Euthanasia

Source: _http://www.nltimes.nl/2016/01/20/euthanasia-rarely-approved-for-advanced-dementia-patients/

Euthanasia rarely approved for advanced dementia patients

Posted on Jan 20, 2016 by Janene Pieters

Euthanasia requests from people with advanced dementia are hardly ever honored, even if they drew up a written request when they were still lucid, according to a study done into the records of 26 legally incompetent dementia patients, news wire ANP reports.

The records were sent in to the Stichting Levenseindekliniek, End of Life Clinic Foundation in English, between March 2012 and May 2015. In each of these cases an authorized representative submitted a request for euthanasia.

The clinic did authorized none of these requests. In almost all cases the clinic concluded that there was no “unbearable suffering”, regardless of whether the patient previously called the situation unbearable. In addition to that, none of the patients could confirm the wish for euthanasia, although they were still able to communicate verbally or non-verbally.

The study, led by emeritus professor of medicine Arie Nieuwenhuijzen Kruseman, will be published in Medisch Contact this week, two weeks after the Ministry of Health published the “Guide to a written request for euthanasia”. The guide states that euthanasia may be granted to people with advanced dementia, if there is a written request prepared while the patient was still mentally competent, and their suffering is unbearable.
 
Source: _http://www.nltimes.nl/2016/02/04/assisted-suicide-to-remain-a-criminal-offense-in-many-cases/

Assisted suicide to remain a criminal offense in many cases

Posted on Feb 4, 2016 by Janene Pieters

Assisted suicide will remain illegal. It is not necessary to change the law on assisted suicide, the committee Schnabel concludes in its advisory report. The committee was asked to investigate whether people who feel that their life is done and want to die, need additional legal options, news wire ANP reports.

In the 243-page report [Dutch only] titled Voltooid Leven, Completed Life in English, the committee states that many of the assisted suicide cases involve an accumulation of old age complaints. And when family members and friends die around you, the elderly often come to the conclusion that their life is over. If these factors lead to “unbearable and hopeless suffering”, the person involved can request euthanasia from a doctor, according to the committee, which was chaired by Paul Schnabel.

The problem is that a wish to end your life can only become reality if a doctor agrees to euthanasia, something that doctors are not obligated to do. And not all doctors believe that a completed life equals unbearable and hopeless suffering. But the committee concluded that only a small group of people will be affected by this and the current Termination of Life Law offers enough room to overcome most of the problems.

The committee did add advice on how to prevent people feeling that their lives are over – prevent people from being lonely and increase self-reliance.

The Schnabel committee was formed in July 2014 at the request of the VVD. This follows a case involving Albert Heringastate. He helped his 99 year old mother commit suicide and was charged for it. The court found him guilty of assisted suicide, but imposed no punishment. On appeal he was completely acquitted.

The VVD requested the investigation on whether the law on assisted suicide needs to be changed. Parliamentarian Arno Rutte said to ANP in a reaction that if “people who weighed the options properly, without pressure or coercion, come to the conclusion that their life is completed”, they should be able to put an end to it.

Similar coverage here:
_http://www.dutchnews.nl/news/archives/2016/02/advice-group-says-no-to-relaxing-euthanasia-rules-to-cover-tired-of-life/


Other news: _http://www.nltimes.nl/2016/02/04/suspect-confesses-to-murder-of-d66-politician-els-borst-over-euthanasia/

Suspect confesses to murder of D66 politician Els Borst over euthanasia

Posted on Feb 4, 2016 by Janene Pieters

Bart van U. confessed to killing former politician Els Borst in February 2014. In a statement he gave the court on Thursday he said that it was his “divine mission” to kill the person responsible for the euthanasia law, Els Borst in his eyes, according to AD reporter Victor Schildkamp, tweeting live from within the courtroom.

Van U.’s bizarre statement led the Public Prosecutor to demand another psychiatric examination in the Pieter Baan Center. According to his lawyer, Van U. does not want to go back to the center and he won’t cooperate. He has been through so many examinations that it is “driving him crazy” and another examination would be “too difficult”.

The judges convened and decided that Van U. will not have to go back to the Pieter Baan Center. According to them, he has been through enough examinations.

This is the first time Van U. said anything regarding the murder on Els Borst. But during his trial for the murder on his sister Lois, killed in January 2015, Van U. also mentioned euthanasia. He stated that he was scared of his sister and that he had to kill her. He felt she would do anything to have him committed and drive him to suicide. He also talked about their different political views and how Lois was “for euthanasia and abortion”.

