Death with dignity in Colombia, and a last minute reversal (Updated)

 The Washington Post has the story (followed by new developments at the very last minute):

She’s 51, a mother and a devout Catholic. She plans to die by euthanasia on Sunday.   By Samantha Schmidt and Diana Durán 

"In November 2018, a doctor gave Martha Sepúlveda her diagnosis: amyotrophic lateral sclerosis, the progressive neurological disease known in the United States as Lou Gehrig’s disease. In the months that followed, the Colombian woman lost control of the muscles in her legs — and she knew it would only get worse.

...

"Sepúlveda started reading about an option that could relieve her fear of what was to come: Euthanasia. Colombia, she learned, is the only country in Latin America — and one of only a few worldwide — that permits patients to end their lives.

"Until this year, the option has been available legally only to those who are expected to live for six months or less. On Sunday, Sepúlveda, who considers herself a devout Catholic, plans to become the first person in Colombia without a terminal prognosis to die by legally authorized euthanasia.

"Colombia’s constitutional court ruled in July that the right to euthanasia — recognized here in 1997 — applies not only to terminal patients, but also to those with “intense physical or mental suffering from bodily injury or serious and incurable disease.”

"The ruling has divided the faithful in this majority-Catholic country. Church officials have described euthanasia as a “serious offense” to the dignity of human life; a member of the national bishops’ conference urged Sepúlveda to “calmly reflect” on her decision and invited all Catholics to pray that God will grant her mercy."

************

Update: some late breaking news:

They cancel euthanasia of the Colombian Martha Sepúlveda, who was going to die this Sunday

"The IPS Incodol (Colombian Institute of Pain) canceled the euthanasia of Martha Sepulveda, which was scheduled for this Sunday at 7 am

"The Interdisciplinary Scientific Committee for the Right to Die with Dignity “unanimously concluded to cancel the procedure.”

"The IPS added that “The request was reviewed and analyzed again in a comprehensive and sufficient manner”, then “it is defined that the termination criterion is not met, as was considered in the first committee ”.

"This 51-year-old woman was to become the first non-terminal patient to access euthanasia this Sunday. Sepúlveda did not know of the mass that was celebrated in his name, nor of the request that the Colombian Episcopal Conference for you to reconsider your decision.

"She was ready to die and had even turned off her cell phone. “Martha has no idea what the priests have said, so it’s really like the world is exploding outside and she has no idea what’s going on. If Martha’s cell phone were available, she would have no life, but we have been very careful that she is in her world, sheltered now and that no one interferes with her peace and tranquility “, said Camila Jaramillo Salazar, her lawyer, before meeting the IPS."

*********

Here's the Washington Post followup on this development:

She had canceled her phone plan and was ready to die. Now a surprise decision has halted her euthanasia bid.  By Samantha Schmidt and Rachel PanBOGOTÁ, Colombia — A 51-year-old woman was set to become the first person in this majority-Catholic country without a terminal prognosis to die by legally authorized euthanasia on Sunday. But a surprise 11th-hour decision by health officials has halted her bid.

"Martha Sepúlveda was awakened by her lawyers Friday night with the news of a letter announcing that her euthanasia procedure scheduled for 7 a.m. Sunday had been canceled, after a medical committee determined that she no longer met the conditions because her health had apparently improved.

"The decision to cancel the procedure came as a complete surprise, according to her lawyers. She had no idea health officials were even meeting to review her case. She had been quietly living out her final hours, and had tuned out media coverage of her case.

...

"“They’re obligating her to live a life that she is not willing to continue to live,” said Lucas Correa Montoya, a lawyer representing Sepúlveda alongside Jaramillo with DescLAB. “What has happened in the past few weeks is an example of the long road ahead for death with dignity in Colombia.”

*******

Update: here's the end of that story:

Colombian woman dies by euthanasia after historic legal fight. By Samantha Schmidt and Diana Durán  January 8, 2022

"A 51-year-old Colombian woman died by euthanasia on Saturday after a historic legal battle to exercise the right in this majority-Catholic country.

"The case of Martha Sepúlveda drew international attention last year when she planned to become the first person in Colombia without a terminal prognosis to die by legally authorized euthanasia. But less than two days before she planned to die in October, a medical committee determined she no longer met the conditions and canceled the procedure. A judge eventually cleared the way for Sepúlveda to move forward.

...

"Colombia was one of the first countries in the world to decriminalize euthanasia; its constitutional court recognized the right in 1997. But for many years, the country extended the right only to patients with a terminal prognosis of six months or less.

...

"Although ALS is a fatal disease with no cure, patients can survive from two to 10 years or more, depending on how their conditions progress. When Sepúlveda first sought out euthanasia, her prognosis did not qualify as “terminal.”

"But in July, the country’s constitutional court ruled that the right applies not only to terminal patients but also to those with “intense physical or mental suffering from bodily injury or serious and incurable disease.” The decision allowed Sepúlveda to schedule her euthanasia for Oct. 10.

