Euthanasia

A paralysed DJ ended his own life with the press of a button in Switzerland after a fruitless campaign for euthanasia in his native Italy.

Fabiano Antoniani died at a euthanasia facility in Forch after reportedly triggering the lethal substance.

The 40-year-old had campaigned for a change in the assisted suicide law in his homeland, but Italy's parliament had shelved the debate 11 times.

Former MEP and activist Marco Cappato, who traveled with Mr Antoniani to Switzerland, could face criminal charges after helping escort the musician to the facility.

Police have questioned him over the death, he said on Twitter.

Mr Antoniani was left blind and tetraplegic by car crash in 2014. The DJ dropped his phone while driving and smashed into the car in front of him as he tried to pick it up.

Also known as quadriplegia, Tetraplegia is paralysis caused by illness or injury that results in the partial or total loss of use of all four limbs and torso.

He appealed to Italy President Sergio Mattarella for the right to die, and shortly before his death, criticised the country for failing to pass laws allowing him to do so.

“Finally I am in Switzerland and, unfortunately, I got here on my own and not with the help of my country,” he said, in a message posted on social media shortly before his death.

“Fabo died at 11.40am. He decided to pass away, respecting the rules of a country which is not his own,” Mr Cappato wrote on Twitter, shortly after he died.

Roberto Saviano, an Italian journalist, who was a friend of DJ Fabo, also wrote: “We distinctly heard you ask for a dignified death. There is no possible justification for the silence that you’ve achieved in response.

“There is no possible justification for the lack of empathy, of attention, and humanity, from the European Parliament, and from the country, which by fate, you were born in.”

In one of Mr Antoniani’s last Facebook posts, he wrote: “F*** the boredom… f*** the problems… f*** the sickness.”

Euthanasia is illegal in Italy, a traditionally Catholic country, but the law upholds a patient’s right to refuse care.

A bill to clarify assisted suicide law has been postponed in Italy three times, but according to La Stampa, will be debated by the Chamber of Deputies this week.

Hundreds have travelled to Zurich to end their lives since the Dignitas organisation was set up in 1998.

The number of assisted suicides in Switzerland, according to statistics from Dignitas and Exit, stood at 416 in 2011 but 1,004 in 2015.

In the UK, a woman suffering from Crohn's disease last month said she will pay £10,000 to end her life in Switzerland because of social care cuts.

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Washington D.C. Becomes 6th Place in the U.S. to Legalize Assisted Suicide

Micaiah Bilger Feb 20, 2017 | 11:05AM Washington, DC

A Washington, D.C. law allowing doctors to prescribe their patients lethal drugs to commit suicide went into effect Saturday after U.S. Congress failed to block the measure, the Washington Times reports.

The district is the sixth area in the U.S. to legalize the deadly procedure, following Oregon, Washington state, Vermont, California and Colorado. The D.C. council passed the law at the end of 2016, despite wide-spread opposition from African Americans, people with disabilities, medical professionals, pro-lifers and religious groups.

U.S. Congressional leaders did take initial steps to overturn the D.C. law, but their measures did not pass in time.

Here’s more from the report:

Under the federal Home Rule Act, a disapproval resolution passed by both houses of Congress and signed by the president within 30 legislative days would have blocked the law from taking effect.

The House Committee on Oversight and Government Reform voted Monday to send a disapproval resolution to the House floor, but it never received a vote. A corresponding Senate resolution did not make
it out of committee. …

Congress can still neutralize the Death with Dignity Act by cutting off its funding through the appropriations process.

Supporters describe the law as “death with dignity” and say it only applies to terminally ill adult patients.

“The advocacy of D.C. residents and local officials is what won this victory,” said Jessica Grennan, spokeswoman for the euthanasia group Compassion and Choices, in a statement. “Democracy conquered the personal mindsets of paternalistic politicians whose opinions should not get in the way of people getting the medical relief they want and need.”

Opponents, however, say the law opens up a wide door for abuse of the elderly and those with disabilities.

“The Act is a recipe for elder abuse, it applies to persons who have years or decades to live and purported oversight is a sham,” said attorney Margaret Dore, president of Choice is an Illusion, in a release earlier this month.

Dore said the new law allows a patient’s heir who could financially benefit from their death to participate in requesting the lethal drugs. She said the law also does not require a doctor or any other unbiased witnesses to be present when the patient takes the drugs.

