Illinois Considers 'Presumed Consent' Organ Harvesting Bill

Patient Trapped in a 23-Year 'Coma' was Conscious All The Time / Commentary / Update  / Update 2

Cheating Death: They Died and Lived to Tell About It

NE Man Pleads Not Guilty in Assisted Suicide of Roommate

Sedation with Dehydration used as “Slow Euthanasia” UK Survey Reveals

Switzerland Officials Crack Down on Suicide Tourism, May Close Dignitas Assisted Suicide Clinic

Study Shows Patients in Vegetative States Can Learn, Predicting Recovery

Commentary: Washington State Quickly Taking First Place in Promotion of Assisted Suicide, by Rita Marker  

The Death Book for Veterans: Ex-Soldiers Don't Need to Be Told They're a Burden to Society

People of Good Will Should be Upset by the Veterans Guide "Your Life Your Choices" that Pushes Euthanasia

British Doctors Practicing "Slow" Euthanasia through Deep Sedation: BBC Report... 

Illinois Considers 'Presumed Consent' Organ Harvesting Bill

An Illinois senator is pushing legislation that would allow doctors to harvest organs from citizens who have not explicitly given consent for the procedure. The Journal Star reported Monday that a hearing was scheduled this week for Sen. Dale Risinger's bill that would establish a "presumed consent" policy governing organ donation for individuals 18 and older.

Under the proposed legislation, individuals who wish to avoid donating their organs would have to explicitly opt-out of donating their organs prior to becoming incapacitated. If passed, the law would be the first of its kind in America.
[http://www.lifesitenews.com/ldn/2010/mar/10030408.html; Life Site News; ALL Pro-Life Today, 5Mar10]

Patient Trapped in a 23-Year 'Coma' was Conscious All The Time
A car crash victim diagnosed as being in a coma for the past 23 years has been conscious the whole time.

Rom Houben was paralysed but had no way of letting doctors know that he could hear every word they were saying.

'I dreamed myself away,' said Mr Houben, now 46, who doctors thought was in a persistent vegatative state.

He added: 'I screamed, but there was nothing to hear.'

 
Rom Houben was trapped in a coma for 23 years and had no way of letting anyone know he could hear what they were saying (picture posed by model)

Doctors used a range of coma tests before reluctantly concluding that his consciousness was 'extinct'.

But three years ago, new hi-tech scans showed his brain was still functioning almost completely normally.


Mr Houben described the moment as 'my second birth'. Therapy has since allowed him to tap out messages on a computer screen.

Mr Houben said: 'All that time I just literally dreamed of a better life. Frustration is too small a word to describe what I felt.'

His case has only just been revealed in a scientific paper released by the man who 'saved' him, top neurological expert Dr Steven Laureys.

'Medical advances caught up with him,' said Dr Laureys, who believes there may be many similar cases of false comas around the world.

The disclosure will also renew the right-to-die debate over whether people in comas are truly unconscious.

Mr Houben, a former martial arts enthusiast, was paralysed in 1983.

Doctors in Zolder, Belgium, used the internationally accepted Glasgow Coma Scale to assess his eye, verbal and motor responses. But each time he was graded incorrectly.

Only a re-evaluation of his case at the University of Liege discovered that he had lost control of his body but was still fully aware of what was happening.

He is never likely to leave hospital, but as well as his computer he now has a special device above his bed which lets him read books while lying down.

Mr Houben said: 'I shall never forget the day when they discovered what was truly wrong with me - it was my second birth.

'I want to read, talk with my friends via the computer and enjoy my life now that people know I am not dead.'

Dr Laureys's new study claims that patients classed as in a vegetative state are often misdiagnosed.

'Anyone who bears the stamp of "unconscious" just one time hardly ever gets rid of it again,' he said.

The doctor, who leads the Coma Science Group and Department of Neurology at Liege University Hospital, found Mr Houben's brain was still working by using state-of-the-art imaging.

He plans to use the case to highlight what he considers may be similar examples around the world.

Dr Laureys said: 'In Germany alone each year some 100,000 people suffer from severe traumatic brain injury.

'About 20,000 are followed by a coma of three weeks or longer. Some of them die, others regain health.

'But an estimated 3,000 to 5,000 people a year remain trapped in an intermediate stage - they go on living without ever coming back again.'

Supporters of euthanasia and assisted suicide argue that people who have lain in persistent vegetative states for years should be given the opportunity to have crucial medical support withdrawn because of the 'indignity' of their condition.

But there have been several cases in which people judged to be in vegetative states or deep comas have recovered.

Twenty years ago, Carrie Coons, an 86-year-old from New York, regained consciousness after a year, took small amounts of food by mouth and engaged in conversation.

Only days before her recovery, a judge had granted her family's request for the removal of the feeding tube which had been keeping her alive.

In the UK in 1993, doctors switched off the life support system keeping alive Tony Bland, a 22-year- old who had been in a coma for three years following the Hillsborough disaster.

Dr Laureys was not available for comment yesterday and it is not clear why he thought Mr Houben should have the hi-tech screening when so many years had passed.

[http://www.dailymail.co.uk/news/worldnews/article-1230092/Patient-trapped-23-year-coma-conscious-along.html#;http://www.dailymail.co.uk/news/worldnews/article-1230092/Patient-trapped-23-year-coma-conscious-along.html##ixzz0Xfoh1ECn; By Allan Hall
23rd November 2009]

Commentary: The Significance of that Case of the Man Trapped in a "Coma" for 23 Years
Bioethicists attempting to define people in supposed PVS as "brain dead" and source of organs

Many people will have read the story of Rom Houben, the Belgium man who was diagnosed as being in a permanent vegetative state (PVS) for 23 years, but who in fact had a condition known as Locked-in Syndrome.

A person in locked-in syndrome is fully aware of all of their surroundings and they hear and remember the conversations that take place around them, but due to their cognitive disability they are unable to respond.