"As her story circulated in Colombian news in early October, her decision drew a rebuke from local church leaders. A member of the national bishops’ conference urged Sepúlveda to “calmly reflect” on her decision and invited Catholics to pray that God would grant her mercy.

"Then, in an 11th-hour move, her euthanasia was abruptly canceled. The Colombian Institute of Pain, or Incodol, which had been scheduled to carry out the procedure, said Sepúlveda’s condition had improved between July and October.

...

"After her appeal, a judge from Medellín ruled on Oct. 27 that Sepúlveda was entitled to die by euthanasia.

"The judge confirmed that patients who endure intense physical or mental suffering — with diseases such as Lou Gehrig’s — are legally allowed to access euthanasia even if their prognosis is not terminal, and that Sepúlveda’s health provider was not justified in its denial of her request.

...

"On Friday, a day before Sepúlveda’s death, a different Colombian patient became the first person without a terminal prognosis to die by euthanasia. The patient, a man in Cali named Victor Escobar, suffered from end-stage chronic obstructive pulmonary disease.

“The fight to take control over the end of life continues and will not end until people in Colombia can access an assisted medical death according to their will and without barriers,” Sepúlveda’s lawyers said."

Opioid prescription and curtailment are associated with increased rates of suicide among rural veterans:

 Chronic pain, followed by prescription of opioid pain medicines, is sometimes followed by opioid addiction.  A recent NBER working paper shows that policies to reduce prescriptions are associated with increased rates of suicide, particularly among rural military veterans.  Presumably some of these are related to addiction, and some are related to pain.

The Opioid Safety Initiative and Veteran Suicides by Joshua C. Tibbitts & Benjamin W. Cowan WORKING PAPER 29139, DOI 10.3386/w29139,  August 2021

"We investigate the relationship between opioid diverting policy and suicides among the veteran population. The opioid epidemic of the past two decades has had devastating health consequences among U.S. veterans and military personnel. In 2013, the Veterans Health Administration (VA) implemented the Opioid Safety Initiative (OSI) with the goal of discouraging prescription opioid dependence among VA patients. Between 2012 and 2017, prescription opioids dispensed by the VA fell 41% (VA, 2018). Because this involved the aggressive curtailing of opioid prescriptions for many VA patients, OSI may have had a detrimental effect on veterans’ mental health leading to suicide in extreme cases. In addition, because rural veterans have much higher rates of VA enrollment, more prescription opioid use and abuse, and lower rates of substance abuse and mental health treatment utilization, we expect any effect of OSI on veteran suicides to be concentrated in rural areas. We find that OSI raised the veteran suicide rate relative to the non-veteran (“civilian”) rate with rural veterans suffering the lion’s share of the increase. We estimate that OSI raised the rural veteran suicide rate by a little over one-third between 2013 and 2018."

New Zealand votes to legalise euthanasia but not marijuana

 The Guardian has the story:

New Zealand votes to legalise euthanasia in referendum--Results must be enacted by the new Labour government by November 2021, but second referendum on legalising cannabis fails to find support  by Eleanor Ainge Roy 

"New Zealanders have voted to legalise euthanasia for those with a terminal illness, in a victory for campaigners who say people suffering extreme pain should be given a choice over how and when to bring their life to a close.

"The decision on whether to legalise euthanasia appeared as a referendum question on the 17 October general election ballot paper, alongside a second referendum question on whether to legalise cannabis – which did not succeed, according to preliminary results.

"The results of the euthanasia referendum are binding and will see the act come into effect 12 months from the final results – on 6 November 2021. Assisted dying will be administered by the Ministry of Health.

...

"The vote makes New Zealand only the seventh country in the world to legalise assisted dying."

Medically assisted dying and the U.S. Supreme Court

 The Washington Post has the story:

Judge Amy Coney Barrett and the future of physician-assisted suicide  by 

Charles Lane

"Barrett co-wrote a 1998 law review article in which she distinguished the dilemmas Catholic judges might face in following church teachings against capital punishment, as well as what she called a more “absolute” doctrine banning abortion and euthanasia, which “take away innocent life.” (updated link: http://pragerfan.com/articles/Catholic_Judges_Capital_Cases.pdf )

...

"Eight of the 50 states and D.C. have permitted physician-assisted suicide, by statute or referendum. (In one, Montana, the state Supreme Court decreed it as a matter of state law, and legislators have tried, unsuccessfully so far, to overturn that ruling.)

Medically assisted dying, at any age, in the Netherlands

 The NY Times has the story:

Netherlands to Allow Doctors to Help End Lives of Terminally Ill Children--Hugo de Jonge, the Dutch health minister, said that “incurably ill” children ages 1 to 12 should be able to die with the help of a doctor.  By Maria Cramer and Claire Moses

"The Dutch government announced plans this week to allow doctors to end the lives of terminally ill children who are under 13 years old, a decision that is bound to inflame the debate over physician-assisted death.

"The Netherlands already allows doctors to facilitate the deaths of people who are over 12 or less than a year old as long as parents have given their consent.