“But, it gets worse,” Dore continued. “The death certificate is required to list a medical condition as the cause of death, which prevents prosecution. The official cause of death is a medical condition (not murder) as a matter of law. For perpetrators, the death certificate is a ‘stay out of jail free card.’”

Many in the D.C. African American community also oppose the new law. As the Washington Post reported previously, D.C. residents are worried that the law will threaten the lives of poor and elderly residents, especially minorities.

“Because of Jim Crow laws . . . we didn’t have the opportunity to have the same jobs, to have the same insurance, the same retirement benefits,” community activist Leona Redmond told the news outlet. “It’s really aimed at old black people. It really is.”

Redmond, who worked to oppose the law, said they fear that, through the legislation, politicians will continue to make cost cuts a higher priority than healthcare for the poor and elderly.

In states where doctor-prescribed suicide is legal, sick people are being denied medical treatment coverage and offered assisted suicide instead. Most recently, Stephanie Packer, a California wife and mother of four who was diagnosed with a terminal form of cancer, said her insurance company refused to cover the cost of her medical treatment.

When Packer asked her insurance company if it would cover doctor-prescribed suicide, the company told her, “Yes, we do provide that to our patients, and you would only have to pay $1.20 for the medication.”

Patients in Oregon reported similar experiences. The D.C. bill is modeled after the Oregon doctor-prescribed suicide law.

No DC Suicide, a coalition of groups opposed to the legislation, also has concerns. The group said the new law does not require patients to have a mental health screening, even though studies have found that depression is a key factor in suicide cases.

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Supreme Court orders retrial for man who helped his mother die

March 14, 2017

The Dutch Supreme Court has ruled that a man found cleared of helping his 99-year-old mother to die in 2013 will have to stand trial again.

At the time the appeal court in Arnhem said Albert Heringa (74) had carried out sufficient checks that his mother was suffering both psychologically and physically and that she really wanted to die.

However, the Supreme Court has now ruled that euthanasia carried out by someone other than a doctor must be subject to ‘very strict rules’ and a different court, this time in Den Bosch, will have to determine whether or not Heringa should be punished for what he did. Heringa’s earlier appeal was ‘granted far too lightly’, judges said in a statement (in Dutch).

The public prosecutor considers Heringa guilty and wants a suspended sentence of three months.

Heringa decided to help his mother die when doctors refused her request to administer a lethal dose of medication. He filmed his mother, who was almost blind and suffering from crippling back pains, as he helped her take the pills that would kill her. The footage featured in a documentary called De laatste wens van Moek (Mum’s final wish) which was broadcast in 2010.

Heringa was disappointed at the outcome of the case, which was expected to go in his favour. ‘I would have liked to have left this behind me but now it will all start again. It is clear that the problems surrounding people who consider their lives completed are not solved. It is back on the political agenda as well,’ Nu.nl quotes him (in Dutch) as saying.

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Dutch politician's killer gets 8 years for euthanasia revenge killing

By Janene Pieters on March 16, 2017 - 14:23

Bart van U. was sentenced on appeal to 8 years in prison and institutionalized psychiatric care for the murders of politician Els Borst and his sister Lois. The sentence given by the court in The Hague on Thursday is equal to what the Public Prosecutor demanded.

Last year Van U. was only sentenced to institutionalized psychiatric care for these murders. The court declared him insane. Van U. confessed to both murders. He said he killed his sister because she bullied him his entire life and that he had enough when she offered him a cookie that she knew he didn't like. In the murder of Els Borst, Van U. claimed that he was on a divine mission to kill those responsible for the euthanasia law.

The Public Prosecutor appealed against the initial ruling. The prosecutor believes that Van U. has severely diminished responsibility, but is not completely insane. The prosecutor also argued that Van U. killed the two women in extremely violent ways - both died of numerous stab wounds.

The court in The Hague ruled in favor of the Public Prosecutor and found Van U. guilty of manslaughter.

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Dutch GPs should refer rejected euthanasia requests to another doctor: end of life foundation

By Janene Pieters on March 24, 2017 - 10:45

Doctors in the Netherlands should refer their patients to another doctor if they can not or do not want to grant a euthanasia request themselves, according to the foundation Levenseindenkliniek (End of Life Clinic), ANP reports (in Dutch).

