Treatment Concerns – Definitions / Living Wills / Palliative Care / Terminal or Excessive Sedation / Organ Donation / DCD or NHBD / Hospice / POLST / DNR

DCD – Donors after Circulatory Death
NHBD – Non Heart Beating Donation
POLST – Physician Orders for Life Sustaining Treatment
DNR – Do Not Resuscitate

Understanding POLST: An Excellent Explanation of POLST

Physician’s Order for Life-Sustaining Treatment (POLST): Your Life or Death – Who Decides? The POLST movement “is a national effort to manage and control death under the guise of compassion.” – Lisa Gasbarre Black, J.D., General Counsel to Catholic Charities Health and Human Services, Diocese of Cleveland, Ohio. (Ethics and Medics, June 2010, The Danger of POLST Orders.) “You have arguments by defenders that make these documents seem innocent, but the pressure is always in favor of removal of treatment.” -E. Christian Brugger, Ph.D., the Cardinal Stafford Chair of Moral Theology at St. John Vianney Theological Seminary in Denver, Colorado. (National Catholic Register, Daily News, May 16, 2012, Physician’s Order for Life-Sustaining Treatment: Helpful or New Threat? by Charlotte Hays.) How POLST Works You may be approached by a doctor, social worker, nurse or chaplain about refusing medical treatments at the end of your life. Next, a brightly colored one page medical order with boxes checked, called the Physician’s Order for Life-Sustaining Treatment (POLST), will be put in your medical record. You might get to see it and sign it; or, you may not. (The patient’s signature is optional on forms used in Wisconsin. Even where it is required, others are signing for patients without telling them. )i A California study found doctors often signed POLST forms without meeting with patients. In the study: 57% of POLST forms were completed by non-health care professionals such as admissions coordinators or business managers of nursing homes; another 15% were completed by nurses and nurses’ aids, bringing the total prepared by non-physicians to 72%.ii “Facilitators” who may have no medical training are...

Controversial Doctors’ Radical Plan to Tackle Organ Shortage: Patients Could be Kept Alive to Become Donors and Hearts Retrieved from Newborn Babies in BMA Proposals

Comment: Note that some of these radical organ donation proposals are already happening in the US, according to this article. N Valko RN A BMA report has revived the debate about how far doctors should go to help save the lives of patients with organ failure. Patients could be kept alive solely so they can become organ donors, hearts could be retrieved from newborn babies for the first time, and body parts could be taken from high-risk donors as part of an urgent medical and ethical revolution to ease Britain’s chronic shortage of organs, doctors’ leaders say . Hearts could also be taken from recently deceased patients and restarted in those needing a cardiac transplant, under controversial proposals from the British Medical Association intended to stop up to 1,000 people a year dying because of the country’s chronic shortage of organs. A new BMA report on ways to increase the supply of organs, which it has shown to the Guardian, has revived the intense ethical debate about how far doctors should go to help save the lives of the growing number of patients with organ failure. The BMA wants a debate about the use of an ethically contentious practice called “elective ventilation”, in which patients diagnosed as dead using brain stem tests – such as those who have suffered a massive stroke – are kept alive purely to enable organ retrieval. While such patients are usually put on artificial ventilation for a short while to enable their relatives to say goodbye or for organ donation, the report says, “elective ventilation is different in that it involves starting ventilation, once...