"In a letter to parliament on Tuesday, the Dutch health minister, Hugo de Jonge, proposed expanding the law to include children between the ages of 1 and 12 who are dying and suffering.

“In a small number of cases, palliative care isn’t sufficient,” Mr. de Jonge wrote. “Because of that, some children suffer unnecessarily without any hope of improvement.”

...

"Three other European countries — Luxembourg, Belgium and Switzerland — allow physician-assisted death, though the laws differ in each country. Belgium allows children to die with the help of a doctor, but in Luxembourg, the law is restricted to adults with an incurable medical condition.

"Canada, parts of Australia and Colombia have also legalized physician-assisted death for adults in certain cases.

...

"Eight states and Washington, D.C., have laws that allow mentally competent adults with a terminal illness and six months or less to live to obtain prescription medication that will hasten their deaths, according to Death With Dignity, an Oregon-based nonprofit that supports such laws."

********

The first link above is to this Gallup Poll report:

MAY 31, 2018,  Americans' Strong Support for Euthanasia Persists  BY MEGAN BRENAN

"72% say doctors should be able to help terminally ill patients die

"Fewer, 65%, express support when the question includes "commit suicide"

"54% think doctor-assisted suicide is morally acceptable"

Organ donation after medically assisted dying, in Canada

In the New England Journal of Medicine, with many authors,
Organ Donation after Medical Assistance in Dying — Canada’s First Cases

February 6, 2020
N Engl J Med 2020; 382:576-577
DOI: 10.1056/NEJMc1915485

"In 2016, following the Supreme Court of Canada’s Carter Decision,1 medical assistance in dying (MAID) became possible with individual court orders. However, owing to the lack of a centrally coordinated Canadian response to the requests of some patients for voluntary euthanasia, as well as concern for individual repercussions, many Canadian providers of assisted dying operate largely independently. With 3 years now passed since euthanasia was approved, it is important to ensure our understanding of current practice for the purpose of quality assurance, provider education, and future research opportunities geared to improve patient-centered practice. Among the practices related to the legalization of euthanasia, organ donation raises challenging issues.

"We performed a historical cohort study of completed MAID organ-donation cases using data from three Canadian provincial organ-donation organizations (Trillium Gift of Life Network, Transplant Québec, and British Columbia Transplant) from June 2016 through January 2019 to describe the initial experience with euthanasia-associated organ donation. A total of 56 patients were referred as potentially eligible for organ donation after MAID on the basis of preliminary assessment by one of the three organ-donation organizations. The mean age was 61 years; 39% of the patients were female. The most common diagnosis was amyotrophic lateral sclerosis, followed by end-stage chronic obstructive pulmonary disease and Parkinson’s disease. Although the majority of Canadian euthanasia cases have involved patients with active cancer,1 our data showed that there is a substantial variety of conditions for which organ donation is a viable possibility. Among the 56 patients in the study, 30 were able to become donors and donated 74 organs. Twenty patients were single-organ donors, while 10 were multiorgan donors. 

Death with dignity, in Germany

Medically assisted suicide, controversial everywhere, has come to Germany.

The Lancet reports:
Germany overturns ban on assisted suicide
Rob Hyde
Published:March 07, 2020DOI:https://doi.org/10.1016/S0140-6736(20)30533-X

"Germany's supreme court has lifted a ban on professionally assisted suicide in a landmark ruling. ...

"Following a campaign by doctors and terminally ill patients, Germany's supreme court has lifted a law which outlawed the provision of assisted-suicide services. These services could range from signing a prescription for a lethal overdose of sedatives, to providing consultation to terminally ill patients on how they could travel outside of Germany to end their lives legally.

"Speaking from Germany's Federal Constitutional Court in Karlsruhe, Judge Andreas Voßkuhle said the 2015 law—paragraph 217 of the German Criminal Code—did not allow a person either “the right to a self-determined death” or “the freedom to take one's life and seek help doing so”. This law, he said, therefore violated the German constitution, and was now void.

"The association Sterbehilfe Deutschland e.V. (Assisted Suicide Germany) was among those campaigning against paragraph 217. Roger Kusch, head of the organisation and Hamburg's former senator for justice, said that the ruling by the supreme court marked “…a wonderful day for our association, for the association members and also for all interested citizens.” He said the ruling meant that no-one now has to suffer the pressure “…from churches and from other people, who believe they have to influence the entire population and the whole of society.”

"Others, however, are less jubilant. Frank Ulrich Montgomery is president of the Standing Committee of European Doctors, which represents national medical associations across Europe. He fears that the supreme court's ruling will mean the principle of doctors preserving life could be rendered obsolete.
...
"“Euthanasia” comes from the Greek word euthanatos (which means easy death), and means taking steps to end an individual's life to relieve suffering. In a medical context, euthanasia refers to a doctor using painless means to end a person's life, providing the patient and the patient's family agree. Assisted suicide, by contrast, refers to when a person is helped to kill themselves. Switzerland has eight right-to-die clinics and is the European country most often associated with euthanasia. However, euthanasia and assisted suicide are legal not only in Switzerland, but also in Belgium, Luxembourg, and the Netherlands, although each country varies on how it defines both terms. In Germany, the issue of the state legalising euthanasia is highly sensitive, especially given that the Nazis used the same term to describe the murder of hundreds of thousands of disabled people."