As expertise center in the field of euthanasia, the clinic mainly wants to deal with complex euthanasia cases, such as when it involves patients with dementia or psychiatric disorders. Yet a relatively large number of the cases they receive involve so-called "non-complex" euthanasia requests - involving patients with a terminal illness. These requests can be handled by the patient's own doctor, or a colleague, according to the foundation.

The clinic therefore wants to arrange a meeting with the professional group for doctors to discuss the matter.

Doctors organization KNMG (in Dutch) also wants to support doctors in referring euthanasia requests. "If a doctor can not agree to a request for euthanasia due to personal reasons, it is important that he speaks to the patient about it in a timely manner and helps him find another doctor", chairman Rene Heman said. "It is not a legal obligation, but a moral and professional responsibility."

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Dutch doctors reject separate euthanasia rules for ‘completed lives’

March 30, 2017

The Dutch doctors association KNMG is not in favor of drawing up specific euthanasia rules for elderly people who consider their lives [to] have been completed.

Although the wish of some people who are not physically ill to die is palpable, new legislation aimed specifically at such cases would be ‘undesirable’, the KNMG said in a statement (Dutch only).

The KNMG says it has carried out extensive consultations with members and experts to draw up its standpoint. The position paper is in response to government moves to bring in special provisions to allow people who consider their lives are at an end to die peacefully.

Last October, health minister Edith Schippers and justice minister Ard van de Steur said in a briefing to MP's 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.

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, and 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.

Autonomous right

The change in the law would ‘do justice to a legitimate and growing wish in society in general’, the ministers said. However, the cabinet position conflicts with the advice of an independent committee of experts earlier in 2016 which said that euthanasia for people who consider their lives to be completed should not be allowed in law.

The current legislation works well but support for it will be undermined if it is extended to include people who are not suffering physically, the KNMG said. ‘Age-related vulnerability, whereby people suffer from multiple medical and non-medical problems, can be deemed to be unbearable suffering’ and therefore fall under the euthanasia legislation, the organization points out.

However, separate legislation for people with ‘no medical grounds’ for the wish to die could have an undesirable social effect, by stigmatizing the elderly, the KNMG said. Instead, the government should invest in measures to make sure the elderly do not feel their lives are pointless.

The expansion of euthanasia rules are likely to become part of the current coalition government talks. D66 is the driving force behind the changes and the VVD have said they will support them. However, the Christian Democrats, who do not back change, are set to have a key role in the new government.

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Number of official cases of euthanasia rise 10% in the Netherlands

April 12, 2017

The number of official cases of euthanasia in the Netherlands rose 10% last year to 6091 and euthanasia now accounts for 4% of total deaths, the regional monitoring boards said on Wednesday.

In 10 cases, the rules for euthanasia were not followed correctly, most of which involved a failure to properly consult a second doctor, the RTE annual report said. In one case, a doctor was reprimanded for ‘crossing the line’ with a patient suffering from severe dementia.

Of the total, 87% of assisted deaths involved people with cancer, serious heart or lung problems or diseases of the nervous system such as ALS.

There were 32 more cases of assisted suicide involving people with dementia, most of whom were in the early stages of the disease. In addition, there were 60 cases involving people with severe psychiatric problems, a rise of four on 2015.

Demographics

Monitoring committee chairman Jacob Kohnstamm said it is not easy to determine why there has been a rise in overall cases. The demographic make-up of the Netherlands could be one reason for the increase, as could a change of opinion among doctors, he said.

Some 85% of euthanasia requests are carried out by the patient’s own doctor, usually at home.

Euthanasia is legal in the Netherlands under strict conditions. For example, the patient must be suffering unbearable pain and the doctor must be convinced the patient is making an informed choice. The opinion of a second doctor is also required.

Since the legislation was introduced in 2002, there have been a number of controversial cases, including a woman suffering severe tinnitus and a serious alcoholic.

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The woman, who has not been named, began to suffer from mental disorders 15 years ago following sexual abuse, according to the papers released by the Dutch Euthanasia Commission. The timescale means she was abused between the ages of five and 15.

News of her death angered anti-euthanasia MPs and disability campaigners in Britain. One Labour MP said it meant sex abuse victims were now being punished with death.

It comes at a time of continued controversy over assisted dying in Britain. A steady flow of people from this country travel to die legally at the Dignitas clinic in Switzerland, and judges and the courts appear to be leaning in favour of making it legal to help someone to die.

Details of the Dutch case were released by authorities anxious to justify euthanasia laws and to demonstrate that mercy killings are carried out under full and correct medical supervision.

The papers said that the woman, who was killed last year, had post-traumatic stress disorder that was resistant to treatment. Her condition included severe anorexia, chronic depression and suicidal mood swings, tendencies to self-harm, hallucinations, obsessions and compulsions.

She also had physical difficulties and was almost entirely bedridden. Her psychiatrist said 'there was no prospect or hope for her. The patient experienced her suffering as unbearable'.

However, the papers also disclosed that two years before her death the woman's doctors called for a second opinion, and on the advice of the new doctors she had an intensive course of trauma therapy. 'This treatment was temporarily partially successful,' the documents said.

Treatment was abandoned last year after independent consultants were called in and said the case was hopeless.

The consultants also said that despite her 'intolerable' physical and mental suffering, chronic depression and mood swings, she was entirely competent to make the decision to take her own life.

The patient, they said, was 'totally competent' and there was 'no major depression or other mood disorder which affected her thinking'. A final GP's report approved the 'termination of life' order and the woman was killed by an injection of lethal drugs, the report said.

In Britain yesterday her case was condemned as 'horrendous' by Labour MP Robert Flello.

He said: 'It almost sends the message that if you are the victim of abuse, and as a result you get a mental illness, you are punished by being killed, that the punishment for the crime of being a victim is death.

'It serves to reinforce why any move towards legalising assisted suicide, or assisted dying, is so dangerous.'

Tory MP Fiona Bruce, chairman of the Parliamentary All-Party Pro-Life Group, said: 'This tragic situation shows why euthanasia should never be legalised in this country. What this woman needed, at a desperate point in her young life, was help and support to overcome her problems, not the option of euthanasia.'

Nikki Kenward, of the disability rights group Distant Voices, said: 'It is both horrifying and worrying that mental health professionals could regard euthanasia in any form as an answer to the complex and deep wounds that result from sexual abuse.'

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111 terminally ill patients took their own lives in first 6 months of California right-to-die law

By Soumya Karlamangla June 27,2017, 6:05 PM

UPDATES: 6:05 p.m.: This article was updated with reactions from experts and medical professionals and was rewritten throughout.
This article was first published at 1:30 p.m.

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.

Supporters of the law pointed to data showing that 191 prescriptions were written, but only 111 patients had taken the pills as of the end of December.

Comparing California’s experience to Oregon’s

California, June 2016 — December 2016 Oregon, January 2016 — December 2016

59% of those who died using a lethal prescription had cancer. 79% of those who died using a lethal prescription had cancer.
46% of those who died were male 54% of those who died were male
90% who died were white, 3% Latino and 5% Asian 96% who died were white, 1.5% Latino and 1.5% Asian
58% who died had a bachelor’s degree or higher 50% who died had a bachelor’s degree or higher
57% who died had Medicare, Medicaid or another type of government insurance; 70% who died had Medicare, Medicaid or another type of government insurance;
31% had private insurance; 4% were uninsured 30% had private insurance; fewer than 1% were uninsured.
The rate of lethal prescription deaths was 6 per 10,000 total deaths in the state. The rate of lethal prescription deaths was 37 per 10,000 total deaths in the state.


Often patients have long-held values and beliefs about what makes a life worth living, and want the peace of mind of knowing that if their conditions worsen, their pain increases, or they become more dependent on others, they won’t have to endure it, said Dr. Tom Strouse, a psychiatrist and palliative care doctor at UCLA.

They “want the option of saying, ‘That’s not how I’m going to live,’” Strouse said. “It’s a contingency planning approach, really.”

Alexandra Snyder, an attorney with Life Legal Defense Foundation and critic of the law, said California is now effectively decriminalizing assisted suicide. There’s no way to determine whether a patient was coerced into taking the drug, she said.

“It’s really tragic that doctors are now thinking that the best they can do for a patient is to give them a handful of barbiturates and leave them to their own devices,” Snyder said of the numbers released Tuesday.

Experts say the low usage numbers in California last year aren’t surprising since patients and physicians are still learning about the new law. In the first year that Oregon’s law was in effect, there were only 15 physician-assisted deaths, though that number had grown to 133 last year.

“The state’s data show that even during the early months of the law’s implementation, the law was working well and terminally ill Californians were able to take comfort in knowing that they had this option to peacefully end intolerable suffering,” said Matt Whitaker, who works for Compassion & Choices, an advocacy group that fought for the law’s passage. The organization released a report this month saying it knew of 504 people who had received prescriptions for lethal medications between June 2016 and June of this year.

Writing the lethal prescriptions is completely voluntary for doctors and medical facilities, and some, including all Catholic and church-affiliated hospitals, have not allowed their physicians to prescribe such medicines.

But Whitaker said that even those groups in California are having an open dialogue about the law and that, generally, he’s been “pleasantly surprised” by how much more willing doctors are to talk about the practice than they were in the early years in Oregon.

“They have really approached the issue head on, and not just closed their eyes and hoped it would go away,” he said.

Similar laws are being considered by several other states. In November, Colorado voters legalized the practice, bringing the percentage of Americans who live in states where the practice is legal to 18%.

California’s law still faces opposition from some corners. A judge ruled this month that a suit to overturn the law will be allowed to go to trial.

Snyder, who filed the suit, said that because the deaths are not investigated, the law “takes away certain legal protections that were afforded people who were sick and elderly and otherwise vulnerable.”

Strouse pointed out that under the law, doctors cannot initiate conversations about aid in dying with their patients. The patient must ask for the medicines themselves.

He said that doctors who do end up writing such prescriptions believe that they are providing people with protections for their personal autonomy.

Some doctors are still uncomfortable with the practice, and many patients’ families reported struggling to find a doctor who would write such a prescription.

California’s data show that 173 physicians wrote the 191 prescriptions statewide.

Sherry Minor’s husband, John, was suffering with a painful terminal lung disease last year. The 80-year-old retired psychologist had lost 80 pounds and could barely eat or talk.

“He just thought he couldn’t go on,” she said.

But they struggled to find a doctor who would participate under the law, until they switched to Kaiser and ultimately got a prescription.

“It was an enormous relief,” said Minor, who lives in Manhattan Beach. “He just felt more comfortable with that mentally.”

John Minor, surrounded by his family, took the pills in September 2016.

“John did what was right for him,” Minor said. “He died peacefully, rather than in agony, and he was in control. He didn’t feel afraid or helpless.”

Copyright © 2017, Los Angeles Times

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Doctors and pharmacies in the nation's capital are now allowed to prescribe life-ending medications to terminally ill patients.

The Death with Dignity Act of 2016 became law with the signature of Mayor Muriel Bowser in December of 2016. Now the Bowser administration has announced the implementation of the law in the District.

The city said the law allows terminally ill D.C. residents over the age of 18 to legally obtain a physician's prescription for medications to end their lives in a humane and peaceful manner.

For a person to elect to end his life legally in the District, the individual must work with doctors and pharmacies licensed in D.C. that are willing to prescribe and dispense the lethal medications.

For doctors and pharmacies, participating in the Death with Dignity program is voluntary.

The city requires patients to make two oral requests to end their life to a doctor, with 15 days between each request. A written request on a city form must be given before the second oral request.

The guidelines also do not allow a person to take the life ending medications in a public place.

The District's Department of Health will oversee the program. Doctors and pharmacies must report to the department if a patient chooses to receive their fatal prescription.

Assisted suicide has long been a controversial issue in D.C. and around the nation. Supporters said it brings a humane end to an individual's suffering, while some opponents fear a person could be pressured into ending his or her life.

Even with its implementation, the law's future remains uncertain.

A spending bill passed by the Republican-led House Appropriations Committee has provision to block the funding of assisted suicides. An amendment introduced by Rep. Andy Harris, R-Md., would repeal the law.

The provision still needs to make it through the full U.S. House and Senate, and get the President's approval before it can take effect.

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SGP leader ‘sounds the alarm’ about Dutch euthanasia in US newspaper

July 21, 2017

The Wall Street Journal has published an article by Kees van der Staaij, leader of the fundamentalist Dutch Protestant party SGP, headlined ‘In the Netherlands, the Doctor Will Kill You Now.’

In the article, which is behind a paywall, Van der Staaij makes a plea for people in other countries to speak out against euthanasia and the way the boundaries of the law are being stretched in the Netherlands.

The Netherlands legalized euthanasia in 2002 for those suffering deadly diseases or in the last stages of life, Van der Staaij writes.

‘Not long after the legislation was enacted, eligibility was expanded to include those experiencing psychological suffering or dementia. Today pressure is mounting on the Dutch government to legalize a euthanasia pill for those who are not ill, but simply consider their lives to be ‘full’.