Non-Brain Death Organ Donation, Part One

Most people who sign organ donor cards assume that they will be carefully diagnosed as “brain dead” before their organs are donated. That was generally true years ago, but a new non-brain death organ donation procedure was developed in the 1990s even though the language on organ donor cards did not change. The current non-brain death organ donation policy started with ethics journal articles in the 1990s. At that time, it was called “non-heart beating donation” and promoted as a way to increase the supply of organs for transplant beyond the usual “brain death” organ donations. This was made possible by linking organ donation to withdrawal of treatment decisions from people considered hopelessly ill or dying but who did not meet the criteria for “brain death.” This change in policy came in the wake of court decisions upholding the right to refuse treatment for incapacitated patients like Nancy Cruzan, a brain-injured woman said to be in a so-called “vegetative state.” Since Dr. George Isajiw and I presented the following paper (“Non-heart beating organ donation” and the “vegetative state”) in 2004, the term “non-heart beating organ donation” has been changed to “donation after cardiac death” (DCD) and now around 5% of organ donations are from nonbrain death organ donors.[i] The numbers are expected to increase with organ donation policies such as the following: In June 1996, the American Medical Association issued its opinion that non-brain death organ donation was ethical.[ii] Eventually, the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) required all hospitals to develop policies for DCD, effective January 2007, while the United Network for Organ Sharing (UNOS)...

More Hospitals & Governments Push for Organ Transplants 5 Minutes or Less After Heart Stops

A growing push has arisen from the medical community to increase the number of available human transplant organs by removing organs from non-brain-dead organ donors who experience “cardiac death” (CD) or 5 minutes of cardiac arrest. A recent article in the New Scientist, entitled “Not brain-dead, but ripe for transplant,” once again brings the contentious procedure back into the limelight. The procedure, known as “donation after cardiac death” (DCD) or non-heart beating organ donation (NHBD) gained notoriety earlier this year in Canada after an Ottawa hospital announced in June its first DCD transplant. Currently the Australian Health Ethics Committee (AHEC) is considering recommending that the government encourage DCD, and government support in the United Kingdom has swelled numbers of DCDs by six-fold in the last 15 years to 120 in 2005 [New Scientist]. Yet the procedure is fraught with pitfalls, with many expressing fear that more doctors may be willing to sacrifice patients in order to harvest their organs to supply the worldwide demand. The New Scientist article relates the story of a 20-year-old “Janet,” who, following a car accident, suffered such extensive injuries that she would have been deemed eligible to have her organs harvested according to DCD’s standards. Janet, however, subsequently recovered and is “wheelchair-bound but happy to be alive.” In many countries, transplant surgeries only take place after doctors determine that a donor-patient is “brain-dead”…and therefore has no chance of recovery. Heart and lung function are maintained by way of life support in order to preserve the donor’s organs until surgeons find a suitable moment to harvest them. The typical DCD donor patient, however, would have...

Today’s ‘Palliative Care’ Disrespects the Natural Law

The natural law tells us that, in the context of health care, 1) food and water are basic treatment and care, and should not be withdrawn lightly; 2) morphine must not be used aggressively to hasten death when a patient is not near the time of death; and 3) pain management must be properly titrated to avoid overdose. In the early 1980s, the “right-to-die” movement identified a serious roadblock to its agenda: Society still considered the provision of nutrition/hydration as “basic care.” Journalist Diana Lynne recounted the moment in Terri’s Story: The Court-Ordered Death of an American Woman (2005): Daniel Callahan, then director of the Hastings Center, observed in 1983, “Denial of nutrition, may, in the long run, become the only effective way to make certain that a large number of biologically tenacious patients actually die.” The problem was, he noted, providing food and fluids was still considered basic care. And a “deep seated revulsion” existed over the prospects of withholding or withdrawing nutrition/hydration. Callahan’s words rang true a short decade later, as they helped shape a more nuanced right-to-die movement that promoted a “third path” to death—not wholly natural, not suicide, but something in between. The ‘third path’ to imposed death There are two distinct wings within the “right-to-die” movement. The more militant wing, which includes Death with Dignity and Compassion & Choices (formerly known as the Hemlock Society), advocates decriminalizing physician-assisted suicide. The “more nuanced” wing, starting with the Euthanasia Society of America (founded in 1938), has undergone several benevolent-sounding name changes, including Concern for Dying, Society for the Right to Die, Choice in Dying, Partnership for...