Medically assisted suicide.

Several recent stories caught my eye on the controversial subject of medically assisted suicide, aka death with dignity, medical assistance in dying (MAID), and some other names.

He died by suicide in front of Alberta’s legislature. He said he wanted to bring attention to Medical Assistance in Dying   By Nadine Yousif, Star Edmonton, Sat., Dec. 7, 2019

"In his own final moments, Chan, 62, wanted people to know about the struggles of his loved ones, and how increased access to medical assistance in dying could help many end what may otherwise be a lifetime of suffering."
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The Champion Who Picked a Date to Die by ANDREW KEH, NY Times, Dec. 5, 2019

"Knowing she had the legal right to die helped Marieke Vervoort live her life. It propelled her to medals at the Paralympics. But she could never get away from the pain.
Andrew Keh and Lynsey Addario spent almost three years reporting on Marieke Vervoort as she and her parents wrestled with her decision to die by euthanasia. They visited her multiple times at home and in hospital stays in Belgium, and accompanied her on trips to the Canary Islands and Japan."
***********

Aid in Dying Soon Will be Available to More Americans. Few Will Choose It.
By October, more than one in five U.S. adults will be able to obtain lethal prescriptions if terminally ill. But for those who try, obstacles remain.
By Paula Span, July 8, 2019  NY Times

Maine yesterday became 8th state to legalize assisted suicide

The AP has the story:

Maine becomes 8th state to legalize assisted suicide

"Maine legalized medically assisted suicide on Wednesday, becoming the eighth state to allow terminally ill people to end their lives with prescribed medication.

"Democratic Gov. Janet Mills, who had previously said she was unsure about the bill, signed it in her office.

“It is my hope that this law, while respecting the right to personal liberty, will be used sparingly,” said Mills.

"Oregon was the first state to legalize such assistance, in 1997, and it took over a decade for the next state, Washington, to follow suit. While still controversial, assisted suicide legislation is winning increasing acceptance in the United States, and this year at least 18 states considered such measures.

"Maine’s measure will allow doctors to prescribe a fatal dose of medication to terminally ill people. It declares that obtaining or administering life-ending medication is not suicide under state law, thereby legalizing the practice often called medically assisted suicide.

"The proposal had failed once in a statewide referendum and at least seven previous times in the Legislature. The current measure passed by just one vote in the House and a slim margin in the Senate.
...
"Maine joins seven other states and Washington, D.C., that have similar laws, according to the Death With Dignity National Center and the Death With Dignity Political Fund. The states are: California, Colorado, Hawaii, Oregon, Vermont, Washington, and New Jersey, whose governor signed the legislation earlier this year.

"Montana doesn’t have a specific law on the books, but the state Supreme Court ruled in 2009 that doctors could use a patient’s request for life-ending medication as a defense against criminal charges."

Frequencies of medically assisted death, in jurisdictions where it is legal

From the Lancet:
Regulation of assisted suicide limits the number of assisted deaths
Gian Domenico Borasio, Ralf J Jox, Claudia Gamondi
Published:February 20, 2019
DOI:https://doi.org/10.1016/S0140-6736(18)32554-6

"Several countries and US states have recently legalised euthanasia, assisted suicide, or both, including Canada and California, USA. In 2017, more than 13 000 patients died through either method of assisted death in countries where these practices are permitted. Euthanasia and assisted suicide have been legal in the Netherlands and Belgium since 2002, whereas assisted suicide has been legal in Switzerland since 1918 and in Oregon, USA, since 1997.

"In assisted suicide, patients take the lethal drug themselves, whereas doctors administer the drug in euthanasia. In 2012, this appeared to be a main reason for the higher frequency of assisted deaths in the Netherlands and Belgium, compared with Oregon and Switzerland. Yet data from the past 5 years suggest that the lack of legislation in Switzerland could also explain the higher frequency of assisted suicide, particularly since an increasing number of patients without terminal illness obtain permission for assisted suicide in Switzerland. By contrast, the lower frequency in Oregon might be explained by the requirement of a maximum life expectancy of 6 months and by the requirement that patients obtain a lethal dose from the pharmacy for auto-administration. On average, 36% of these patients in Oregon end up not using the lethal drug and die of their illness"

Medically assisted death

The Guardian and the BBC bring us up to date on death with dignity in the Netherlands.