Van der Staaij is referring to draft legislation proposed by potential coalition partner D66, which wants to introduce assisted suicide for people who consider their lives to be complete. The measure, which is opposed by many doctors, is likely to be central in the ongoing coalition formation talks.

In the article, Van der Staaij goes on to refer to several controversial euthanasia cases in the Netherlands.

The article ends with a call to action. ‘The Dutch government often speaks out when human rights are under pressure in other countries,’ writes Van der Staaij. ‘Now the fundamental right to life is under pressure in the Netherlands, it is time for others to speak out against Dutch euthanasia practices.’

Fundamentalist

According to the Volkskrant [in Dutch], the Wall Street Journal describes Van der Staaij as an MP but does not mention that he is a member of the SGP.

Van der Staaij says on the party website [in Dutch] that he is thankful for being given such a platform in the US. ‘We want to show that the so-called ‘strong boundaries’ [around euthanasia] do not exist,’ he said. ‘The Netherlands is evidence of this. What was considered unthinkable by pro and anti campaigners 10 to 15 years ago has now become a reality… this is an alarm.’

Other languages

More articles in other papers are planned and the party has appealed on its website [in Dutch] for translators into German, Spanish and French.

The Staatkundig Gereformeerde Partij is the most orthodox of Holland’s fringe Christian parties and has three seats in the 150-member parliament.

The party believes that the country should be governed ‘entirely on the basis of the ordinances of God as revealed in the Holy Scriptures’. The SGP does not believe women should play an active role in politics and is also against homosexual rights, abortion and euthanasia.

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This text was drawn from “Dying: A Memoir,” by Cory Taylor, which is out August 1st from Tin House Books.

Cory Taylor was the award-winning author of “Me and Mr. Booker,” “My Beautiful Enemy,” and “Dying: A Memoir.” She died on July 5, 2016.

Questions for Me About Dying

By Cory Taylor July 31, 2017

A few months back, I was invited to take part in a program for ABC television called “You Can’t Ask That.” The premise of the show is that there are taboo subjects about which it is difficult to have an open and honest conversation, death being one of them. The producer of the program explained that I would be required to answer a number of questions on camera. She said questions had been sent in from all over the country, and the ten most common had been selected. I wasn’t to know what these were until the day I went into the studio for the filming.

[...]

The questions, as it turned out, were unsurprising. Did I have a bucket list, had I considered suicide, had I become religious, was I scared, was there anything good about dying, did I have any regrets, did I believe in an afterlife, had I changed my priorities in life, was I unhappy or depressed, was I likely to take more risks given that I was dying anyway, what would I miss the most, how would I like to be remembered? These were the same questions I’d been asking myself ever since I was diagnosed with cancer, back in 2005. And my answers haven’t changed since then. They are as follows.

[....]

Yes, I have considered suicide, and it remains a constant temptation. If the law in Australia permitted assisted dying I would be putting plans into place right now to take my own life. Once the day came, I’d invite my family and closest friends to come over and we’d have a farewell drink. I’d thank them all for everything they’ve done for me. I’d tell them how much I love them. I imagine there would be copious tears. I’d hope there would be some laughter. There would be music playing in the background, something from the soundtrack of my youth. And then, when the time was right, I’d say goodbye and take my medicine, knowing that the party would go on without me, that everyone would stay a while, talk some more, be there for each other for as long as they wished. As someone who knows my end is coming, I can’t think of a better way to go out. Nor can I fathom why this kind of humane and dignified death is outlawed.

No, it would not be breaking the law to go out on my own. The newspapers are full of options: hanging, falling from a great height, leaping in front of a speeding train, drowning, blowing myself up, setting myself on fire, but none of them really appeals to me. Again I’m constrained by the thought of collateral damage, of the shock to my family, of the trauma to whoever was charged with putting out the flames, fishing out the body, scraping the brains off the pavement. When you analyze all the possible scenarios for suicide, none of them is pretty. Which is the reason I support the arguments in favor of assisted dying, because, to misquote Churchill, it is the worst method of dying, except for all the others.

[....]

Yes, I’m scared, but not all the time. When I was first diagnosed, I was terrified. I had no idea that the body could turn against itself and incubate its own enemy. I had never been seriously ill in my life before; now suddenly I was face to face with my own mortality. There was a moment when I saw my body in the mirror as if for the first time. Overnight my own flesh had become alien to me, the saboteur of all my hopes and dreams. It was incomprehensible, and so frightening, I cried.

