Although the full details of the bill have not yet been published, it is expected that it would allow assistance only for people who had been given a limited prognosis, such as up to six months to live.
Ms. Leadbeater was able to introduce the bill after she was one of a group of backbench lawmakers selected in a lottery to bring new proposals before Parliament.
The debate over assisted dying practices was reignited in December, when the celebrated British broadcaster Esther Rantzen said she would consider traveling abroad to end her life, given her diagnosis of terminal lung cancer. Prime Minister Keir Starmer has said he promised Ms. Rantzen that his government would allow a debate and a vote on the subject.
How does the public feel about the practice?
In a recent poll, two-thirds of respondents in Britain said they believed assisted dying should be allowed, under certain conditions.
Image
A group of protesters wearing white masks and medical robes stand in a line in front of the Houses of Parliament. They hold signs reading "Don't make doctors killers"
Opponents of assisted dying initiatives in front of the Houses of Parliament in April.Credit...Ben Stansall/Agence France-Presse — Getty Images
Still, critics question whether the proposed law could be used to pressure vulnerable people, including those with disabilities, to end their lives before they’re ready. The archbishop of Canterbury, the Most Rev. Justin Welby, who leads the Anglican Church, told the BBC this week that the idea of assisted dying was “dangerous,” saying he believed it could lead to people who are not terminally ill “feeling pressured to ask for it.”
Will the law pass?
The debate would be the first time British lawmakers have debated assisted dying since 2015, when members of Parliament overwhelmingly rejected a proposal to allow assisted dying. Since then, many Western nations have legalized assisted dying, and there is increased public support for such measures.
Mr. Starmer — who supported the 2015 measure — has said the government will remain neutral in the debate, allowing lawmakers to vote according to their conscience rather than along party lines. He recently told journalists he believed the law should be changed.
Doctor-Assisted Death Is Legal in 10 States. Could New York Be No. 11? https://www.nytimes.com/2024/06/01/nyre ... de-ny.html
June 1, 2024
How Aid in Dying Became Medical, Not Moral https://www.nytimes.com/2023/10/24/scie ... icide.html
Oct. 24, 2023
https://www.nytimes.com/2024/10/17/worl ... ament.html
Re: Euthanasia
Britain’s Emotional Debate Over Assisted Dying
As lawmakers prepare to vote on legalizing assisted suicide for the terminally ill in England and Wales, an intense public discussion has unfolded.
Sarah Tarlow, whose husband Mark took his own life in 2016 after suffering a debilitating neurological illness. “I think it is cruel to make people die horrible, prolonged deaths against their will and that’s what the present situation currently does,” she said.Credit...Andrew Testa for The New York Times
Sarah Tarlow had a sense that something was wrong as soon as she opened her front door and called out to her bedridden husband upstairs. There was no reply. Instead of the sound of the radio that normally echoed from his room, the house was engulfed in silence.
Unable to move his legs, incontinent, his eyesight failing, without any sense of taste or smell, her partner of more than two decades, Mark Pluciennik, had taken a lethal drug overdose.
Because it is illegal in Britain to help someone die by suicide, Mr. Pluciennik, who suffered from an undiagnosed neurological illness, chose one of his wife’s rare absences, in May 2016, to take his own life, protecting Ms. Tarlow from possible prosecution.
But that meant dying completely alone.
“I think it was enormously brave what he did. I’m not sure I could be that brave,” Ms. Tarlow, a professor of historical archaeology at Leicester University, said while sipping coffee at her home in a snow-covered village 30 miles from Leicester, in England’s Midlands. “I think it was a courageous thing, I think it was a loving thing.”
Even Britons who go abroad to die — for example to Switzerland, where the law is more permissive — must do so alone to protect their families. With growing awareness of such cases, British lawmakers are on Friday scheduled to vote on whether to permit assisted dying in limited circumstances.
Image
A family photo of Mark Pluciennik, smiling, with his hand against his chin.
Mark Pluciennik, who took a lethal overdose in 2016. He waited until his wife was away so that she would not be accused of helping him. “I still get upset and angry that he died on his own,” Ms. Tarlow said.