Here are some excerpts from the Guardian's long read:

Death on demand: has euthanasia gone too far?
Countries around the world are making it easier to choose the time and manner of your death. But doctors in the world’s euthanasia capital are starting to worry about the consequences
By Christopher de Bellaigue

"Keizer is one of around 60 physicians on the books of the Levenseindekliniek, or End of Life Clinic, which matches doctors willing to perform euthanasia with patients seeking an end to their lives, and which was responsible for the euthanasia of some 750 people in 2017. For Keizer, who was a philosopher before studying medicine, the advent of widespread access to euthanasia represents a new era. “For the first time in history,” he told me, “we have developed a space where people move towards death while we are touching them and they are in our midst. That’s completely different from killing yourself when your wife’s out shopping and the kids are at school and you hang yourself in the library – which is the most horrible way of doing it, because the wound never heals.
...
"Euthanasia has been legal in the Netherlands for long enough to show what can happen after the practice beds in.
...
"In 2002, the parliament in the Hague legalised euthanasia for patients experiencing “unbearable suffering with no prospect of improvement”. Since then, euthanasia and its close relation, assisted dying, in which one person facilitates the suicide of another, have been embraced by Belgium and Canada, while public opinion in many countries where it isn’t on the national statute, such as Britain, the US and New Zealand, has swung heavily in favour.

"The momentum of euthanasia appears unstoppable; after Colombia, in 2015, and the Australian state of Victoria, in 2017, Spain may be the next big jurisdiction to legalise physician-assisted death, while one in six Americans (the majority of them in California) live in states where it is legal. In Switzerland, which has the world’s oldest assisted dying laws, foreigners are also able to obtain euthanasia.
...
"Euthanasia is counted as a basic health service, covered by the monthly premium that every citizen pays to his or her insurance company. But doctors are within their rights not to carry it out. Unique among medical procedures, a successful euthanasia isn’t something you can assess with your patient after the event. A small minority of doctors refuse to perform it for this reason, and others because of religious qualms. Some simply cannot get their heads around the idea that they must kill people they came into medicine in order to save.
...
"At any meeting organised by the NVVE [Dutch Voluntary Euthanasia Society], you will look in vain for poor people, pious Christians or members of the Netherlands’ sizeable Muslim minority. Borne along by the ultra-rational spirit of Dutch libertarianism (the spirit that made the Netherlands a pioneer in reforming laws on drugs, sex and pornography), the Dutch euthanasia scene also exudes a strong whiff of upper-middle class entitlement.

"Over coffee I was introduced to Steven Pleiter, the director of the Levenseindekliniek. We went outside and basked in the early October sun as he described the “shift in mindset” he is trying to achieve. Choosing his words with care, Pleiter said he hoped that in future doctors will feel more confident accommodating demands for “the most complex varieties of euthanasia, like psychiatric illnesses and dementia” – not through a change in the law, he added, but through a kind of “acceptance … that grows and grows over the years”. When I asked him if he understood the scruples of those doctors who refuse to perform euthanasia because they entered their profession in order to save lives, he replied: “If the situation is unbearable and there is no prospect of improvement, and euthanasia is an option, it would be almost unethical [of a doctor] not to help that person.”
...
"Even those who have grave worries about the slippery slope concede that consensual euthanasia for terminal illness can be a beautiful thing, and that the principle of death at a time of one’s choosing can fit into a framework of care. The question for any country contemplating euthanasia legislation is whether the practice must inevitably expand – in which case, as Agnes van der Heide recognises, death will eventually “get a different meaning, be appreciated differently”. In the Netherlands many people would argue that – for all the current wobbles – that process is now irreversible."
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And here's a link and a figure from the BBC story, which concentrates on the difficult case of dementia--difficult because even the clearest directive from a patient with early stage dementia who wants to end his or her life as the disease progresses can often not be confirmed by the patient once dementia is fully established.

Wanting to die at 'five to midnight' - before dementia takes over

Medically assisted death debated in Australia

A bill is under consideration in Australia regarding medically assisted suicide, aka death with dignity.  (The politics are complicated by the fact that Australia has both states and territories.) Here's the story from the Guardian:

David Leyonhjelm confident voluntary euthanasia bill will pass Senate
Liberal Democrat pressures Malcolm Turnbull to permit vote in lower house

"The bill to allow the Northern Territory and Australian Capital Territory to legislate for euthanasia – reversing a ban imposed by the commonwealth in 1997 – has support from at least 18 Labor senators, the nine Greens, eight crossbench senators and a small but growing group of Coalition senators. It needs 39 to pass the Senate.
...
"“Australians with a terminal illness should have a right to die with dignity, ideally with effective palliative care, but with sufficient safeguards, that right, in extreme cases, should also extend to voluntary euthanasia.”
***************

An earlier, related post:

Friday, May 4, 2018

Death with dignity: David Goodall flies from Australia to Switzerland

Death with dignity: David Goodall flies from Australia to Switzerland

The Australian has the story:
Professor David Goodall, 104, prepares to die in Switzerland

"Australia’s oldest working scientist and prominent euthanasia campaigner David Goodall will access a Swiss voluntary euthanasia scheme weeks after securing a fast-tracked appointment with a Basel-based agency which assists people to die.

"The botanist, ecologist and Emeritus Professor who celebrated his 104th Birthday in April, received news last week that he had secured an appointment with pro-euthanasia group Life Circle and assisted dying expert Dr Erika Preisig in Basel for early May.