Patients Supposedly in Vegetative/PVS State “Not Just Aware But Paying Attention”

We have written dozens of stories the common theme of which is that patients diagnosed in a “persistent vegetative state” or “minimally conscious” are either (a) misdiagnosed or (b) much more aware than they are given credit for. http://www.lifenews.com/2013/11/12/study-patients-supposedly-in-vegetative-state-not-just-aware-but-paying-attention/   Another Study Shows Patients in PVS State Show Awareness How many of these news reports do we need to read about patients who are wrongly diagnosed as being in a so-called persistent vegetative state (PVS) before we eliminate this dangerous, unscientific and completely subjective diagnosis? http://www.lifenews.com/2013/12/23/quit-calling-them-vegetables-study-shows-patients-in-pvs-state-show-awareness/   So-Called “Vegetative” Patient Communicates With Doctors The battle to protect patients in a so-called vegetative state from euthanasia took a positive turn today with the news that doctors have been able to communicate with one patient....

Waking the Dead – One Day, 'Deep Coma' Victims Will be Able to Talk and Move Around (Sept 2010)

Waking the Dead – One Day, 'Deep Coma' Victims Will be Able to Talk and Move Around Patients thought to be in a "persistent vegetative" state after suffering devastating brain damage could soon be able to "talk" and even steer a wheelchair, one of Britain's top neuroscientists has predicted. Dr Adrian Owen at Cambridge University has already proved for the first time that some victims who show no outward signs of awareness, cannot only comprehend what people are saying, but also answer simple questions. Now he believes a new breakthrough will mean that it will not be long before they can communicate using a voice synthesizer almost in "real time" and even move around using a motorised wheelchair. Dr Owen has already shown that using a functional magnetic resonance imaging (fMRI) brain scanner one patient was able to give "yes" or "no" responses to queries. He and his team have gone a step further and shown that a similar response can be achieved using a much cheaper and smaller Electroencephalography (EEG) machine which measures electrical activity in the brain. That means that for as little as £30,000 they will have access to the outside world in much the same way as the scientist Stephen Hawking. However instead of using their cheek or eyelid to communicate, they will activate different parts of the brain. Dr Owen, whose team is moving from Cambridge to the University of Western Ontario, Canada, believes the new devices could be available within 10 years. "I would never have believed that within a few years we would be actually communicating with a patient who was in...

Link: Euthanasia Society of America and National Hospice & Palliative Care Organization (2011)

The Link Between the Euthanasia Society of America and the National Hospice & Palliative Care Organization   The National Hospice & Palliative Care Organization is indisputably the successor organization of the Euthanasia Society of America. A new timeline to show the direct legal, corporate and philosophical connection between the Euthanasia Society of America and the National Hospice & Palliative Care Organization can be found at:  http://www.hospicepatients.org/images/euthanasia-soc-of-america-to-natl-hosp-and-palliative-care-org.jpg [Ron Panzer for Hospice Patients Alliance; N Valkko R.N. 9 Jan...

Mum’s Grief: Medics Left 22 Week Very PreTerm Baby to Die

Baby Tom fought for life for 46 minutes before dying in his mother’s arms. Mother’s fury over ‘no revival’ policy after seeing 22-week-old son die despite his 46min battle to live (dailymail.co.uk, 16 March 2011) Fri, 18 Mar 2011 A 22-week-old pre-term baby fought for life for 46 minutes but died in his mother’s arms after hospital staff refused to treat him. Tracy Godwin gave birth to her son Tom on 6 March last year when she was in the 22nd week of her pregnancy. But the 31-year-old was left aghast when medics at Southend University NHS Hospital refused to help her son. She had not been told that the hospital does not intervene with babies born under 23 weeks. Describing the experience she said: “They put him in my arms and he cried and was wriggling around. I could feel him breathing and see his eyelashes and fingers and toes. “But I kept thinking, ‘Where’s the incubator?’ We were begging the midwives to do something to help him but no one was saying anything. He was not stillborn, he was trying to live. “If they had tried for an hour and said they couldn’t do anything more for him or he was severely brain damaged, that would have been different, but he wasn’t given a chance.” Miss Godwin, who was administered the painkiller pethedine, added: “Because of the drug I wasn’t myself and I keep thinking if I hadn’t taken it and withstood the pain, maybe I would have had more fight in me to demand a doctor”. “We never saw one. It was a disgrace. I just...