Credit...via Sarah Tarlow
The proposed bill, introduced by a Labour lawmaker, Kim Leadbeater, would impose strict conditions — too restrictive to cover Mr. Pluciennik’s case. The only people eligible would be those aged 18 or over in England or Wales who have received a terminal diagnosis and been told they have no more than six months to live. Lethal drugs would have to be self-administered, and two doctors and a judge would have to approve the decision.
Still, this would be a landmark piece of legislation in England and Wales, where the law treated attempted suicide as a crime until 1961. (Different laws apply in Scotland and Northern Ireland.)
Some compare the change to the legalization of abortion in 1967 and the abolition of the death penalty in 1969. Assisted dying is legal in a handful of European countries, Canada and New Zealand, and in 10 U.S. states and the District of Columbia.
The Labour government is remaining neutral on the issue, with lawmakers given the freedom to vote as they wish, making it impossible to predict the outcome.
While many senior ministers are expected to support the measure, two of the most prominent — the health secretary, Wes Streeting, and justice secretary, Shabana Mahmood — are opposed. Mr. Streeting said that the country’s creaking national health service would incur new costs if it had to train staff to deal with assisted dying. He also believes that palliative care in Britain is not good enough, meaning that some may feel they have no practical alternative but to end their lives prematurely.
Prime Minister Keir Starmer has not said how he will cast his ballot but when the issue was last debated in 2015, he voted in favor. Lawmakers rejected the policy then by 330 votes to 118.
Image
Kim Leadbeater being interviewed by a man with a microphone, outside the Palace of Westminster in October, surrounded by people carrying placards in favor of assisted dying.
A Labour lawmaker, Kim Leadbeater, introduced the proposed change to the law. The Labour government is remaining neutral on the issue, with lawmakers given the freedom to vote as they wish, making the outcome of Friday’s vote impossible to predict.Credit...Justin Tallis/Agence France-Presse — Getty Images
A clear majority of Britons support the principle of assisted dying, with 65 percent in favor and 13 percent opposed, according to one survey. But that support is “absolutely contingent” on strong safeguards, said Luke Tryl, U.K. director of More in Common, the research organization that conducted the poll. For voters, the most important protection was “proof that someone isn’t being pressured,” he said.
Faith leaders have spoken out against the proposed changes and opponents worry the legislation could lead to Britons being coerced into ending their lives or doing so out of guilt at the physical or financial burden their care places on relatives.
“I honestly believe the pressure of self-coercion is the risk here,” said Liz Carr, an actor and disability rights campaigner. Some people, she said, might think, “‘My family is having to look after me, I’m incontinent, I don’t want to use all the money I have saved over the years on care, it would be better for those who love me not to see me like this, I will do the honorable thing.’”
Ms. Carr, who is best known in Britain for her role in a BBC crime drama, “Silent Witness,” has been ill since age seven with a rare condition, and has used a wheelchair from the age of 11. She fears that if the law is adopted, its scope will be increased and that it will pose a risk to those with complex medical conditions.
“Once you cross that line and even vote yes to considering it, everything changes because ending your life medically becomes a possibility,” she said.
Ms Carr, who recently made a BBC documentary on the issue called “Better Off Dead?”, believes that many doctors and judges — who would make key decisions — share a widespread, unconscious social bias against older or disabled people, valuing their lives less than those of others.
Image
Liz Carr, in a sequined silver dress, at the 2024 BAFTA TV Awards.
“Once you cross that line and even vote yes to considering it, everything changes because ending your life medically becomes a possibility,” said Liz Carr, a well-known TV actor and disability rights campaigner.Credit...Joe Maher/Getty Images
Patients with complex medical needs might be more likely to agree to end their lives at difficult points, Ms. Carr added, recounting how she recently sat in a room with around a dozen disabled people, each of whom had wanted to die at some point.
“Sometimes we need to be held back, and we need to be told ‘No,’ and we need support rather than the belief that we would be better off dead,” she said.
She fears the legislation would push in the opposite direction. “The fact that a law exists that would easily help you end your life — at your deepest, darkest time — that is what terrifies me and so many disabled people because it feels like a permanent sword of Damocles hanging over us.”
But Ms. Tarlow, who supports the bill, thinks it is too restrictive in only applying to those judged to have six months to live. “I don’t see the rationale, personally, in having to have the terminal prognosis; I don’t see why it’s OK to curtail a short period of suffering but not a long one,” said Ms. Tarlow, who has written a memoir called The Archaeology of Loss.
