‘Death is not a failure’: Medical schools adapt end-of-life lessons

“You go in focusing on wanting to be a hero and fix things,” Gawande said. “Teaching people in med school what it means to be an effective clinician for giving people cutting-edge care for quality of life — as opposed to quantity of life — is a neglected skill.” ~ Dr Dr. Atul Gawande, a surgeon at Brigham and Women’s Hospital and author of the book “Being Mortal.” 

Posted on April 26, 2018 .

I am convinced that physician-assisted dying can be, and is, practised responsibly

Through my experience of Oregon’s law, I came to realise that it was cavalier of me to believe that hospice and palliative care professionals could indeed meet all the needs of people who were dying, or that some needs were less worthy than others, such as the need to manage the circumstances of one’s death. It is true that the vast majority of people who have an assisted death in Oregon cite the loss of their autonomy and/or being less able to engage in activities that make life enjoyable. But suffering is a deeply personal and subjective phenomenon.

Posted on April 23, 2018 .

Medical aid in dying helps physicians care for whole patient

As a physician, it is my duty to educate my patients about their disease and their options and then to ensure their decisions are carried out.

That’s why I support patients having access to the End of Life Option Act. This compassionate, humane law gives terminally ill adults the option to request prescription medication that they decide to take, at their discretion, to peacefully die in their sleep if their suffering becomes intolerable

Posted on April 3, 2018 .

Should your doctor help you die? How N.J. lawmakers voted after emotional hearing.

fter a lengthy and sometimes angry hearing in Trenton, an Assembly panel on Monday approved a bill that would allow terminally ill people to request medication from a doctor to end their lives. It cleared the Assembly Judiciary Committee by a 5-2 vote.

The bill (A1504) was backed a group of nurses, physicians and family caregivers who insisted these patients deserve the chance to limit their suffering.

Posted on March 14, 2018 .

Doctors urge legalisation of assisted dying

Assisted dying has more support than ever in Britain and should be legalised, according to leading medical experts.

Writing in The BMJ they urged the British Medical Association to drop its opposition to assisted dying, where doctors provide or administer drugs to help patients end their lives. Surveys have shown support from up to 80 per cent of the public for a change in the law. A poll last October found 55 per cent of doctors wanted it to be made legal, subject to safeguards.

Fiona Godlee, the journal’s editor-in-chief, said: “The BMJ supports the legalisation of assisted dying. The great majority of the British public are in favour and there is now good evidence it works well in other parts of the world.”

Posted on March 14, 2018 .

I’m a doctor with end-stage cancer. I support medical aid in dying

I have had discussions with patients about putting them on a ventilator and later disconnecting it to end prolonged dying processes. I helped patients decide whether or not to undergo treatment when the alternative was death. However, when a terminally ill patient with cancer asked me to help him die peacefully to end his suffering, I was afraid that I might lose my license or, worse still, end up in prison. I’m embarrassed to say that I declined to give him a lethal prescription, as I put my needs ahead of his. That is a morally compromised position.

Posted on March 14, 2018 .

The voices of the dying changed my mind: Albright

It would comfort those with terminal illnesses to know that they could end their suffering, even if they never end up using the drug. Why should they be denied that peace of mind?

These stories carry heavy moral weight, balancing the scales against critics who can't feel their pain.

Before hearing their voices, I was certain my own religious faith and personal philosophy would prevent me from taking these drugs, even if provided the opportunity. 

But listening to them brought humility to my logic: If I were put to the test, suffering and robbed of my independence, would my judgment on this issue change?

Posted on March 13, 2018 .

Doctor: My terminally ill patients deserve end of life options

Sam and I had heartfelt conversations on his disease state and prognosis. His mind was clear throughout the course of his disease — ALS does not affect memory or cognitive function. He didn’t want a stomach tube for feeding or a tracheostomy to help him breathe. Sam wanted an option as to how he would die.

One day, I got a call from his wife. Sam had died from aspiration pneumonia —not the option he would have chosen. He wanted the option that could now be provided by House Bill 160.

As a physician who has practiced medicine in Delaware for over 33 years, I help my patients make decisions about their health every day. Educating patients and discussing diagnoses and treatment options may be the most important thing I do. Sometimes decisions are easy; many times, the decisions are difficult.

Patients with terminal illnesses that have no curative treatment are extra special in my eyes. They face something for which none of us is ready.

Posted on March 13, 2018 .

What next for palliative care and assisted dying?

An excellent summary of why the palliative care sector is so vehemently opposed to assisted dying laws. Written by the “father of palliative care” Prof Ian Maddocks who was closely involved in creating the Victorian legislation.

"What lies ahead for assisted dying and palliative care? The acknowledged dedication to best practice among palliative care staff feeds confidence that palliative care and voluntary assisted dying will find separate and complementary but not competitive roles, respecting each other in a common focus on the care of persons who experience major discomfort in progressive, advanced terminal illness."

Posted on March 13, 2018 .

P.E.I. doctor calls his role in medically assisted death a 'profound experience'

CANADA: Dr. Matt Kutcher calls his role in the medically assisted death of his patient a "profound experience" that has forever changed him as a physician.

"To be in a situation where you were about to end someone's life and have them look you in the eye, and hold your hand and say, 'Thank you so much,'" said Kutcher.

Helping Paul Couvrette on May 10, 2017 was the first time Kutcher had been involved in a medical assistance in dying (MAID) procedure.

"It did feel pretty profound. You were able to really provide somebody with the means to realize a decision that is probably as momentous as a decision can be," said Kutcher.

Posted on March 13, 2018 .

I Support Medical Aid In Dying As A Doctor And A Daughter

A doctor in Hawai‘i explains why she supports expanded end-of-life options.

"I’ve watched people die.

Some slip away peacefully in their sleep, the best-case scenario. Perhaps for days they are comatose, barely arousable, and then, slowly, their organs fail. In some cases, people describe that everything seemed fine until they couldn’t awaken their loved one.

But I’ve also seen suffering.

People taking shallow breaths as their lungs fill up with fluid, their hearts racing in an effort to keep up. Others in pain, getting doses of morphine to stop their “air hunger” or help alleviate discomfort as their bodies fail. Still others hooked up to machines, with no hope of recovery but no directives on when to let them go.

It doesn’t mean that I don’t value life, or hold my duties as a physician — to do no harm — lightly. It’s just that I define harm as suffering, and if there is a way that I can help to prevent suffering, I feel compelled to do just that."

Posted on March 13, 2018 .

Big gains for the euthanasia campaign

The Royal New Zealand College of General Practitioners — which has 4800 members, representing nearly 90 per cent of GPs — announced publicly in its submission that it had adopted a neutral position on voluntary assisted dying.

“That’s a major move by the college and will have considerable influence. The research evidence is pretty clear that a neutral or supportive stance by the relevant medical association, or college, is pivotal in doctors feeling comfortable to engage in providing assisted dying services. Anecdotally, it also appears to have a strong influence on whether politicians will vote in favour of legal AD.”

Posted on March 13, 2018 .

Who speaks for doctors on euthanasia?

Opposition by doctors is one of the most powerful forces in ensuring that parliamentary bills for assisted dying fail to become law. Doctors are regularly ranked among the most trusted members of society and will undoubtedly be involved in implementing any law change. If they say assisted dying is unethical or wrong, the public takes notice.

Posted on March 13, 2018 .

Depression and MAID: Terminally ill patients are often depressed. But that doesn’t mean they’re incompetent.

One of the most challenging things in assessing competence is trying to determine whether and to what degree the person’s decision is distorted by depression. It is not abnormal to feel depressed in the face of great suffering and a hopeless prognosis. Assessors must consider carefully whether the depression is biasing the patient to the point that they’re unable to think flexibly about their options and the potential scenarios—in a sense significantly impairing the voluntariness of their decision.

Posted on March 13, 2018 .

The right-to-die under the spotlight at World Federation of Right to Die Societies conference in South Africa

The World Federation of Right-to-Die Societies (WFRtDS), in association with DignitySA, is holding its 22nd biennial conference in Cape Town from 6-9th September 2018 at the Cape Sun Hotel. You are invited to join the conversation.

The timing of this conference is likely to coincide with the South Africa High Court hearing of the requests for an assisted death by a terminally ill palliative care specialist, Dr Sue Walter, and a businessman living with Motor Neuron Disease, Dieter Harck. This court hearing comes as a consequence of the Supreme Court of Appeal overruling a previous High Court decision to grant the late Advocate Robin Stransham-Ford a physician assisted death in 2015.

The conference theme is: #AssistedDying: Human rights in the 21stCentury. Global thought leaders will share their knowledge and expertise on campaign strategies, medical, legal, ethical, constitutional, cultural, and religious issues related to assisted dying.

Posted on March 13, 2018 .