The case of Rom Houben is significant given that many bioethicists are attempting to redefine the status of people in PVS as being similar to "brain death," meaning that it is being argued that these people have lost self-awareness and therefore should be treated as non-persons or dead people.

Non-persons do not have the right to live and in fact many bio-ethicists suggest that these people should be treated as organ donors.

Dr. Steven Laureys, the prominent neurologist from Belgium diagnosed Houben as being in a locked-in syndrome rather than PVS based on a brain scan that indicated that Houben's brain was functioning at near to normal response.

Dr. Laureys has released a new study concerning PVS stating: "Anyone who bears the stamp of 'unconscious' just one time hardly ever gets rid of it again." He also stated that: "There may be many similar cases of false comas around the world," and "patients classed in a vegetative state are often misdiagnosed."

The concern about misdiagnosing PVS is not new.

Professor Keith Andrews in the UK stated several years ago in his study that 43% of people diagnosed as PVS are misdiagnosed.

This is a significant concern in the UK ever since the 1993 court decision that determined that Tony Bland could be dehydrated to death, even though he was not otherwise dying. Since that decision, many people in the UK, who were not otherwise dying, have died by dehydration because it had been determined that they were in PVS.

For instance, Terri Schiavo was dehydrated to death in 2005 based on her diagnosis of PVS and the insistence by her husband that she did not want to live in this manner.

In March 2004, I had the opportunity to be at a presentation in Rome by Dr. Laureys concerning people in a vegetative state.

At that presentation Dr. Laureys showed us brain scans of people in PVS and compared them to people who were healthy. By analyzing the brain scans he was able to show us the injured parts of the brain of the PVS patients. He then compared the brain scans of people in PVS to healthy people who were sleeping.

There were incredible similarities between the scans of the healthy people who were sleeping to the people who were PVS. He concluded that other than the identifiable injured areas of the brain, medical experts know less about PVS than they would like to admit.

At the same Congress I heard a presentation by an Italian physician who operated an "Awakening Centre." Awakening centers are places that focus on recovery for people who are in a coma state. This physician explained how the use of stimulation techniques have resulted in incredible successes at regaining consciousness for their patients.

At a similar Congress in Rome in 2007 I listened to a Polish physician explain about his incredible success at awakening his patients who are in a coma state. How many awakening centers exist in the world? How many in North America?

As executive director of the Euthanasia Prevention Coalition I have received many phone calls from friends or family members of people who are in coma.

My experience is that medical professionals are too quick to give up on people who are in a coma or cognitively disabled. Family members are often pressured into withdrawing medical treatment or pressured into removing food and fluids from the person in coma, even before they were given a reasonable opportunity for recovery.

Medical professionals need to be far more careful before diagnosing a patient as PVS.

If society rejects Hippocratic medicine and accepts euthanasia, the time would come where people in PVS would be treated as non-persons, euthanized out of a concept of false compassion or used as an organ donor based on utilitarian ethics.

Since approximately 40% of PVS cases are misdiagnosed, and since the PVS diagnosis is often treated like a death sentence, therefore society needs to reject the current paradigm by once again treating people in coma states as human beings deserving of care.

We must reject the dehumanizing of the PVS patient and develop new techniques to offer them new opportunities for recovery.

[24November2009, Alex Schadenberg, Chairman, Euthanasia Prevention Coalition, www.LifeSiteNews.com]

UPDATE

Comatose for 23 Years, Belgian Feels Reborn
Helped by a therapist, Rom Houben's outstretched finger tapped with surprising speed on a computer touchscreen, spelling out how he felt "alone, lonely, frustrated" in the 23 years he was trapped inside a paralyzed body.

After a doctor found he was wrongly diagnosed as being in a vegetative state, and worked out a way for him to communicate, Houben said he now feels reborn.

"And just like with a baby, it happens with a lot of stumbling," the 46-year-old Belgian wrote, tapping out the words in Dutch for Associated Press Television News on Tuesday as an aide guided his hand.

A leading bioethicist, however, expressed skepticism that Houben was really communicating, saying the responses seem unnatural for someone with such a profound injury and an inability to communicate for decades. The medical team guiding Houben said it had done special tests to verify it was Houben communicating.

Injured in a car crash in 1983 when he was 20, Houbon was diagnosed as being in a vegetative state, though doctors now believe he was conscious the whole time.

An expert using a specialized type of brain scan that was not available in the 1980s says he finally realized Houben was suffering from a form of "locked-in syndrome," in which people are unable to speak or move but can think and reason, and provided him with the equipment to communicate.

Now, assisted by a speech therapist who moved his finger letter-by-letter along a touch-screen keyboard, Houben says years of being unable to move or express himself left him feeling "alone, lonely, frustrated, but also blessed with my family."

"It was especially frustrating when my family needed me," wrote Houben, who says he heard his father died during that time, but was unable to show any emotion. "I could not share in their sorrow. We could not give each other support."

"Just imagine. You hear, see, feel and think but no one can see that. You undergo things. You cannot participate in life," he wrote.

The therapist, Linda Wouters, told APTN that she can feel Houben guiding her hand with gentle pressure from his fingers, and that she feels him objecting when she moves his hand toward an incorrect letter.

Despite the occasional typo, the responses seemed fluid and conversational Tuesday. Suffering from a cold, he opened the interview by typing out, with the help of his therapist: "You catch me at a bad moment, I have looked better."

Dr. Steven Laureys of Belgium's Coma Science Group, whose testing uncovered Houben's misdiagnosis three years ago, says he has discovered some degree of consciousness using state-of-the-art equipment like PET scans on other patients and looks at about 50 cases from around the world a year.

But none are as extreme as that of Houben, who was fully conscious inside a paralyzed body. Many center on the fine distinction between a vegetative state and minimal consciousness.

Arthur Caplan, a bioethics professor at the University of Pennsylvania who has had no direct contact with Houben or personal knowledge of the case, said he is skeptical of Houben's ability to communicate after seeing video of his hand being moved along the keyboard.

"That's called 'facilitated communication,'" Caplan said. "That is Ouija board stuff. It's been discredited time and time again. When people look at it, it's usually the person doing the pointing who's doing the messages, not the person they claim they are helping."

But Laureys' team showed Houben an object while his aide was taken outside, and when she came back in he was able to write it down correctly, said Prof. Audren Vandaudenhuyse, a colleague of Laureys.

"So all that has been checked and confirmed, so we are sure it is him who is talking," Vanhaudenhuyse said.

Houben's mother, Fina, told the AP her son has been communicating for three years and she believes no one is guiding him.

"At first he had to push with his foot on a sort of computer mouse which only had a yes-no side," she said in a telephone interview. "Slowly he got better and developed through a language computer and now communicates with this speech therapist holding his hand."

Dr. James Bernat of Dartmouth Medical School said he could not comment on the facts of Houben's case specifically. However, he called Laureys "a very rigorous scientist and physician ... one of the world's leaders" in the field of brain imaging in people with consciousness disorders.

Houben's mother said her son has become so proficient at punching sentences that he has even started writing a book. He has also written an article titled "Hidden wealth ... the force of silence" for the in-house magazine at the 't Weyerke institute in eastern Belgian where he is being treated.

Asked Tuesday how he felt when his consciousness was discovered, Houben tapped out rapidly with the help of his aide: "I especially felt relief. Finally...able to show that I was indeed there."

Laureys said he is now re-examining dozens of other cases. In a recent study, 40 percent of the patients diagnosed as being in a vegetative state were in fact minimally conscious.

American experts acknowledged a vegetative state diagnosis can often be wrong. But in most cases, they said, it involves a patient who is minimally conscious, whose muted and intermittent signs of awareness might be overlooked, rather than a patient like Houben, who is fully conscious but paralyzed.

Experts blamed the difficulty of diagnosis, insufficient training of doctors and a lack of follow-up to look for subtle signs that a once-vegetative patient has actually improved.

"Many people recover over time," said Dr. Joseph J. Fins of the Weill Cornell Medical College. "It's very easy for the label that is affixed at one point to sort of become eternalized, and so no one questions the diagnosis."
[Associated Press Medical Writer Marilynn Marchione and Science Writer Malcolm Ritter contributed to this report. Writer Raf Casert, Associated Press, 25Nov 09, BRUSSELS,
http://news.yahoo.com/s/ap/eu_belgium_coma_recovery/print]

UPDATE 2

Dr. Steven Laureys: How I Know 'Coma Man' is Conscious
"Powerlessness. Utter powerlessness. At first I was angry, then I learned to live with it."

These are reportedly the words of Belgian man Rom Houben, believed for over 20 years to be in a vegetative state. Houben drew the attention of the global media this week when it emerged that he may have been conscious the whole time. Videos appeared of him typing his thoughts into a touch screen; he was even reported to be writing a book about his experiences.

Then doubts surfaced as to whether Houben really was typing, because his finger is guided by an aide. Steven Laureys of University of Liège in Belgium, who first diagnosed Houben as being conscious in 2006, told New Scientist how he knows he was right – and showed his anger at the speculation over the typing.

From the online videos, it looks as if when Rom Houben types, his eyes are closed, he types surprisingly quickly and that his hand is guided by an aide. Can we be sure the words attributed to him are really his?

What is happening now is very regrettable. I feel sorry for Rom and about what some people have written on the net. He knows what people are saying, and one can only try to imagine what he has already been through. He has gone from being ignored for many years and considered vegetative to being recognised as conscious. And now he is again being treated as if "it is impossible, he cannot be a cognitive being". Should I respond to that? I don't want to.

I accept some people may have been insensitive, but could it be possible that he isn't really communicating through the finger-guided touch screen?

I am a scientist, I am a sceptic and I will not accept any communication device if it is not properly tested. But I am not the one who made him communicate with the touch screen, I was just there to help him get rid of the diagnosis of vegetative state. And I don't think one can say, based on videos on the internet, something meaningful about the use of the touch screen.

Did you ever communicate with him in any other way?

He has undergone a very extensive medical and neurological assessment – but as his physician I cannot tell you more. I am in a difficult position: do you want me to put his medical record on the internet, or show the videos we made for his assessment? I don't think you would like it if I put results of your IQ test on the internet.

Can you say what makes you so sure he is conscious?

When I first saw Rom three years ago, he had been diagnosed as being in a vegetative state. We used the Coma Recovery Scale – Revised (PDF), which is a bedside behavioural assessment done in a very standardised way, and which you do repeatedly so as not to miss any signs of consciousness. And he showed minimal signs of consciousness. So we didn't even need fancy scanning methods to change the diagnosis. Then he had a brain scan – and we saw near-normal brain function.

What kind of a brain scan did you do?

He had many scans – but I don't want to go into this. We can limit ourselves to one brain scan, a PET scan, which is very straightforward. It measures the brain energy used by injecting radioactively labelled glucose.

How did this indicate he was conscious – I thought we didn't yet have a signature of consciousness?

You are right, we don't have the neural correlate of consciousness. However, there is a whole literature on the brain's metabolic activity in the vegetative state and on its activity when it is functioning normally.

We wrote a paper on this in Lancet Neurology in 2004, in which we reviewed how PET scanning has shown high metabolic levels in the brains of patients in a locked-in syndrome compared with those in a vegetative state. However, what is still a major challenge is to disentangle vegetative from a minimally conscious state and other disorders of consciousness. This is not as black and white.

Can you elaborate?
In July we published our paper in BMC Neurology showing that 41 per cent of vegetative patients may actually be minimally conscious, based on the Coma Recovery Scale – Revised.

Rom is different to this because he has more than minimal brain function – his brain scans show that he has near normal function. But he has still put a human face to the very important problem of assessing consciousness, the importance of using a standardised scale and the power of neuro-imaging.

Are you following up with these people too?

Yes, we are following up with all the patients. So far we have only shown they are in a minimally conscious state, whereas Rom has a higher level of consciousness.

[27 November 2009, Celeste Biever,
http://www.newscientist.com/article/dn18209-steven-laureys-how-i-know-coma-man-is-conscious.html?full=true&print=true]

They Died, and Lived to Tell All About It

Electric circuits will break your heart every time. Take my cellphone (please): it went out in the rain a few weeks ago and then lay neglected in a sopping wet coat pocket overnight. The next morning, it was dead.

Nothing revived it, not the usual prayers and imprecations nor the overnight immersion in rice recommended by Internet experts. After 72 hours, it was clearly time to give up and head for the store.

But when the moment came to unplug the corpse from its charger and plug in its immensely expensive replacement — executioner, stay your hand: Look who’s waking up!

Dr. Sanjay Gupta’s new book, Cheating Death, deals with the human equivalent of this little drama, and if it seems insensitive to equate a smart piece of plastic with a catastrophically ill human being, absolutely no disrespect is intended, but the analogy still holds.

This is a can-do book about death by the well-known medical correspondent for CNN and Time (and near nominee for surgeon general), which means no bittersweet philosophic reflections on the natural arc of human existence.

The subject is simple science: the ways the body’s circuitry can betray us, and the ways we are learning to fight back.

The science, of course, is far from simple, which makes it a fitting showcase for Dr. Gupta’s skills as a popularizer. Straightforward and readable, it is a book that will undoubtedly infuriate many experts with its elisions and oversimplifications.

But the stories are great. A young skier falls into an icy crevasse and dies of exposure; a healthy 68-year-old man has a cardiac arrest at the gym and dies on the treadmill; a 59-year-old man has a fatal heart attack behind the wheel of his car. Fifty years ago, all of them would be underground, but the last decade has seen enough progress in resuscitation — or perhaps resurrection is the word — that they are all now alive and more or less intact.

Their deaths were actually, in Dr. Gupta’s words, visits to “a gray zone — a faint no-man’s land where you are neither truly dead nor actually alive.”

Those words could easily describe the average intensive care unit, where imperiled organs are carefully nurtured while the rest of the patient comes along for the ride. However, dead hearts and dead brains have traditionally been the end of the line in intensive care.

Not so much anymore, Dr. Gupta says.

For instance, it has been known for a long time that freezing can mimic death — a standard E.R. dictum states that no man is dead till he is warm and dead. But the process of rewarming a frozen human is perilous, for often it is not the lack of warmth or oxygen that kills so much as their restoration, which sets off a cascade of cellular destruction.

Cautiously rewarming the frozen skier took a few days, but her recovery from the revival took many months. That was 10 years ago, and experts have since begun to manipulate cellular processes with more finesse.

Cold is now used specifically to minimize organ damage, as it was for the man who died on the treadmill. After his heartbeat was restored, he was transferred to an I.C.U. specializing in therapeutic hypothermia, where he was chilled for days. Weeks later he emerged from a coma to a long recuperation but, finally, complete health.

The man who died behind the wheel of his car had an easier time: “Just six weeks after he died, the only lingering effect is a set of sore ribs.”

He was revived with a new resuscitation technique that uses only rapid chest compressions with no mouth-to-mouth breathing at all, under the assumption that maintaining high levels of oxygen in the blood is far less important than keeping the blood moving along. In some places, this technique has transformed the routinely dismal survival rates of out-of-hospital resuscitations.

Dr. Gupta visits scientists who can put laboratory creatures into deep hibernation with various gas mixtures, a pseudo-death that reverses instantly with no ill effects. Their goal is to create a chemical “pause button” for humans: “a way to slow the candle, stop time, cheat death” long enough to get a car accident victim or wounded soldier to care.

The neurology of the near-death experience, with its shining white light and cascade of memories, is the subject of one chapter; another addresses the apparent miracle of catastrophic illness that melts away, with or without prayer.

But the book’s focal point, and the place where Dr. Gupta is likely to get some grief, is a short chapter on the dead brain. He introduces a man who “can tell his story today” because one doctor refused to give up on him and pull the plug, despite what appeared to be an irreversible coma. This leads to several other oft-told anecdotes of hopeless comas unexpectedly lifting. “Decisions are made every day in this country to withdraw and remove people from life support without really giving them a chance,” the patient’s doctor says.

I can almost hear the ethicists and the transplant surgeons groaning in unison. This material is complex and inflammatory enough to need a far longer and more technical discussion than Dr. Gupta’s breezy listing of mistakenly hung crepe. Great stories are fine, but sometimes there is no getting around the need for highly untelegenic, unromantic, unhappy data.

Review of Dr. Sanjay Gupta's Book 'Cheating Death' - NYTimes.com

[ABIGAIL ZUGER, M.D., A version of this article appeared in print on November 24, 2009, on page D5 of the New York edition, http://www.nytimes.com/2009/11/24/health/24books.html?_r=1&ref=health&pagewanted=print ; http://www.nytimes.com/2009/11/24/health/24books.html]


COMMENT: Note this stunning quote at the end of the article: "But the book’s focal point, and the place where Dr. Gupta is likely to get some grief, is a short chapter on the dead brain.

He introduces a man who “can tell his story today” because one doctor refused to give up on him and pull the plug, despite what appeared to be an irreversible coma. This leads to several other oft-told anecdotes of hopeless comas unexpectedly lifting. “Decisions are made every day in this country to withdraw and remove people from life support without really giving them a chance,” the patient’s doctor says.

I can almost hear the ethicists and the transplant surgeons groaning in unison. This material is complex and inflammatory enough to need a far longer and more technical discussion than Dr. Gupta’s breezy listing of mistakenly hung crepe. Great stories are fine, but sometimes there is no getting around the need for highly untelegenic, unromantic, unhappy data."

   Note that this writer, like so many in the media, is confused about "dead brain" and "irreversible coma." But, as usual, this doesn't seem to stop her from criticizing people like Dr. Gupta.

   Having worked with people who recovered after being pronounced "hopeless", I have found it so discouraging that when such great recoveries occur, the medical people and ethicists often get angry. I call it the "blood on the hands" syndrome meaning that once a person makes a death decision, he or she has to continue to justify it. Apparently, even the possibility that these health care professionals might have made a mistake is just too hard for them psychologically.