Van U. has to appear in court again for the substantive hearing in the Els Borst murder case on March 29th. Now that he’s confessed to the murder, the big remaining question is how accountable he is.

Similar coverage here:
_http://www.dutchnews.nl/news/archives/2016/02/man-accused-of-killing-former-minister-confesses-blames-euthanasia-legislation/
 
Source: _http://www.nltimes.nl/2016/02/24/euthanasia-patient-saves-five-lives-with-organ-donation/

Euthanasia patient saves five lives with organ donation

Posted on Feb 24, 2016 by Janene Pieters

One man recently saved the lives of five other patients by donating his organs after euthanasia. He gave his last breath in an operating room at the Erasmus Medical Center in Rotterdam, while five other patients lay waiting in five other operating rooms, AD reports.

The man suffered from the effects of a stroke and therefore decided that he no longer wanted to live. He died in the operating room surrounded by his loved ones, Erasmus MC staff and a doctor from the Levenseindekliniek – the End of Life Clinic in English.

According to AD, almost everything about this case is exceptional. The fact that the man could donate five organs – including his liver, kidneys and pancreas – in itself is very special, usually only about three organs are suitable. The fact that the euthanasia was carried out by a doctor from the Levenseindekliniek in another hospital is unique. And donating organs after euthanasia is a rare occurrence in the Netherlands.

The first time someone donated their organs after euthanasia in the Netherlands was in 2012. Last year there were eight. A total of 15 Dutch people have made their organs available after their euthanasia.

The main reason that this is so rare, is that most people who decide on euthanasia suffer from cancer and their organs are therefore not viable. And not everyone wants to donate their organs as this would mean dying in an operating room, instead of at home, and family members only having about 5 minutes to say goodbye. Organs need to be transplanted immediately after death.
 
Source: _http://www.dutchnews.nl/features/2016/02/a-huppekeeeuthanasia/

Dutch documentary awakens euthanasia debate about wider rules

February 29, 2016

A recent Dutch television documentary on euthanasia in which a 68 year-old woman suffering from semantic dementia was given a lethal injection may well herald a turning point in what many consider to be an increasingly broader – and unacceptable – interpretation of the rules. Hanneke Sanou assesses the reactions.


The documentary, broadcast by public broadcaster NTR in Feburary to mark the start of a week of discussions on euthanasia, followed three clients of the Levenseindekliniek, a clinic for people who want to end their lives but whose family doctor is unwilling to cooperate. Some cases include people with mental problems or dementia, and people who consider their lives to be complete.

Earlier this month an advisory commission rejected the norm ‘a life completed’ as grounds for euthanasia if the person requesting it does not also suffer from physical problems constituting ‘unbearable and hopeless suffering’, the basis on which Dutch law allows euthanasia to take place. All cases are reviewed by a committee which determines if doctors acted in accordance with due care.

Deterioration

The story of Hannie Goudriaan, a former health care worker, begins in 2008 when she starts to notice ‘something not right in the head’, as her husband Gerrit Goudriaan puts it. His wife turns out to be in the early stages of semantic dementia, a disease that gradually erases meaning from words and concepts.

She tells family doctor Gert Bloemberg that if she deteriorates to the point where she can’t recognise loved ones or is unable to communicate she no longer wants to live, a statement she also puts in writing.

Several years later, in 2014, Hannie decides the time has come but her first port of call, the family doctor, now doubts whether she is mentally competent enough to confirm her initial wish. The doctor, overwhelmed by the complexity of the case, decides that there are insufficient grounds.

Remco Verwer, the doctor in charge of her case at the Levenseindekliniek, to which the couple then turns, becomes convinced of her wish to die. Hannie, by this time, has lost much of her understanding of words and seems to use the word ‘Huppekee’ (something like ‘there goes’) as a substitute for the act to end her life.

Nothing left


Meanwhile Hannie is shown fit enough to drive a car and enjoy the occasional outing. According to the review committee’s report, which states that doctors had acted with due care, Hannie then has an unusually lucid moment during a talk with a SCEN doctor ( SCEN stands for Support and Consultation in cases of Euthanasia in the Netherlands) during which she ‘clearly and calmly’ repeats her wish to die because ‘there is nothing left’.

The final scenes show Hannie as she is given the injection, murmuring ‘terrible’.

Reactions to the programme were immediate, and mixed. In the NRC clinical ethicist Erwin Kompanje professed himself ‘gobsmacked’ and ