Euthanasia

Ministers back assisted suicide for people who feel their life has been completed

October 13, 2016

People who feel their ‘life has been completed’ should get the legal right to die with the help of a specialist care worker, health minister Edith Schippers and justice minister Ard van de Steur have told MPs in a briefing (in Dutch).

The proposal follows years of discussion in parliament and in society at large about the right of people who consider their lives have reached the end, to die peacefully.

In their briefing, the ministers say that ‘elderly’ people with a consistent and well-considered wish to die – whether ill or not – should be able to take a drug to end their lives. Family members would not be allowed to administer the drug.

All requests for help would be assessed by a specially trained care worker and an independent expert to make sure the patient is not acting on impulse or has come under undue pressure from his or her family, the ministers said.

Justice

The practice would not be considered euthanasia, in which the patient is said to be suffering unbearably, and in which doctors have an active role.

The change in the law would ‘do justice to a legitimate and growing wish in society in general’, the ministers said.

The cabinet believes that people who consider their life to be complete should have the autonomous right to ask for help to kill themselves, the ministers said in their letter.

Experts

The cabinet statement follows a report by an independent committee of experts earlier this year which said that euthanasia for people who consider their lives to be completed should not be allowed in law.

The committee was set up following the acquittal of a man who had helped his 99-year-old mother to die because she felt her life was at an end.

In November 2014, the voluntary euthanasia society (NVVE) relaunched its campaign to have a pill made available to elderly people who wish to end their lives.

Drion

The idea for such a pill was first launched at the beginning of the 1990s by senior judge and euthanasia campaigner Huib Drion and became known as ‘Drion’s pill’.

The NVVE says the pills should only be issued by pharmacists or family doctors. ‘This is important to make sure the drugs cannot be used for suicide, abuse or murder,’ the organisation said.

The ministers’ plan will require new legislation, separate from the current euthanasia legislation, which will outline the system of checks and balances to ensure there is no abuse.

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Fmr. parliamentarian, wife commit joint suicide

By Janene Pieters on October 25, 2016 - 08:14

Former CDA parliamentarian Frans Jozef van der Heijden and his wife ended their lives together on Friday at the ages of 78- and 76-years respectively. They explain their decision to do so in an obituary published in newspaper AD on Tuesday.

"The discussion on a self-chosen end of life is still dominated by the question of whether people who think that they have completed their lives, may end that life", the obituary reads. "Most obvious is whether people who feel that their lives threaten to end in great suffering and burden (including due to severely degraded care) may end that life now that they not yet suffer and burden themselves and others."

The CDA does not find it appropriate to comment on the couple's suicide at this stage. "Our thoughts are with the relatives and we wish the family and friends a lot of strength", the party said. CDA party chairman Ruth Peetoom describes Van der Heijden as a passionate and authentic CDA member. "I am deeply touched and sad", she said, according to NU.nl.

Van der Heijden was member of the Rotterdam City Council from 1970 and CDA parliamentarian from 1982 to 1998. He was the spokesperson for Home Affairs, elderly policy, police and mental health care, among other things. In 1998 he left parliament, but returned to the Rotterdam City Council. He left the Rotterdam council in 2006. Van der Heijden was made a Knight in the Order of the Dutch Lion and Knight in the Order of Oranje-Nassau for his political merit.

Van der Heijden's wife Connie was also active in the Rotterdam municipal politics. The couple married in 1963.

According to AD, the couple's family will make no further statements on the obituary.

Assisted suicide at the end of a full or completed life has been a topic of debate over the past weeks. The government wants to amend the euthanasia law so that elderly people who believe their life is complete can qualify for euthanasia, under strict conditions.

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Earlier today [i.e. October 19], the D.C. City Council voted to allow physician-assisted suicide. But the debate isn't over. The Washington Post reports that "the council must still hold a final vote on the bill, possibly as early as Nov. 15," and that the mayor, Muriel Bowser, must decide if she'll sign or veto the bill.

The mayor should veto the bill. Physician-assisted suicide will change us all, for the worse—as I explain in a Heritage Foundation report, "Always Care, Never Kill: How Physician-Assisted Suicide Endangers the Weak, Corrupts Medicine, Compromises the Family, and Violates Human Dignity and Equality."

Too many people view physician-assisted suicide as a purely private matter between an autonomous adult who desires to die, and another autonomous adult who can provide medical assistance in death.

But no man is an island. Allowing doctors to prescribe deadly drugs to assist in the suicides of their patients is not simply a one-off interaction between two consenting adults. Changing the laws that govern how doctors operate will change the entire ecosystem of medicine. It'll change how doctors relate to their patients and how much patients can trust their doctors.