   I have been criticizes when I talk about the amazing recoveries I've seen. The "experts" call them mere anecdotes. But these "anecdotes" often eventually show a pattern and that is often how medical advances are made. For example, babies with Down Syndrome were routinely institutionalized in the 1960s but as the result of some parents insisting on trying to help their children-anecdotal evidence-people with DS are living longer and achieving more than ever. This was not the result of new scientific technologies but rather heroic parents who refused to accept the status quo.

  I so hope that the self-proclaimed  "medical experts" will eventually open their eyes and truly look at these kinds of cases. As I have written before, in the "old days" of the late 60s and 70s, we didn't automatically talk about withdrawing treatment as soon as the person seemed to be on the terminal trajectory to death and, as a result, we were surprised and humbled with some of these patients recovered. We need to get back to that wisdom instead of embracing a "right to die" mentality that insists that death is something to be gotten over with as soon as possible by any means possible.

NE Man Pleads Not Guilty in Assisted Suicide of Roommate

Comment:  How easy is it to drug someone you want dead, then put a bag over their head and say "he/she wanted to die I guess.... I was just there..."  Cheryl. CHN
[Ed. Comment: As noted, how do we know this isn't pre-meditated murder using "assisted suicide" as a cover-up? If assisted suicide becomes accepted, we can be sure that many murders will be covered with this ploy!]

A 28-year-old Lincoln man accused of helping a friend commit suicide has pleaded not guilty to second-degree murder.

Dallas Huston entered his plea this week in Lancaster County District Court.Huston called police Sept. 16 to tell them he found the body of his 22-year-old roommate, who had plastic wrap around his head.

Autopsy results showed the man died of asphyxiation. Toxicology reports showed he had also taken sleeping pills.

Police say Huston told others about the death and that he helped.

Huston is due back in court in February.

[Information from: KLKN-TV, http://www.klkntv.comCheryl Eckstein, Founder President Compassionate Healthcare Network (CHN), www.chninternational.com/default.html; CHN is member of the World Federation of Doctors Who Respect Human Life (WFDWRHL) past president Dr. Karel Gunning - March 15, 1926 - June 29, 2007.
Associated Press - November 27, 2009, Lincoln, NE
http://www.kcautv.com/Global/story.asp?S=11580234; N. Valko RN, 28Nov09]

Sedation with Dehydration used as “Slow Euthanasia” UK Survey Reveals

“Slow euthanasia by deep sedation" is a current reality in the British health care system, and not just a journalistic myth, a survey of UK doctors has revealed.

The study found that continuous deep sedation (CDS) was more frequently requested by patients or relatives seeking a “hastened death” and was associated “with a greater incidence of other end-of-life decisions containing some intent to end life by the doctor”.

Under existing medical care protocols in the UK, patients who are designated as dying, can have food and hydration withdrawn until they die of dehydration, even when continued hydration can still be of medical benefit.

“Doctors supporting legalization of euthanasia or physician-assisted suicide, or who were nonreligious, were more likely to report using CDS,” the researchers found.

Published in the Journal of Pain and Symptom Management, the survey also said that 18.7 per cent of the 2,923 doctors polled used CDS to keep patients unconscious for long periods to control pain, most often for those who were dying of cancer. Ethicists say that this use of CDS is legitimate if it is not in conjunction with premature withdrawal of hydration. The study also noted that “specialists in care of the elderly were least likely to report the use of CDS”.

Critics of the Liverpool Care Pathway (LCP), a widely used protocol for treating the terminally ill, have said that it is a “pathway to death” that presumes the intention to end the life of the patient.

In September, after the publication of a letter by physicians warning that the LCP is hastening the death of patients who are often refused food and hydration, pro-life leaders in the UK said that through a combination of existing legislation and various end-of-life medical care protocols, euthanasia has been effectively made legal in the UK without any act of the government.

John Smeaton, Director of the Society for the Protection of Unborn Children (SPUC), Europe's leading pro-life organisation, told LSN, "We have a government policy of silent euthanasia right now in this country.

“This is being brought about through a number of different factors, but significantly the Mental Capacity Act of 2005, that formally defined the provision of food and fluids as medical treatment.” [30October09, Hilary White, London,  www.LifeSiteNews.com]

Switzerland Officials Crack Down on Suicide Tourism, May Close Dignitas Assisted Suicide Clinic
Switzerland announced plans this week to crack down on “suicide tourism”, signaling that it might close the Dignitas clinic that is responsible for killing hundreds of people via assisted suicide.

The draft bills could set off a rush of people from Britain and elsewhere in Europe to travel to Switzerland to kill themselves before the changes take place. Eveline Widmer-Schlumpf, the Justice Minister, said that two options would be presented to parliament.

Either clinics such as Dignitas and Exit, which deals chiefly with Swiss patients, will have to accept much stricter regulation or they will be closed down.

The tightening of the rules would require patients to present two medical opinions declaring their disease incurable, that death is expected within months and that they have made their decision of sound mind and fully aware of their options.

“It won’t be possible in future for someone to cross the border and commit suicide a few days later with the help of an organization,” Widmer-Schlumpf said. She did not stipulate how long the waiting period should last because it would vary based on each individual case.

But the assisted suicide clinics are financially dependent on large numbers of patients passing relatively quickly through the system and it has benefited from lax local laws. If the bill passes, the federal government would take over enforcement of the laws from regional authorities.

Ludwig Minelli, the founder of Dignitas, criticized the proposals and claimed the government would be promoting suicide over assisted suicide. Minelli also says that the bills, if passed, would prompt other countries to look at legalizing assisted suicide as they have resisted knowing that residents can easily travel to Switzerland and other nations like the Netherlands where it is legal.