Health Care Law: New Words, Same Meaning (2010)

by Rita L. Marker On March 23, 2010, President Obama signed HR 3590, the "Patient Protection and Affordable Care Act" (P.L. 111-148, 124 Stat. 119) which was drafted by the Senate. The following week, on March 30, 2010, he signed HR 4872, the "Health Care and Education Reconciliation Act of 2010" (P.L. 111-152, 124 Stat. 1029) as part of the budget reconciliation process, amending and modifying HR 3590. Together, they make up the new health care law that is often referred to as ObamaCare. During the months leading up to passage of the health-care overhaul legislation, there was a lot of discussion—sometimes very heated discussion—about death panels, end-of-life consultations, and advance care planning. But are those words in the new law? The answer is "no." In fact, the phrase, "death panel," was never in any version of the law. It was used by many to describe what they believed would happen if the law passed. The reasons for that concern were provisions about end-of-life consultations and advance care planning that would be paid for under several early versions of health care reform. Heightening that concern was the fact that the assisted-suicide advocacy group Compassion & Choices (C&C)—previously known as the Hemlock Society—had openly acknowledged that it had played a major role in formulating and supporting the end-of-life and advance care planning portions of the early bills. However, one can search the more than two thousand pages of the new law and not find the words "end-of-life options" or "advance care planning." So, it would be tempting to breathe a sigh of relief and assume that the problems envisioned by...

How Will Hospice Care Change?

[Note: Read the comment at end. I think that comment is more likely than the answer from the NYT. Left out of all the discussion is how assisted suicide will “work” in hospice. The Obamacare bills I read used the same disclaimer terminology about not condoning assisted suicide that Oregon’s assisted suicide law uses. While the end comment is “only” a comment, it is a comment worth repeating, if simply to stimulate reflection.] Q. I am a medical social worker in the hospice arena. Would this bill include cuts to the hospice Medicare program? What would this bill mean to hospice programs in general? — Mary Z A. Hospice benefits won’t change under the new law, said Vicki Gottlich, a senior policy lawyer at the Center for Medicare Advocacy. The House provision that would have required plans to offer voluntary end-of-life counseling — which led to the infamous “death panel” claims that government bureaucrats would be empowered to give the thumbs up or thumbs down to care for the critically ill — was dropped. Nothing similar was included in the Senate bill, which ultimately became law, Ms. Gottlich said. Comment: Douglaston, NY May 12th, 2010 The buildings will still be there, the admission standards for hospice care will still be there, but there are lots of changes this law will make to hospices, and they’re not good. Hospice care is often provided by non-profits, and church or religious affiliated agencies. Should they not undertake the paperwork required by the secretary, the states, the countless bureaucracies this law creates, hospices will see their reimbursement cut 2% for each report they...

Melbourne Doctor: Most Donors Still Alive when Organs are Removed (10/08)

A prominent Melbourne doctor has written that, contrary to popular belief, most organ donations take place before the donor is actually dead. He argues that the vague criterion of "brain death" has blinded potential donors to the fact that their organs are often harvested while they are still alive. Pediatric intensive care specialist Dr. James Tibballs published his controversial views in the Journal of Law and Medicine earlier this month, calling upon medical institutions to review their organ harvesting guidelines to ensure that donors know that they may be volunteering to surrender their life on the operating table. Tibballs points out that current medical practices usually contravene the law, which state that a donor must display irreversible cessation of all functions of their brain or of blood circulation in order to be eligible for the surgery. Australian doctors, however, usually wait only two minutes after a heart has stopped beating before giving the green light for harvesting, said the pediatric specialist. But Tibballs says two minutes is inadequate time to determine whether the loss of circulation is "irreversible." The two minutes criterion was established purely for utilitarian reasons, he says – because waiting longer could threaten the viability of donated organs. "It could be troubling for the public to realise that doctors looking out for organ donors are also the ones formulating guidelines on how to declare death for organ transplantation," observed Tibballs. "For this reason, there should be members of the community and people with legal backgrounds on the committee that create these clinical guidelines used to declare someone dead." Organ donor groups have criticized Tibballs' article, expressing...