"Dr Goodall is not terminally ill but has poor eyesight and declining mobility. In evidence submitted to a Western Australian parliamentary inquiry on end of life options, he said that his quality of life had deteriorated and he wanted to access an assisted dying program.

"Dr Goodall is now at the centre of a crowd-funding push organised by local pro-euthanasia group Exit International to raise $15,000 to upgrade his fares to business class so he can travel to Basel in relative comfort.

"The campaign has already exceeded the $15,000 target and volunteers running the campaign have told The Australian his seats have now been upgraded and tickets booked."
********

Here's the Washington Post story:
A scientist just turned 104. His birthday wish is to die.

"“I greatly regret having reached that age. I would much prefer to be 20 or 30 years younger,” he told the Australian Broadcasting Corp. When asked whether he had a nice birthday, he told the news organization: “No, I’m not happy. I want to die. ... It’s not sad, particularly. What is sad is if one is prevented.”

“My feeling is that an old person like myself should have full citizenship rights, including the right of assisted suicide,” the 104-year-old added.
...
"For the past two decades, Goodall has been a member of Exit International, a nonprofit organization based in Australia that advocates for the legalization of euthanasia, according to the group’s website.
...
"In most countries, euthanasia and physician-assisted suicide are illegal. However, a handful of nations — including Belgium, Luxembourg and the Netherlands — have legalized one or both of the practices, according to the nonprofit group ProCon.org. For years, Australia has banned such practices, but in November, the state of Victoria became the first to pass a euthanasia bill, which, by summer 2019, will allow terminally ill patients to end their lives.
...
"In the United States, only six states — California, Colorado, Hawaii, Oregon, Vermont and Washington state — and Washington, D.C., have death-with-dignity laws for terminally ill patients.

"Goodall does not have a terminal illness.
...

"The Australian Broadcasting Corp. reported [in 2016] that after nearly two decades on the campus, Goodall was told to leave amid concerns about his well-being. The incident gained international media attention, with Goodall, then 102, calling it ageism in the workplace.

“It’s depressed me; it shows the effect of age. The question would not have arisen if I were not an old man,” he told the news organization at the time.

"University officials later reversed their decision.

"But Goodall said his health is declining.

"He told the Australian Broadcasting Corp. that several months ago he fell down in his apartment in Perth and, for two days, he lay on the floor until his housekeeper found him.
...
"Goodall said he believes it is time for him to die, but his country’s new legislation is of no use to him because it applies only to those who are terminally ill."
*********

And he's on his way:
David Goodall en route to Europe after emotional goodbye with family
AT THE age of 104, professor David Goodall has said goodbye to his family before boarding a flight to Europe to end his life.   AAP MAY 4, 2018

California's End of Life Option Act: the first six months

Independence of a sort.
California's End of Life Option Act (aka medically assisted suicide; death with dignity, right to die)  has now been in effect for six months, and the first report on its take-up has been issued.  The LA Times has the story:
111 terminally ill patients took their own lives in first 6 months of California right-to-die law

"A total of 111 people in California took their own lives using lethal prescriptions during the first six months of a law that allows terminally ill people to request life-ending drugs from their doctors, according to data released Tuesday.

"A snapshot of the patients who took advantage of the law mirrors what’s been seen in Oregon, which was the first state to legalize the practice nearly two decades ago. Though California is far more diverse than Oregon, the majority of those who have died under aid-in-dying laws in both states were white, college-educated cancer patients older than 60.

"The End of Life Option Act made California the fifth state in the nation to allow patients with less than six months to live to request end-of-life drugs from their doctors.

"Physician-assisted deaths made up 6 out of every 10,000 deaths in California between June and December 2016, according to state data. That’s much lower than the 2016 rate in Oregon, where lethal prescriptions accounted for 37 per 10,000 deaths.

"But the findings have done little to calm the debate over whether allowing doctors to prescribe lethal medications is acceptable medical practice.
...
"California’s data show that 173 physicians wrote the 191 prescriptions statewide."

California's right to die law: early days

The Mercury News brings us up to date on California's right to die law
California’s right-to-die law: Patients struggling to find doctors who will help
"It’s been nearly a year since California began allowing terminally ill residents to end their lives with the help of a physician. And for Ray Perman, the right-to-die law worked exactly as lawmakers intended.

"On Feb. 4, as his family gathered around his bed, the 64-year-old Piedmont resident ingested a lethal dose of sedatives and passed away peacefully — in his own home, on his own terms — after years of battling cancer.
...
"But for many other Californians, the End of Life Option Act — which took effect June 9, 2016 — has led to a desperate race against time. Frustrated and unable to care for themselves, these terminal patients have frantically searched to find the required two physicians they must work with to terminate their lives.

"Add in the law’s mandated 15-day waiting period between the two oral requests they must make to the two doctors for the medication and it’s often too late to follow through with their plans.
...

“At this stage in the law, it’s a little bit of a hard road,’’ said Judith Geisser, a retired attorney who lives in Oakland.