Ultimately, it will change how society views the weak and the marginalized and affect our family relationships—how we view our elders and our duties toward them.

continued...

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Supreme Court advice: No punishment for mom's assisted suicide

By Janene Pieters on November 9, 2016 - 12:40

Albert Heringa should not be punished for helping his 99-year-old mother commit suicide, according to an Advocate General of the Supreme Court who studied the case. The court in Arnhem previously ruled that Heringa should not be punished. The Advocate General advises that the ruling be upheld, NOS reports (in Dutch).

In 2008 Heringa helped his mother end her life. She was staying in a nursing home, suffered from heart failure, severe back pain and was almost blind. Her doctor said that he would not perform euthanasia on her. Heringa decided to help his mother when he found out she had been collecting pills to commit suicide. The pills she collected would not work, so he gave his mother the pills that would. She took the pills voluntarily and ended her life.

When Heringa was first prosecuted, the court in Zutphen found him guilty of assisted suicide, but did not impose a punishment. The judges found he acted out of love and charity. The Public Prosecutor appealed. A court in Arnhem acquitted Heringa last year. The court found that Heringa rightly invoked a state of emergency, a form of force majeure, because the doctor refused to help. He felt morally obliged to help his mother have a painless, dignified death she wanted. According to the court, Heringa acted very carefully and transparently. He filmed everything.

The Public Prosecutor did not agree with this ruling and appealed to the Supreme Court. According to the Public Prosecutor, Heringa could not sufficiently motivate that there was an emergency.

The Advocate General examined the question of whether and when someone who isn't a doctor can call upon a state of emergency. She concluded that the court in Arnhem was right to rule that this was a "very exceptional situation". This ruling can not be used for general conclusions, and exceptional situations will have to be judged case by case, she added.

According to the Advocate General, Heringa gave his mother the drugs at her express request. She took the pills completely voluntarily and ended her life. She therefore advises that Heringa not be punished.

According to NOS, the advice of the Advocate General is always seriously considered. An Advocate General at the Supreme Court is sometimes asked for independent advice in ongoing proceedings. He or she is assisted by academic staff. While the advice is not binding, the Supreme Court ruling usually corresponds to the advice. The Supreme Court is expected to rule on this case in March.

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Assisted dying could be legalised for over-75s who have had ‘enough of life’

December 19, 2016

Assisted suicide could be extended to anyone over the age of 75 who no longer wants to live, even if they are not ill, under a bill brought forward by D66 MP Pia Dijkstra.

The bill would make it legal to arrange the death of anyone with an ‘intrinsic and consistent’ wish to die. The request would be granted and carried by a registered end-of-life practitioner, which could be a doctor, nurse or psychologist, and they will have to seek a second opinion before deciding.

A number of safeguards are included in the proposed legislation. The wish to die must be confirmed in a second interview after the original request, with a gap of at least two months in between. The case will also be reviewed by an independent commission, as happens currently with euthanasia.

At the moment euthanasia is legal in the Netherlands only for patients who are experiencing unbearable suffering with no prospect of improvement. Cancer patients account for around 70% of euthanasia deaths, but the total number has increased by 70% in the last five years.

Dijkstra told Nieuwsuur (Dutch only): ‘There are plenty of examples of people who say, “I’ve had enough of life, I have children and grandchildren, they’re all doing well, but I’m detached, I don’t play a role in their lives any more. The only thing waiting for me is decline and I don’t want to go through that.”’

Dijkstra said the conditions were designed to ensure that assisted suicide would only be granted to people who made the request ‘of their own free will, properly considered and without pressure from outside’ and who were mentally fit to make the decision.

The bill will be placed online so people can comment and respond before it is put before Parliament, which will not happen until after the general election next March, Dijkstra said.

Health minister Edith Schippers told Parliament in October that the government was looking to legalise assisted suicide for elderly people who were ‘suffering from life’, but did not bring forward any firm proposals.

At the time her plan was criticised by opposition politicians who said the government should be concentrating on improving the quality of life for the elderly.

Gert-Jan Segers, leader of the ChristenUnie party, said: ‘In what kind of society do we want to live? What’s the answer to loneliness? I can’t accept that it’s giving someone a pill.’

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<snip>

I used to believe in euthanasia.

I thought it was short-sighted and cruel to force people to endure their tragically slow decline in health simply for the sake of appearances. To support the commitment that conventional medicine upholds to "never quit." Are people meant to be kept alive at all costs?

I used to think they should be allowed to die, with dignity, if their condition was hopeless.

If their condition was hopeless.

This is the operative term.