Oxford Neonatologist: Time Has Come to Consider “Mandatory Organ Donation” (10/08)

Oxford Neonatologist Says Time Has Come to Consider “Mandatory Organ Donation” Also suggests that “donor death” criteria for organ donation should be abandoned   According to Dr. Julian Savulescu, the Uehiro Chair of Practical Ethics at the University of Oxford, and neonatologist and Oxford graduate student Dominic Wilkinson, bold steps may have to be taken to increase the supply of organs for transplant.  This, they say in a co-authored article published today, could be accomplished by removing one simple impediment – the requirement of donor "death." In a separate article, published last week, Wilkinson suggested an even more radical plan – mandatory organ donation. "We could abandon the dead donor rule," wrote the pair in today’s article, published on Oxford’s Centre of Practical Ethics’ website. "We could for example, allow organs to be taken from people who are not brain dead, but who have suffered such severe injury that they would be permanently unconscious, like Terry Schiavo, who would be allowed to die anyway by removal of their medical treatment." Romanian-Australian professor Savulescu's most recent statements are entirely of a piece with his outspoken advocacy of the most controversial forms of human manipulation, including genetic screening, cloning, human/plant or human/beast hybrids, and the use of performance enhancing drugs for athletes. Savulescu, a proponent of the most radical form of utilitarian ethics, told the Sydney Morning Herald in August that when he was a young doctor he was a “believer,” until he encountered an unsettling image of death in the form of a corpse.  "That, for me, just made the meaninglessness of death extremely vivid," he said.  "You think there's...

Poll: Americans Becoming More Opposed to Euthanasia, Worry About Elderly (2/10)

Poll: Americans Becoming More Opposed to Euthanasia, Worry About Elderly A new national poll finds Americans are largely split on the idea of legalizing euthanasia, but the opposition to the practice is growing. The new survey from Angus Reid Public Opinion, a Canadian polling firm, contains a flawed polling question but the results are still somewhat useful. Although three states — Oregon, Washington, and Montana — have allowed assisted suicide, Angus Reid uses the term "euthanasia" when asking Americans about it. "Generally speaking, do you support or oppose legalizing euthanasia in the U.S.?" the February 4-5 poll of 1,001 Americans asked. The survey found 42 percent support euthanasia while 37 percent are opposed and 22 percent are unsure. Breaking the polling results down further, 14 percent answered "Strongly Support," 28 percent "Moderately Support", 14 percent "Moderately Oppose," and 23 percent "Strongly Oppose." The poll found little partisan difference on the issue with 47 percent of Democrats supporting euthanasia while 51 percent of Republicans oppose it. Some 47 percent of independents backed legalized euthanasia. Although a plurality supported the vague concept of euthanasia, the level of support is down from the August 2009 poll Angus Reid conducted. That survey found support for euthanasia at a 45-32 percent clip with 23 percent undecided. Also, the poll asked a follow-up question asking if people felt legalizing euthanasia "would leave vulnerable people without sufficient protection." Fifty-two percent agreed, 32 percent disagreed, 15 percent were unsure.  [20Feb10, DC,...

Commentary: ‘Cardiac Death’ Allows One to Kill the Organ Donor (7/09)