"Geisser watched as her dying brother’s oncologists — one in Santa Rosa who had treated him for colorectal cancer, another in San Francisco who had diagnosed his subsequent brain cancer — politely declined to help him die, or even refer him to colleagues who would.

...
"Geisser offers this advice to anyone who wants to take advantage of the law: Start your search for the two physicians sooner rather than later.

“When you’re not healthy, and not at your best, that’s not the time to manage the path through this law,’’ said Geisser, who was forced to scramble to find a physician to help her 67-year-old brother Pat fulfill his last wish.
...
"Opponents of the law, including Californians Against Assisted Suicide, have watched its implementation with dread and cite a litany of concerns.

“It’s bad policy,’’ said the group’s spokesman, Tim Rosales.

"He said there are too many loopholes in the law, including the fact that the law doesn’t require those patients receiving lethal prescriptions to get any type of counseling beforehand from a mental health professional. In addition, he said, “there’s no requirement that somebody who stood to gain financially from that individual’s passing could not be involved in the process.’’
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see my earlier post:

Friday, June 10, 2016

Death in California isn't the same anymore

Assisted suicide--the musical

A Theatrical Rebuttal to the Farce of ‘Dignicide’
The creator of ‘Assisted Suicide: The Musical’ says euthanasia denies the value of people who have illnesses or disabilities.

Liz Carr, an actress with disabilities created a popular London musical to speak out against assisted suicide...

So she created a musical. Much of “Assisted Suicide” involves Ms. Carr taking on her alter ego, a character named Documentary Liz. Film footage shows Documentary Liz living a humdrum disabled life, while a lachrymose melody plays and a narrator dourly describes the scene: “Liz feels trapped, imprisoned by her difficult circumstances. Liz has few freedoms, few choices on a day-to-day basis.”

Onstage, the real Ms. Carr rolls her eyes and provides a running commentary, acidly mocking the documentary clichés. “Music is always used very manipulatively,” she tells me. “The music feeds the emotional journey. It tells you, ‘This is a tragedy. This has one way to go.’ ” The aim is to normalize a choice that was unthinkable a generation ago, with the result that people like her are impelled to conclude: “You know what, my life isn’t worth living.”

Growing up with a severe disability, Ms. Carr recalls, “life was bleak.” She excelled at academics, but no amount of therapy seemed to improve her physical ability. She was never consciously suicidal, “but I didn’t see a future or an escape. I couldn’t see a point. So in that sense I’ve been to very dark places.” She pressed on, however, and now enjoys national prominence as an actress and disability activist.

Ms. Carr, who was born in 1972, considers herself lucky that euthanasia wasn’t on the cultural radar when she was young. “Assisted suicide has become part of the narrative of death, of illness, of disability,” she says. That was the work of euthanasia proponents, who knew that “it takes 15 to 20 years to get social support and to get the culture to change—then you pass the law.”

Assisted dying appeal to be heard in Britain

The Guardian has the story
Assisted dying

Terminally ill former lecturer wins right to fight assisted dying ban
Appeal court reverses high court ruling in case of Noel Conway, who has motor neurone disease and seeks judicial review

"In their judgment, Lord Justice McFarlane and Lord Justice Beatson said: “It is arguable that the evidence demonstrates that a mechanism of assisted dying can be devised for those in Mr Conway’s narrowly defined group that is practical so as to address one of the unanswered questions in the [earlier Nicklinson right to die case].”

Supported by the organisation Dignity in Dying, Conway has instructed lawyers to seek permission for a judicial review of the ban on assisted dying, which he says prevents him ending his own life without protracted pain. Assisted dying is prohibited by section 2(1) of the Suicide Act 1961 and voluntary euthanasia is considered murder under English and Welsh law."

Doctor assisted suicide in Colorado: repugnance outlives legalization

You can figure out much of this story from the headline (but there's more): Colorado’s aid-in-dying law in disarray as big Catholic health systems opt out

...
"A third big health system in the state, HealthONE, has decided it won’t dispense life-terminating medications or allow patients to take them on the premises of its eight hospitals. But HealthONE, which is not faith-based, won’t impose similar restrictions on its doctors. A spokeswoman declined to provide details.

"The state’s law, which became effective last month, requires that such patients be 18 or older, have six months or less to live, be mentally competent, and ask for aid in dying twice over 15 days, in addition to a separate written request.

“Everyone is in a mad scramble figuring out what they’re doing to do and how they’re going to do it,” said Jennifer Moore Ballentine, president of The Iris Project, a Colorado consulting firm that is running a series of seminars on the new law over the next few weeks.

Colorado’s aid-in-dying law contains “conscience” provisions allowing physicians, nurses, and pharmacists to “opt out” of participating. Health systems can also bar the practice on their premises. Other states where aid in dying has become legal — Oregon, Washington, California, Vermont, and Montana — have similar provisions, and Catholic health care systems in those states have taken advantage of it.