Now, with my awareness of documented cases of spontaneous remission, my knowledge of radically transformative healing paths, my work with Dr. Nicholas Gonzalez and his long-term care for the terminally ill, and my own cases of total reversal of mental illness diagnoses within the space of months, I no longer believe anything is hopeless.

With the right tools and the right mindset, the body is capable of negentropic feats of healing.

The failures of psychiatry are only a source of hopelessness if you don't believe there's another version of the story, another way, and a deep meaning to your struggle.

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Euthanasia rarely approved for advanced dementia patients, despite lucid requests

By Janene Pieters on January 6, 2017 - 10:49

Euthanasia is hardly ever approved for advanced dementia patients, despite the fact that the Ministries of Public Health and Security and Justice gave the go ahead that it can be given to dementia patients who requested it in a written declaration while they were still lucid. Since the euthanasia request declaration system was implemented end 2015, there's only been three known cases of it being used, the Volkskrant (Dutch only; behind paywall) reports based on information from the euthanasia review committees RTE.

According to the newspaper, many doctors are unclear about what is allowed and what isn't, due to conflicting rules in law and doctors' guidelines.

In 2012 doctors organization KNMG implemented its own rules on when to approve euthanasia. These rules were more strict than the legal requirements and stated that verbal or non-verbal communication with the patient was needed for euthanasia. End of 2015 the Ministries decided to clarify the matter by adding to the euthanasia guidelines that euthanasia can be approved for an advanced dementia patient if that patient made a declaration asking for euthanasia while the patient was still lucid, and if that patient is suffering unbearably.

According to Jacob Kohnsthamm, chairman of the RTE, the problem lies in determining whether a dementia patient has "hopeless and unbearable suffering". "The unbearable suffering can often not be identified in these patients. At a moment where a deep dementia patient sits quietly in a corner in a nursing home, that's impossible", he said to the newspaper.

Steven Pleiter, director of the End of Life Clinic which handles complex euthanasia requests, confirms this. "For our doctors it is not a matter of not wanting, but not being able to. Many patients change as the dementia progresses. Sometimes patients will suddenly go: I do not want euthanasia, how did you get that? With one single patient the suffering was visible. But in many others it's not." he said to the Volkskrant.

Robert Schurink, chairman of the Dutch association for voluntary end of life NVVE, calls it disappointing that nothing changed since the euthanasia declaration was given the go ahead in 2015. "People sign such a declaration with conviction. They think that it is settled. But as soon as they pass the time of mental competence, doctors suddenly don't want to anymore. The Minister [Edith Schippers of Public Health] wanted to solve this ambiguity in 2015 and indicated that it is allowed. But many doctors don't want to burn their fingers, even if there's visible suffering. They feel bound to the old standards of the KNMG and demand that the patient communicates himself."

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Euthanasia controversy: Doctor rebuked for helping uncertain woman die

By Janene Pieters on January 26, 2017 - 11:35

For the first time in Dutch history a doctor in the Netherlands was reprimanded for giving euthanasia to a dementia patient while it was not conclusively established that euthanasia was what the woman wanted at that time, Trouw reports (Dutch only). The implementation of euthanasia was also traumatic, the Regional Review Committee concluded, according to the newspaper.

The patient in question is a woman around the age of 80 years, suffering from dementia so far advanced that her husband could no longer cope with the care she needed. She had to be placed in a home. While the woman was still lucid she indicated that she definitely did not want to end up in a "home for demented elderly". She also stated in her will that she wanted euthanasia "when I myself find it the right time".

In the nursing home the woman spent her days frightened and angry. She wandered the halls of the home at night and missed her family. After a few weeks the doctor at the home determined that the woman was suffering unbearably and is no longer mentally competent, but that the declaration she gave in her will justifies euthanasia.

Euthanasia was preformed seven weeks after the woman was admitted into the nursing home. To calm the woman down, the nursing home doctor gave her a first dose of sedative in a cup of coffee. A second dose was injected into her. She seemed to fall asleep. But when the infusion was inserted she "pulled back", and while the doctor injected the euthanasia agent, she moved as if to get up. The doctor decided to continue while family members held the patient down. The woman died shortly afterwards.

The review committee determined that the woman's declaration in her will did not clearly state that she wanted to be euthanized after being admitted to a nursing home. The words "when I myself find it the right time" does not take into account a situation in which the woman was no longer mentally competent. The committee can understand how the doctor read it as a well-considered wish, but still feels that it was too broad an interpretation.

The committee also concluded that the doctor "crossed a line" by giving the woman the first dose of sedative secretly - hidden in a cup of coffee. And that the doctor should have stopped at the woman's movements at the end. Even though it is possible that the movements were purely physical reactions, it can not be certain.