Commentary: ‘Cardiac Death’ Allows One to Kill the Organ Donor Analysis by Dr. John Shea MD FRCP(C), Medical Advisor to LifeSiteNews.com   In 2006, research done by Dr. Gerald Buckberg, a cardio-thoracic surgeon and UCLA expert, demonstrated that a person can survive cardiac arrest for an average of 72 minutes if they are given the following treatment: cardio-pulmonary resuscitation, the use of a heart-lung machine to keep blood and oxygen circulating, and gradual restoration of blood and oxygen flow. This research was done at hospitals in Alabama and Ann Arbor, Michigan and also in Germany. Of 34 patients, seven died, only two had permanent neurological changes and 25 recovered completely. One patient had been in cardiac arrest for two and a half hours. Similar results were obtained by research in Japan, Taiwan, and elsewhere in Asia. In 1997, the Pittsburgh Protocol declared that cardiac arrest lasting two to five minutes causes 'cardiac death' and that it is ethically acceptable to remove vital organs for transplantation if a person is in cardiac arrest. The evidence provided by Dr. Buckberg and others directly contradicts this. Cardiac death was accepted according to the Pittsburgh Protocol with fanfare and approbation in Canada on January 27, 2006. In December, 2002, Drs. M.L. Weisfeldt and L. Becker demonstrated that resuscitation was possible up to 15 minutes after cardiac arrest. It is now clear that the use of cardiac arrest as a criterion of death is no longer tenable. Will Dr. Buckberg's research be ignored by bioethicists, hospitals, and physicians as was Dr. Weisfeldt's work or will the hunt for transplant organs continue its inexorable course,...

Governor Jeb Bush Signed Bill Allowing Stillborn Children Birth Certificates (2006)

Parents of stillborn children will be able to get a certificate of the child's birth under a bill Gov. Jeb Bush signed (2006). Florida is now the 14th state to offer certificates of stillbirths to mothers who carry their children at least 20 weeks and deliver them. The bill was pushed in the Legislature by Daryl and Beth Logullo of Vero Beach, whose child Katherine was stillborn last year. The measure is named "Katherine's Law." The Logullos and other backers of the bill said it's not fair for the parents of stillborn children to only get a death certificate with no official acknowledgment to memorialize that the baby was born. "We're just very excited that the state is recognizing our children by issuing birth certificates to them that were born still. It's a wonderful day," Daryl Logullo said. "Any woman in the state of Florida going back to the 1930s that has ever had a still born child can get what they deserve and that's their child's birth certificate."   Bush also signed a bill repealing Florida's tax on alcoholic drinks. The measure does away with the last of the per-drink tax, which has long been a bane of restaurants and bars, because owners say it costs them more to collect and remit than it brings in for the state. "Today marks the beginning of the end — ensuring that a large and unfair burden will finally be lifted off the backs of Florida's restaurants and hotels," said Carol Dover, president of the Florida Restaurant and Lodging Association. The tax is 3.3 cents per ounce of spirits or 4...

Assisted Suicide and the Corruption of Palliative Care (2008)

For the past two decades, euthanasia/assisted-suicide ideologues have worked overtime to conflate palliative care—the medical alleviation of pain and other distressing symptoms of serious illness—with intentionally ending the life of the patient. The movement’s first target was the hospice, a specialized form of care for the dying created forty years ago in the United Kingdom by the late, great medical humanitarian Dame Cicely Saunders. Determined to treat what she called the “total pain” of dying patients, Saunders’ great innovation was to bring a multidisciplinary team to the task of ensuring that their physical pain, existential suffering, spiritual needs, and mental health are all properly attended. Saunders believed that suicide prevention, when needed, is an essential part of the package, crucial to fulfilling a hospice’s call to value the lives and intrinsic dignity of each patient until the moment of natural death. Indeed, when I was trained as a hospice volunteer, my instructor pounded into my head the importance of reporting to the hospice team any suicide threats or yearnings my patient might express so they could initiate proper intervention. As a consequence of this philosophy, many patients who might have killed themselves were later very glad still to be alive to get the most of the time they had remaining. But assisted-suicide advocates wish to transform hospice into “hemlock” (as one advocate once put it), a facilitator of suicide rather than a preventer. They believe that access to lethal prescriptions should be considered merely another menu item available for dying patients (and ultimately others) “to control the timing and manner of their deaths.” Toward this end, advocates often point...