But the Colorado law specifically states that health systems can’t prohibit doctors who work for them from discussing end-of-life options with patients or writing prescriptions to be taken off-site. This provision was crafted to prevent health systems from erecting barriers to access; only Vermont has a similar rule, but it doesn’t have a heavy concentration of Catholic hospitals.

Advocates for Colorado’s law say the two big Catholic health systems may be testing that provision."
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And in Vermont: Vermont governor discloses his father used state’s end-of-life law

The politics of assisted suicide / death with dignity

My discussions of assisted suicide / death with dignity as a repugnant transaction included a recent post noting that in the most recent elections, Colorado joined the states (including California) that allow physicians to prescribe lethal drugs to mentally fit, terminally ill adults who want to end their lives.

It's therefore interesting to note that Supreme Court nominee Judge Neil M. Gorsuch has a 2006 book The Future of Assisted Suicide and Euthanasia suggesting that this is never justified. The publisher's website says:
 “The Future of Assisted Suicide and Euthanasia provides the most thorough overview of the ethical and legal issues raised by assisted suicide and euthanasia--as well as the most comprehensive argument against their legalization--ever published.”

In other (related) news, 
House committee moves to block D.C.’s assisted-suicide law

"In a rare step, a House committee voted 22 to 14 Monday night to block a law that would make assisted suicide legal in the District, opening a new front in the conflict between congressional Republicans and the overwhelmingly Democratic capital city.

It was one of only a handful of times in the four-decade history of D.C. home rule that members of Congress have tried to use their constitutional power to overturn a city law, and the first attempt since the GOP took control of both Congress and the White House in January.

The vote was largely along party lines, as 21 Republicans and one Democrat, Rep. Jim Cooper of Tennessee, voted yes while 13 Democrats and one Republican, Darrell Issa of California, voted no."

Repugnance and state elections...right to die, and marijuana

Several repugnant transactions became less so (at least they moved from illegal to legal) along with the other results of last Tuesday's elections.

After Colorado, right-to-die movement eyes new battlegrounds

"By an overwhelming vote Tuesday, Coloradans approved a ballot initiative allowing physicians to prescribe lethal drugs to mentally fit, terminally ill adults who want to end their lives. Colorado is the sixth state to allow the practice, following Oregon, Washington, Montana, Vermont and California. Washington, D.C., is poised to approve similar legislation as soon as this month.

Colorado’s ballot initiative proposal met resistance from religious groups with moral objections and disability advocates leery of abuse of power. Opponents raised over $2.6 million, the bulk of which came from the Archdiocese of Denver. Supporters, who argued that terminally ill patients deserve the option to “die with dignity,” raised over $5.4 million, mostly from the Compassion & Choices Action Network."

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 Arizona rejected marijuana legalization, and in Maine it passed by a hair, with a 50.2 percent majority finally counted on Thursday. Marijuana is now legal in some form in many more American states, with perhaps a quarter of the population. The Guardian notes the results of Tuesday's ballots...

"Approved: California voters approved recreational marijuana, a huge victory in the fight for cannabis legalization, paving the way for the largest commercial pot market in the US.

Approved: Massachusetts also voted for recreational pot, extending legal weed from coast to coast.

Approved: Nevada became the third state to approve a recreational cannabis law, making the west an even stronger region for marijuana sales.

Approved: Earlier in the night, Florida voters passed a constitutional amendment to legalize medical marijuana, the first victory in a string of high-profile cannabis measures on Tuesday’s state ballots.

Approved: North Dakota was the second state to approve medical weed, with the approval of Measure 5, which approves the use of marijuana to treat a number of diseases, including cancer, Aids, epilepsy and hepatitis C.

Approved: Arkansas also passed a medical cannabis measure that would allow patients with specific conditions to buy medicine from dispensaries licensed by the government.

Rejected: Arizona was the first state to vote against its marijuana measure, with the news early on Wednesday morning that voters have rejected Proposition 205. The measure would have legalized recreational pot.

Approved: Montana residents voted to expand the state’s medical marijuana system with the passage of Initiative 182, which removes limits on the number of patients providers can serve. Proponents of the measure argued that the existing restrictions blocked patients from accessing care.

Advocates and opponents agree that California’s Proposition 64 is the most important cannabis measure America has seen and could be an international game-changer for marijuana policy in the US.

California, which recently overtook the UK to have the fifth largest economy in the world, is expected to have a recreational marijuana market greater than Colorado, Washington, Oregon and Alaska combined, said Ethan Nadelmann, executive director of the Drug Policy Alliance.

“When I talk to everybody from allies to government officials in Mexico and I ask them what’s it going to take to transform the debate,” he said, “the response to me is when California legalizes marijuana.”

Too close to call: As of Wednesday afternoon, a recreational measure in Maine was still too close to call.

Colorado and Washington became the first states to legalize recreational marijuana in 2012, paving the way for Oregon, and Alaska to follow suit.

As medical and retail cannabis operations have spread across the US, legal marijuana has become the fastest-growing industry in the US, with some analysts projecting sales to reach $22bn by 2020."