On other points, including the presence of hopeless and unbearable suffering and consulting other doctors on the matter, the committee found the doctor acted correctly and according to the rules.

In January last year the Ministries of Security and Justice and Pubic Health gave the green light to allow euthanasia in advanced dementia patients, provided that the patient left a written request for euthanasia while he or she was still lucid. Despite this, euthanasia is hardly ever granted to patients with advanced dementia.

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Dutch politicians, social organizations team up in "aging with dignity" manifesto

By Janene Pieters on January 31, 2017 - 10:16

A number of Dutch political parties and civil society organizations teamed up in a manifesto calling for more effort to be put into making sure that elderly people can grow old with dignity. A coordinating minister for elderly policy and encouraging family care are two of the priorities in the manifesto, ANP reports.

The manifesto was initiated by ChristenUnie leader Gert-Jan Segers, director Jan Slagter of broadcaster MAX and director Manon Vanderkaa of elderly organization KBO-PCOB. Their plans are supported by political parties CDA, SP and several Dutch celebrities. It can be signed online.

The manifesto is titled "Aging with Dignity" and according to Segers, it is one way to make sure the quality of life for older people increases again in the Netherlands. He adds that opinions on how to improve quality of life for the elderly will continue to differ. "But where we can find each other politically and socially is in a commitment to a society in which older people are seen and appreciated."

Other calls in the manifesto include a call for the "acceptance and revaluation of old age", making volunteering more attractive and countering loneliness among the elderly. There should also be "life coaches", instead of death coaches, who can answer the elderly's life questions and can help where needed.

Last year the government presented a plan to help people die who feel their life has been completed. The CDA, SP and ChristenUnie are against this plan, feeling that effort should rather be put into preventing people from experiencing their life as already done.

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Dutch doctors against euthanasia for advanced dementia patients

By Janene Pieters on February 10, 2017 - 13:45

A group of 220 Dutch doctors took out an advertisement in NRC on Friday to show that they are against granting euthanasia to advanced dementia patients. The doctors believe it's wrong to give euthanasia based on a statement which the patient can no longer confirm.

"Our moral reluctance to end the life of a defenseless human being is too big", the ad reads. Among the signers are also doctors specialized in helping patients die.

The doctors want to restart the conversation about euthanasia for severely demented people, according to NOS (Dutch only). Since 2015 there were three cases of euthanasia granted to patients with advanced dementia. Initiator and geriatric doctor Boudewijn Chabot wants a court to decide whether these cases were carefully handled according to the rules.

The rules for euthanasia for elderly people with dementia were adjusted in December 2015. The Ministries of Public Health and Security and Justice changed the euthanasia guidelines to state that euthanasia can be granted to advanced dementia patients if they made a written declaration with this wish while they were still lucid. Before this adaption, a patient had to express the desire for death himself. But this is no longer required.

A Dutch doctor was recently rebuked for granting euthanasia to a dementia patient, the first time in Dutch history that this happened. The Regional Review Committee concluded that the patient's wish for euthanasia was not clear enough.

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A: What about war? What is better? This is open because all are murderers and suicides. It is the supreme lesson you all must learn before you can graduate to ethereal existence. Your thinking is too simplified.

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This is a great topic to talk about, as it is such a difficult subject to really have a definite yes or no opinion on, unless you have experienced the desire to do this yourself, majority of us have no room to talk really.
As everyone else I have my own opinions also. They are very split both ways, as i am sure most peoples will be on this topic.

Firstly I feel that as souls before cominig to earth we pre planned certain events to happen, or things we were born with etc, in order to learn a very specific lesson, like acceptance, patience, so on and so forth, so we agree to be for example paralysed from the neck down in this life in order to do this. My theory is that the more severe the handicap, pain etc the more we want to learn this lesson, as maybe it is a lesson that is taking lifetimes to achieve so putting ourselves in such a severe situation with our bodies, we have much more chance to finally learn this lesson...

Now if one chooses to die in some ways i feel they are avoiding the situation that they pre planned. And will just ave to repeat the cycle again until they learn what it is to learn being in whatever state they were in.
In a completely different way, if one conciously chooses to die, with total acceptance and awareness of what they are about to do and have peace in thier hearts, this may actually also be a lesson in choosing nobly when to die and when not to. Do they really have to live? Choosing to die I feel in some ways can be a noble act, with as many powerful lessons and choosing not to.

This is why it is so hard to have a straight opinion on this topic as it is actually impossible to when we do not know the whole truth spiritually speaking of the lessons each and every one of these souls came here to learn??

Ciou :)

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