U.K. Prime Minister to Press Ahead on Presumed Consent Organ Donation (11/08)

 Despite his own task force having said that it will not succeed, UK Prime Minister Gordon Brown has said he will not give up on a plan that would see every person in the UK automatically registered as an organ donor. Brown said of the task force and his plan, “While they are not recommending the introduction of a presumed consent system, as I have done, I am not ruling out a further change in the law.” The PM indicated that the government would “revisit” the question at the end of the “next stage” of the campaign. Brown’s plan is to implement a system of “presumed consent,” meaning that every person in the UK would be considered a potential organ donor unless he or she specifically opted out or relatives objected. Brown maintains that it is only with presumed consent that the problem of the availability of organs for transplants can be solved. The taskforce, however, said that a presumed consent system would do little to increase the number of transplants. Elisabeth Buggins, chairman of the Organ Donation Taskforce, said the group was concerned that an opt-out system could prevent implementation of an improved public awareness campaign. She also told the BBC there was worry among doctors that the families of patients might feel pressured to donate. She also added that presumed consent would change the donor-recipient dynamic for the worse. “People who have received an organ said that the concept of a gift — of that organ being freely given by the family, by the donor — is very important to them,” she said. To bring in presumed...

Government-Funded National Health Care: Is This Really What We Want? (2008)

Comment:  It’s truly mystifying that this media outlet can publish an article like this clearly highlighting one of the problems of government-funded healthcare in another country, but refuse to see what is coming down the pike for Americans if government-run, universal healthcare is implemented.   Pushes for the legalization of euthanasia and physician-assisted suicide will also be stepped up because of strained budgets as well as a general sense of hopelessness among those who suffer.  Furthermore, money will be diverted away from cancer drug research—and other types of disease research—as the system collapses under its own weight.  Recently, a cancer patient was denied payment for chemotherapy in Oregon by the Oregon Health Plan.  Instead, she was offered assisted suicide.  (See http://www.katu.com/news/26119539.html)   What else might we expect?  If it’s cheaper to offer a lethal prescription for one to die, why bother investing in training staff in effective palliative care and pain management?  Yes, in Great Britain and Oregon [and soon in WA State], a “right to die” has clearly evolved into a “duty to die.”  –Deb Sturm, RN    Cancer Patients Lose Shot at Longer Life in U.K. Cuts (Update1) Jack Rosser's doctor says taking Pfizer Inc.'s Sutent cancer drug may keep him alive long enough to see his 1-year-old daughter, Emma, enter primary school. The U.K.'s National Health Service says that's not worth the expense. Rosser, 57, was told the cost of Sutent, 3,140 pounds ($4,650) per treatment for his advanced kidney cancer, was too high for the NHS — the government agency that funds the nation's health care. The resident of the town of Kingswood, in southwest England, has...

Keeping a Promise When Life is Near Its End (2008)

Comment: This article shows how realistic reassurance is better than euthanasia-for EVERYONE in the family. N.V. Keeping a Promise When a Life Is Near Its End By ELLEN D. FELD, M.D. “If something should happen to me, and I couldn’t help myself, would you be willing to help me?” It is the question so many of us dread hearing. My mother asked it of me around her 75th birthday. Of course I didn’t need to ask what she meant by “something” or “help.” She was a card-carrying member of the Hemlock Society. On her bookshelves were titles like “Final Exit” and “The Peaceful Pill Handbook.” “Can I think about that?” I said, hoping she might forget to follow up. It was a ridiculous hope: she took as gospel my every medical comment, and she never forgot a single one. My mother had been ready to die for years. Not that she was suicidal, but she had always been one of those people who found the cloud in every silver lining. For my mother, life’s positives outweighed its negatives, but just barely. When she lost all but her peripheral vision to macular degeneration and could no longer read, drive or teach, the scales tipped in the opposite direction. Whenever an acquaintance died or received a diagnosis of something swift and painless, her reaction (often to the dismay of those around her) was “Oh, that lucky fellow.” Her greatest fear was of a stroke or some other catastrophe that would force her to live on for unwanted years, unable to care for herself. Her own mother, after a stroke, had spent...