Approximately 400 people turned to suicide centers in Switzerland in 2007 with 132 people coming from other nations and 199 of them from Britain. [Zurich, Switzerland, www.LifeNews.com]

Study Shows Patients in Vegetative States Can Learn, Predicting Recovery
Brain-damaged patients who appear to have lost signs of conscious awareness might still be able to create new memories -- showing signs of new neural networks and potential for partial recovery, a new study shows. In patients who have survived severe brain damage, judging the level of actual awareness has proved a difficult process. And the prognosis can sometimes mean the difference between life and death.

According to a Scientific American report, new research suggests that some vegetative patients are capable of simple learning -- a sign of consciousness in many who had failed other traditional cognitive tests. The findings are presented in a paper today in Nature Neuroscience. Mariano Sigman, senior study author and director of the Integrative Neuroscience Laboratory at the University of Buenos Aires, said researchers wanted to "have an objective way of knowing whether the other person has consciousness or not."

The neuroimaging work had surprised doctors by showing that some vegetative patients, when asked to imagine performing physical tasks such as playing tennis, still had activity in premotor areas. In other patients, verbal cues sparked language sectors. Recent research has revealed that about 40 percent of vegetative state diagnoses is incorrect -- which could have an impact on cases such as the painful starvation and dehydration death of Terri Schiavo.
[26Sept09, Washington, DC, www.LifeNews.com, #4715]

Commentary: Washington State Quickly Taking First Place in Promotion of Assisted Suicide, by Rita Marker

Live in Washington State? In a crisis? Suicidal?

Call 911.

Then what?

A dispatcher sends crisis negotiators who, if they follow the suggestions provided at a recent negotiators' training session, could help you consider "all options." If you're eligible, you may be referred to friendly volunteers who will help you find a doctor willing to prescribe a deadly drug overdose.

Just take the prescription to a pharmacy. Have it filled by a pharmacist who hands it to you with instructions to "take this with a light snack and alcohol to cause death."

But what if the pharmacy has opted out of participation in assisted suicide?

Not to worry.

Washington pharmacies are required to fill your prescription.

And what if you're not "qualified" for assisted suicide under Washington's Death with Dignity Act?

No sweat. There's help for you, too. Exit International, an equal opportunity death facilitator, has just established its North American headquarters in Bellingham, WA.

Enter the twilight zone that is Washington State.

Last November, Washingtonians went to the polls and approved Initiative 1000, the Washington "Death with Dignity Act," a law that is almost identical to Oregon's assisted-suicide law. During the campaign, assisted-suicide advocates assured voters that the measure, if passed, would be solely a matter of choice for patients who wanted "aid in dying" and that health care providers would not have to participate in it.

That was Then, This is Now

Soon after the law passed, residents of Mount Vernon, a city north of Seattle, heard that Skagit Valley Hospital was one of many health care institutions that had opted out of assisted suicide. They assumed this meant their local hospital would be an assisted-suicide-free zone.

However, while a hospital's opting out means there won't be any patients taking the deadly overdose on the premises, it doesn't prevent hospital staff from making referrals for help in committing suicide.

Take, for example, a recent program held in the community. Like most jurisdictions, Mount Vernon has a team of experienced commissioned law enforcement officers who are highly trained crisis/hostage negotiators. To continually enhance their life-saving skills, they have periodic training sessions. One routine training that took place in early August indicates how assisted-suicide promotion can permeate activities in unexpected ways.

As part of that recent training session, Amber Ford, a social worker from the hospital's oncology department, presented a comprehensive two-hour discussion about the suicide risk among cancer patients. According to one of the attendees, her presentation was sensitive and informative. But, at the end, a jarring note was introduced.

Prefacing her comments by explaining that she was aware of I-1000's controversial nature, Ford explained that assisted suicide, like hospice care, was among the alternatives available to cancer patients.

And, in keeping with providing all options now available in the state, she distributed a brochure from Compassion & Choices (C & C), the assisted-suicide advocacy group (formerly called the Hemlock Society).

The brochure explains: "C & C created the coalition that passed I-1000 into law and now stewards, protects and upholds Washington's Death with Dignity Act. There is never a fee for any service provided by C & C, and confidentiality is strictly protected." A toll-free number is provided to make access to assisted suicide only a phone call away. The brochure notes that a C & C volunteer can help patients "locate physicians who support a patient's choice to use the law" - in other words, to find a doctor willing to prescribe a deadly overdose of drugs.

The irony was not lost on one experienced negotiator in attendance:

    "I find it interesting that, as crisis negotiators, we are trying to talk people out of killing themselves. But by the end of the afternoon, we had a social worker from the oncology department of the hospital talking about being able to assist people in killing themselves."

If, indeed, part of crisis management eventually includes offering suicide assistance, it could lead to a rather bizarre screening process. When a 911 call comes in, will there be an extra step in the screening process? If a person calls, asking for help for a suicidal family member, will the screener ask if the person is terminally ill? If not, crisis negotiators could be dispatched to the scene. But, if the suicidal person is terminally ill, will she be given C & C's toll free number - so C & C could dispatch assisted-suicide facilitators?

Death from your Friendly Pharmacist

Crisis negotiators aren't the only professionals faced with changing expectations of their role in the assisted-suicide-friendly state. Washington pharmacists are getting a rude awakening as well. When the campaign for I-1000 was ongoing, C & C assured voters that it would be completely a matter of choice for health care providers. Because of those assurances many in the health professions believed passage of the law would not affect them. They bought the hype but (like members of Congress) didn't read the bill.

It's true that the assisted-suicide law defines a health care provider as a person who is licensed to administer health care or dispense medication. And it also provides immunity for those who do not participate. This led those who own pharmacies to assume that they would not have to dispense assisted suicide drugs.

They were wrong.

In the law, "participation" is very narrowly defined. It only refers to those activities that constitute the duties of the attending physician, the consulting physician or the counselor under the law. It does not include dispensing drugs.

Pharmacy owners who assumed they could opt out were very much mistaken.