“I think it would be a compassionate act to vote for the bill because I think it is cruel to make people die horrible, prolonged deaths against their will and that’s what the present situation currently does,” she said.
Her husband, who was also an archaeology academic, endured five years with his condition deteriorating before his death aged 62.
Despite Mr. Pluciennik’s careful planning (he left two letters), Ms. Tarlow was questioned after his death by the police, who seized medication as well as her husband’s phone and laptop.
It transpired that she must have handed him the package containing the pentobarbital he bought illegally on the internet to end his life. Ms. Tarlow did not open his mail and thinks that the parcel arrived shortly before one of their three children’s birthdays, so she assumed it contained a present. Nonetheless the police talked to her as though she might be a criminal, she said.
But her main argument is that people are already taking their lives, either by going abroad or by subterfuge. So, on Friday — the day after her late husband’s birthday — Ms. Tarlow plans to stand outside Parliament to demonstrate in favor of assisted dying.
“Mark was absolutely isolated and was absolutely on his own,” she said. “I still get upset and angry that he had to die on his own when I should have been there.”
https://www.nytimes.com/2024/11/27/worl ... 778d3e6de3
As lawmakers prepare to vote on legalizing assisted suicide for the terminally ill in England and Wales, an intense public discussion has unfolded.
Sarah Tarlow, whose husband Mark took his own life in 2016 after suffering a debilitating neurological illness. “I think it is cruel to make people die horrible, prolonged deaths against their will and that’s what the present situation currently does,” she said.Credit...Andrew Testa for The New York Times
Sarah Tarlow had a sense that something was wrong as soon as she opened her front door and called out to her bedridden husband upstairs. There was no reply. Instead of the sound of the radio that normally echoed from his room, the house was engulfed in silence.
Unable to move his legs, incontinent, his eyesight failing, without any sense of taste or smell, her partner of more than two decades, Mark Pluciennik, had taken a lethal drug overdose.
Because it is illegal in Britain to help someone die by suicide, Mr. Pluciennik, who suffered from an undiagnosed neurological illness, chose one of his wife’s rare absences, in May 2016, to take his own life, protecting Ms. Tarlow from possible prosecution.
But that meant dying completely alone.
“I think it was enormously brave what he did. I’m not sure I could be that brave,” Ms. Tarlow, a professor of historical archaeology at Leicester University, said while sipping coffee at her home in a snow-covered village 30 miles from Leicester, in England’s Midlands. “I think it was a courageous thing, I think it was a loving thing.”
Even Britons who go abroad to die — for example to Switzerland, where the law is more permissive — must do so alone to protect their families. With growing awareness of such cases, British lawmakers are on Friday scheduled to vote on whether to permit assisted dying in limited circumstances.
Image
A family photo of Mark Pluciennik, smiling, with his hand against his chin.
Mark Pluciennik, who took a lethal overdose in 2016. He waited until his wife was away so that she would not be accused of helping him. “I still get upset and angry that he died on his own,” Ms. Tarlow said.
Credit...via Sarah Tarlow
The proposed bill, introduced by a Labour lawmaker, Kim Leadbeater, would impose strict conditions — too restrictive to cover Mr. Pluciennik’s case. The only people eligible would be those aged 18 or over in England or Wales who have received a terminal diagnosis and been told they have no more than six months to live. Lethal drugs would have to be self-administered, and two doctors and a judge would have to approve the decision.
Still, this would be a landmark piece of legislation in England and Wales, where the law treated attempted suicide as a crime until 1961. (Different laws apply in Scotland and Northern Ireland.)
Some compare the change to the legalization of abortion in 1967 and the abolition of the death penalty in 1969. Assisted dying is legal in a handful of European countries, Canada and New Zealand, and in 10 U.S. states and the District of Columbia.
The Labour government is remaining neutral on the issue, with lawmakers given the freedom to vote as they wish, making it impossible to predict the outcome.
While many senior ministers are expected to support the measure, two of the most prominent — the health secretary, Wes Streeting, and justice secretary, Shabana Mahmood — are opposed. Mr. Streeting said that the country’s creaking national health service would incur new costs if it had to train staff to deal with assisted dying. He also believes that palliative care in Britain is not good enough, meaning that some may feel they have no practical alternative but to end their lives prematurely.