“I can’t die,” I sobbed. “Not me. Not now.”

But I’m used to dying now. It’s become ordinary and unremarkable, something everybody, without exception, does at one time or another. If I’m afraid of anything it’s of dying badly, of getting caught up in some process that prolongs my life unnecessarily. I’ve put all the safeguards in place. I’ve completed an advanced health directive and given a copy to my palliative-care specialist. I’ve made it clear in my conversations, both with him and with my family, that I want no life-saving interventions at the end, nothing designed to delay the inevitable. My doctor has promised to honor my wishes, but I can’t help worrying. I haven’t died before, so I sometimes get a bad case of beginner’s nerves, but they soon pass.

[....]

No, I am not unhappy or depressed, but I am occasionally angry. Why me? Why now? Dumb questions, but that doesn’t stop me from asking them. I was supposed to defy the statistics and beat this disease through sheer willpower. I was supposed to have an extra decade in which to write my best work. I was robbed!

Crazy stuff. As if any of us are in control of anything. Far better for me to accept that I am powerless over my fate, and that for once in my life I am free of the tyranny of choice. That way, I waste a lot less time feeling singled out or cheated.

continued...

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'Dying together was their deepest wish':
Dutch couple, both 91, pass away holding hands in rare double euthanasia after kissing each other goodbye

By Chris Pleasance for MailOnline
Published: 10:05 BST, 14 August 2017 | Updated: 11:35 BST, 14 August 2017

* Nic and Trees Elderhorst, 91, died surrounded by family in Netherlands on July 4
* Nic suffered stroke five years ago that left him debilitated and in constant pain
* Trees had fatal form of dementia that meant she would be unable to care for him
* Pair shared a final kiss before they passed away holding hands, daughters said

An elderly couple who were married for 65 years have died holding hands after their request for a double euthanasia was granted in the Netherlands.

Nic and Trees Elderhorst, both 91, passed away surrounded by family at their home in Didam, in the country's east, on June 4.

The pair made the request to die together because of Nic's failing health and Trees' inability to take care of her ailing husband.

Nic suffered a stroke five years ago which greatly reduced his mobility and left him in constant pain.

The stroke had caused numerous health complications and meant he required constant care and antibiotics to keep him alive.

The burden of caring for her husband meant Trees' health had also begun to decline to the point where she felt unable to give him adequate care.

Her memory had been badly affected and only with the help of neighbours, friends and healthcare workers did the couple manage keep going.

Both feared that if one of them were to die, the one left behind would be left to deteriorate in a nursing home.

After Nic's stroke in 2012, the couple signed a special euthanasia will and studied, with the help of their children, the laws involved in ending their lives.

The Netherlands introduced a euthanasia law 17 years ago, and since then more than 5,500 people have chosen ended their lives.

After a specialist diagnosed Trees with vascular dementia, a progressive and lethal form of dementia, the conditions to file a euthanasia request were met for both.

One of the couple's daughters told local media: 'It soon became clear that it could not wait much longer.

'The geriatrician determined that our mother was still mentally competent. However, if our father were to die, she could become completely disorientated, ending up in a nursing home, something which she desperately did not want.

'Dying together was their deepest wish.'

It took half a year for the 'End of Life clinic' to deal with the request, in what was described as 'an intensive period' by the couple's daughters.

Two teams, one for each senior, had to determine if Nic and Trees had an individual wish to die independent from each other.

After both teams determined that all conditions had been met, they worked with the couple and their family to pick a date on which they wanted to die.

Nic and Trees Elderhorst told all their friends and neighbours about their decision, for which they said they got a lot of support.

They then spent time saying goodbye to everyone and made arrangements for their funeral.

One of their daughters said that when the day came, they said some final sweet words to each other before they died.

The daughter said: 'They gave each other a big kiss and passed away confidently holding hands. According to their own wish.'

According to Dutch media, the euthanasia of Nic and Trees Elderhorst is exceptional as not many couples with a joint death wish get final authorisation.

Dick Bosscher of the Dutch Association of Voluntarily Life Ending said: 'It must be a coincidence when both people meet the demands for euthanasia at the same time.

'Dual requests are therefore rarely honoured.'

Spokesman Koos van Wees of the End of Life clinic explained that 'the difficulty is that both of the married people have to be more or less in the same situation with their illness', which according to him is 'very rare'.

Van Wees said: 'It happens more often that one is further in the process. The other then wants to join because they do not see a future alone. That is often not enough for the request to be granted.'

The Netherlands has been debating a proposed extension of euthanasia laws which would give all over-75s the right to assisted suicide.

Liberal parties publicly advocate the extension, although no law has yet been filed after the May 15 elections failed to produce a new government.

According to the political parties led by the left-liberal D66 Party, a few conditions would have to be met first, including a 'sustainable, well-considered and intrinsic' wish to die.

A specially trained 'life-ending consultant' would give their verdict about the death wish, which has to be seconded by another consultant or checking committee.

The life-ending consultant would have at least two interviews with the OAP, with at least two months between, to make sure the person knows what they are deciding and that they are not being pressured by their environment. The life-ending consultant could be a doctor, a nurse, a psychologist or a psychotherapist.

But three Christian parties, as well as the Socialist Party (SP), have vowed to stop any such law.

MP Renske Leijten of the SP said: 'Elderly care is not in order, a lot of OAPs are lonely and then they are making the ending of life easier?'

Gert-Jan Segers, an MP for the Christian Union, also attacked the plan.

He said: 'The proposal relies on the myth that this is an individual choice, but relatives, society and care workers are also involved.'

His party said the law would contradict with the duty of government to care for and protect the elderly, especially those in a vulnerable position.

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[The developer] Bickmore says the chat-bot could be particularly helpful for people that are socially isolated and otherwise wouldn't be having difficult end-of-life conversations at all.

"It's hard for humans to be non-judgemental when they're having these kinds of conversations," says Rosemary Lloyd from The Conversation Project, a charity that encourages people to have conversations about their end of life care. "So some people might find it easier to talk to a chat-bot about their thoughts."

Harriet Warshaw at The Conversation Project says a chat-bot would be a good first step towards talking about end-of-life decisions with a loved one.

We've also long known that talking about difficult topics with automated agents is oddly comforting, whereas talking about your end-of-life decisions with people who will be most affected by them is particularly emotionally fraught.

Writer and film-maker Avril Furness agrees that technology can be a useful way to help people start having difficult conversations about death.

Furness, who has explored the subject of assisted suicide, says Bickmore's chat-bot system is another good way to get people thinking about the end of their life, helping them work through their feelings without worrying what someone else thinks. "This chat-bot isn't going to judge you."

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Public prosecutor investigates euthanasia of woman with dementia

September 28, 2017

The public prosecution department has opened a criminal investigation into a doctor who performed euthanasia on a woman who had severe dementia.

It is the first time since the law legalizing euthanasia came into effect in 2002 that there has been a formal criminal probe into a doctor’s actions. The doctor has already been formally reprimanded for breaking euthanasia guidelines.

The case centers on a 74-year-old woman, who was diagnosed with dementia five years ago. At the time she completed a living will, saying she did not want to go into a home and that she wished to die when she considered the time was right.

After her condition deteriorated, she was placed in a nursing home where she became fearful and angry and took to wandering through the corridors at night. The nursing home doctor reviewed her case and decided that the woman was suffering unbearably, which would justify her wish to die.

The doctor put a drug designed to make her sleep into her coffee which is against the rules. She also pressed ahead with inserting a drip into the woman’s arm despite her protests and asked her family to hold her down, according to the official report on the death. This too contravenes the guidelines.

Once the public prosecution department has finished its investigation it will decide whether or not the doctor, a specialist in geriatric medicine, should face criminal charges.

Severe dementia

Last year, the justice and health ministries relaxed the guidelines for performing euthanasia on people with severe dementia a little so that patients can be helped to die even if they incapable of making their current feelings known. However, they do have to have signed a euthanasia declaration with their family doctor before they became seriously ill to be considered for help in dying.

Euthanasia is legal in the Netherlands under strict conditions. For example, the patient must be suffering unbearable pain and the doctor must be convinced the patient is making an informed choice. The opinion of a second doctor is also required.

In 2015 some 5,500 people, mainly cancer sufferers, were helped to die under the euthanasia legislation. Of them, 109 were suffering dementia and were in the early stages of the disease. Since the legislation was introduced in 2002, there have been a number of controversial cases, including a woman suffering severe tinnitus and a serious alcoholic.

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