Not only does the assisted-suicide law not give them the right to refuse to dispense a prescription for assisted suicide, but the Washington Administrative Code positively requires all pharmacies to deliver and distribute all lawfully prescribed drugs or devices to patients. That requirement was affirmed in July when the U.S. Court of Appeals for the Ninth Circuit in Stormans v. Selecky vacated a preliminary injunction preventing its enforcement.

The word games continue even after the patient dies from physician-assisted suicide. If she had taken pills that she stockpiled on her own, her death certificate would reflect that the cause of death was a barbiturate overdose and the manner of death was "suicide." However, if she is a C & C facilitated death, the state forbids any hint of that on her death certificate.

Instructions from the Washington Department of Health make it crystal clear that doctors, coroners and others must refer to her underlying illness, not the drug overdose, as the cause of death and the manner of death must be listed as "natural." According to the Washington State Department of Health, "The cause of death section may not contain any language that indicates that the Death with Dignity Act was used."

Assisted-suicide advocates are well aware that, in Washington, they've found a friendly home from which they can expand their operations. The welcoming atmosphere has attracted Exit International's Dr. Philip Nitschke (sometimes called the Australian Kevorkian).

During the few months in which euthanasia and assisted suicide were legal in Australia, Nitschke was the specialty's sole practitioner, using his "death by laptop" method. In the past, he received funding for development of a "peaceful pill" - the label used for a quick, sure do-it-yourself death - from the Hemlock Society.

Long a believer in equal suicide opportunity for anyone of any age for any reason, he has said assisted suicide should be available to children and teens.

Recently, Nitschke announced establishment of a North American base in the college town of Bellingham, WA where he plans to hold an "Exit workshop" in the Fall, covering such topics as how to obtain end-of-life barbiturates, how to store and test veterinary Nembutal, and how to use helium and a plastic bag to end your life.

Move over, Holland. Move over, Oregon. Washington State is rapidly taking over first place when it comes to embracing the grim reaper.
[Rita Marker, September 29, 2009
LifeNews.com Note: Rita Marker is an attorney and executive director of the International Task Force on Euthanasia & Assisted Suicide.  http://www.lifenews.com/bio2972.html ]

The Death Book for Veterans: Ex-Soldiers Don't Need to Be Told They're a Burden to Society. If Obama wants to better understand why America's discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Department of Veterans Affairs (VA).

He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices."

It was first published in 1997 and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."

Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.

"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political "push poll." For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be "not worth living."

The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to "shake the blues." There is a section which provocatively asks, "Have you ever heard anyone say, 'If I'm a vegetable, pull the plug'?" There also are guilt-inducing scenarios such as "I can no longer contribute to my family's well being," "I am a severe financial burden on my family" and that the vet's situation "causes severe emotional burden for my family."

When the government can steer vulnerable individuals to conclude for themselves that life is not worth living, who needs a death panel?

One can only imagine a soldier surviving the war in Iraq and returning without all of his limbs only to encounter a veteran's health-care system that seems intent on his surrender.

I was not surprised to learn that the VA panel of experts that sought to update "Your Life, Your Choices" between 2007-2008 did not include any representatives of faith groups or disability rights advocates. And as you might guess, only one organization was listed in the new version as a resource on advance directives: the Hemlock Society (now euphemistically known as "Compassion and Choices").

This hurry-up-and-die message is clear and unconscionable. Worse, a July 2009 VA directive instructs its primary care physicians to raise advance care planning with all VA patients and to refer them to "Your Life, Your Choices." Not just those of advanced age and debilitated condition—all patients. America's 24 million veterans deserve better.

Many years ago I created an advance care planning document called "Five Wishes" that is today the most widely used living will in America, with 13 million copies in national circulation. Unlike the VA's document, this one does not contain the standard bias to withdraw or withhold medical care. It meets the legal requirements of at least 43 states, and it runs exactly 12 pages.

After a decade of observing end-of-life discussions, I can attest to the great fear that many patients have, particularly those with few family members and financial resources. I lived and worked in an AIDS home in the mid-1980s and saw first-hand how the dying wanted more than health care—they wanted someone to care.

If President Obama is sincere in stating that he is not trying to cut costs by pressuring the disabled to forgo critical care, one good way to show that commitment is to walk two blocks from the Oval Office and pull the plug on "Your Life, Your Choices." He should make sure in the future that VA decisions are guided by values that treat the lives of our veterans as gifts, not burdens.

[Jim Towey, president of Saint Vincent College, was director of the White House Office of Faith-Based Initiatives (2002-2006) and founder of the nonprofit Aging with Dignity. http://online.wsj.com/article/SB10001424052970204683204574358590107981718.html#printMode]



People of Good Will Should be Upset by the Veterans Guide that Pushes Euthanasia
by Bradley Mattes
First there were angry senior citizens at town hall meetings, literally fearing for their lives. They're worried that under the President’s proposed health care plan they'll be denied critical life-saving services because of their age. There’s good reason for their concern. And what’s come to light since then won't make them sleep any easier.

The Obama administration now seems to have our nation’s veterans in the crosshairs. Perhaps you've heard about the booklet Your Life Your Choices—also known as the Death Book for Veterans. This book is particularly alarming, so I want to share some detail you may not have heard.

I have the book on my desk. Part of it consists of reasonable dialogue on the importance of sharing your wishes regarding potential future medical treatment with trusted family members or friends. I agree that communication before a health crisis arises is key.

But look at one section titled “What makes your life worth living?” It lists 18 potential physical conditions, and the veteran is required to check which column reflects his outlook on life. One of those columns is “not worth living.” I'm all for personal autonomy in choosing appropriate health care, but this booklet clearly crosses the line.

Keep in mind it’s designed for veterans, some who've recently returned from the Middle East, missing limbs or sight. Others may be dealing with paralysis or traumatic brain injuries.

Many are looking at months or years of rehabilitation—facing a future that’s dramatically and often permanently altered. The physical wounds are accompanied by the infliction of psychological damage: depression, the fear of being dependent on others or financial concerns.