Prime Minister Keir Starmer has not said how he will cast his ballot but when the issue was last debated in 2015, he voted in favor. Lawmakers rejected the policy then by 330 votes to 118.
Image
Kim Leadbeater being interviewed by a man with a microphone, outside the Palace of Westminster in October, surrounded by people carrying placards in favor of assisted dying.
A Labour lawmaker, Kim Leadbeater, introduced the proposed change to the law. The Labour government is remaining neutral on the issue, with lawmakers given the freedom to vote as they wish, making the outcome of Friday’s vote impossible to predict.Credit...Justin Tallis/Agence France-Presse — Getty Images
A clear majority of Britons support the principle of assisted dying, with 65 percent in favor and 13 percent opposed, according to one survey. But that support is “absolutely contingent” on strong safeguards, said Luke Tryl, U.K. director of More in Common, the research organization that conducted the poll. For voters, the most important protection was “proof that someone isn’t being pressured,” he said.
Faith leaders have spoken out against the proposed changes and opponents worry the legislation could lead to Britons being coerced into ending their lives or doing so out of guilt at the physical or financial burden their care places on relatives.
“I honestly believe the pressure of self-coercion is the risk here,” said Liz Carr, an actor and disability rights campaigner. Some people, she said, might think, “‘My family is having to look after me, I’m incontinent, I don’t want to use all the money I have saved over the years on care, it would be better for those who love me not to see me like this, I will do the honorable thing.’”
Ms. Carr, who is best known in Britain for her role in a BBC crime drama, “Silent Witness,” has been ill since age seven with a rare condition, and has used a wheelchair from the age of 11. She fears that if the law is adopted, its scope will be increased and that it will pose a risk to those with complex medical conditions.
“Once you cross that line and even vote yes to considering it, everything changes because ending your life medically becomes a possibility,” she said.
Ms Carr, who recently made a BBC documentary on the issue called “Better Off Dead?”, believes that many doctors and judges — who would make key decisions — share a widespread, unconscious social bias against older or disabled people, valuing their lives less than those of others.
Image
Liz Carr, in a sequined silver dress, at the 2024 BAFTA TV Awards.
“Once you cross that line and even vote yes to considering it, everything changes because ending your life medically becomes a possibility,” said Liz Carr, a well-known TV actor and disability rights campaigner.Credit...Joe Maher/Getty Images
Patients with complex medical needs might be more likely to agree to end their lives at difficult points, Ms. Carr added, recounting how she recently sat in a room with around a dozen disabled people, each of whom had wanted to die at some point.
“Sometimes we need to be held back, and we need to be told ‘No,’ and we need support rather than the belief that we would be better off dead,” she said.
She fears the legislation would push in the opposite direction. “The fact that a law exists that would easily help you end your life — at your deepest, darkest time — that is what terrifies me and so many disabled people because it feels like a permanent sword of Damocles hanging over us.”
But Ms. Tarlow, who supports the bill, thinks it is too restrictive in only applying to those judged to have six months to live. “I don’t see the rationale, personally, in having to have the terminal prognosis; I don’t see why it’s OK to curtail a short period of suffering but not a long one,” said Ms. Tarlow, who has written a memoir called The Archaeology of Loss.
“I think it would be a compassionate act to vote for the bill because I think it is cruel to make people die horrible, prolonged deaths against their will and that’s what the present situation currently does,” she said.
Her husband, who was also an archaeology academic, endured five years with his condition deteriorating before his death aged 62.
Despite Mr. Pluciennik’s careful planning (he left two letters), Ms. Tarlow was questioned after his death by the police, who seized medication as well as her husband’s phone and laptop.
It transpired that she must have handed him the package containing the pentobarbital he bought illegally on the internet to end his life. Ms. Tarlow did not open his mail and thinks that the parcel arrived shortly before one of their three children’s birthdays, so she assumed it contained a present. Nonetheless the police talked to her as though she might be a criminal, she said.
But her main argument is that people are already taking their lives, either by going abroad or by subterfuge. So, on Friday — the day after her late husband’s birthday — Ms. Tarlow plans to stand outside Parliament to demonstrate in favor of assisted dying.
“Mark was absolutely isolated and was absolutely on his own,” she said. “I still get upset and angry that he had to die on his own when I should have been there.”
https://www.nytimes.com/2024/11/27/worl ... 778d3e6de3