It is in this context that some of our war heroes will read Your Life Your Choices [http://lifenews.com/bio2933.html ]. After each of the 18 scenarios on page 21, a veteran is to ask himself or herself if life would be worth living. But a scant few actually reflect life-threatening situations.

Most indicate less critical burdens like being confined to a wheelchair, incontinence or not being able to “shake the blues.” Some don't reflect the physical condition of the veteran at all, but instead how others will be affected: being a financial burden, not able to contribute to the family well being, or causing stress for other family members. These make me wonder—whose suffering is this booklet designed to alleviate?

The “instructions” that follow sent a chill up my spine. If the veteran more than once checked the column called “worth living, but just barely,” he or she is asked what combination of those would it take to make his or her life “not worth living”? If the veteran checked “can't answer now” he or she is asked what would it take to “help you decide”? See page 21 in its entirety, http://www.lifeissues.org/euthanasia/pdf/YLYC_Page_21.pdf .

The obvious purpose of this booklet is to be an advance directive of sorts for medical treatment. Several of the pages even asked for the veteran’s initials and date. But at the back of the booklet where resources are listed, the only group indicated under “advance directives” is Choice in Dying, formerly known as the Euthanasia Society. The purpose of this organization is solely to advocate euthanasia.

The Veterans Administration might as well abandon all subtleties, dig a grave and push our nation’s heroes into it. We owe a debt of gratitude to America’s veterans that we can never repay. The VA has not only brought shame upon its department but also on our whole nation.

After the group Aging with Dignity brought this booklet to light, a disclaimer has been added that a revision is in the works. But no amount of change can take away the stain of the intended purpose—to nudge America’s war heroes toward the grave in an effort to protect limited government resources. If you'd like to see the entire publication, click http://www.lifeissues.org/euthanasia/pdf/your_life_your_choices.pdf.

Please contact the Veterans Administration: Phone: 202.501.0364. Mail: National Center for Ethics in Health Care, Veterans Health Administration (10E), 810 Vermont Ave., NW, Washington, DC 20420.

Tell them America’s veterans deserve better.

[August 28, 2009, LifeNews.com; Bradley Mattes is the executive director of Life Issues Institute, a national pro-life educational group. Mattes is a veteran of the pro-life cause, with over 33 years of educational, political and humanitarian experience; http://www.lifenews.com/bio2942.html ]

British Doctors Practising "Slow" Euthanasia through Deep Sedation: BBC Report has revealed that physicians in the UK are increasingly seeing and using "continuous deep sedation" as a form of "slow" euthanasia.

Adam Brimelow, BBC News health correspondent, writes that the use of continuous deep sedation, also known as "terminal sedation" is becoming more common in the UK and may be the way physicians are skirting the law prohibiting direct euthanasia. 
 
Research has shown that 16.5 percent of all deaths in the UK are associated with continuous deep sedation until death, a number twice that of Belgium and the Netherlands, both countries that already have legalised direct euthanasia.

Deep sedation can be used intermittently or continuously until death, and the depth of sedation can vary from a lowered state of consciousness to unconsciousness.  Under UK law, patients can give a directive to medical staff that they refuse 'palliative care' or 'terminal sedation', or 'any drug likely to suppress respiration'.

Alex Schadenberg, the head of Canada's Euthanasia Prevention Coalition, said that continuous deep sedation is a technique that can be used ethically in cases of dying patients to alleviate intractable pain, such as neuropathic pain that does not respond to morphine, but the ethics depends upon the situation and the intention.

"It's important to make the distinction," Schadenberg told LifeSiteNews.com, "between what we do with someone who is nearing death and someone who is in pain but not dying." In some cases, he said, patients who are not dying but may be suffering are put into deep sedation, and then dehydrated to death - a use that is always unethical.

However, "if your patient is nearing death and is experiencing organ failure, you really can't be putting food and fluid into a body that can't use the fluids. When the body is shutting down, this is a natural part of the dying process. But when they're not dying, like Terri Schiavo, or someone who is experiencing great pain associated with cancer, that is a different issue, because then we are talking about causing that person's death.

"[Deep sedation] can be a backdoor route to euthanasia if it is used unethically," he said. "The issue is intention. The intention must be the alleviation of pain and suffering. Even a long-term sedation can be ethical as long as the person is not being dehydrated to death. A good palliative care physician won't use the technique very often."

Last year, Dutch researchers found that the use of continuous deep sedation until death was becoming more widespread in the Netherlands where direct euthanasia is already legal. In 2001, researchers found that in six European countries deep sedation was used in 8.5 percent of all deaths in patients with cancer and other diseases.

"The increased use of continuous deep sedation for patients nearing death in the Netherlands suggests that this practice is increasingly considered as part of regular medical practice," said lead researcher Judith Rietjens, a postdoctoral researcher in the Department of Public Health at Erasmus University Medical Center in Rotterdam.

"Also, the use of continuous deep sedation may in some situations be a relevant alternative to the use of euthanasia for patients," Rietjens said.

Deep sedation is associated now with approximately 10 percent of all deaths in the Netherlands, an increase that coincided with an increase in public disquiet about the numbers of active euthanasia cases - numbers that have since declined.

Schadenberg said that the answer to the puzzle is simple: "The statistics of active euthanasia have gone down in the Netherlands because they are simply resorting to deep sedation instead.

"But in fact this simply means that patients are being euthanised slowly in conjunction with the withdrawal of fluids. It is why this is being called 'slow euthanasia'. A lethal injection is quicker, but in fact the ethics are no different. Both intend death."

Judith Rietjens confirmed this, saying, "We can see in our study that those sub-groups where we saw an increase of continuous deep sedation - just in those sub-groups - we saw a lowering of the frequency of euthanasia."


Related:   Britain's Pathway to Euthanasia - NHS Protocols for Dehydrating Disabled Patients to Death
http://www.lifesitenews.com/ldn/2008/jul/08070303.html

Elderly Woman Rescued by Family from NHS Dehydration Order
http://www.lifesitenews.com/ldn/2008/jul/08070205.html
[18Aug09,  Hilary White, London, www.LifeSiteNews.com]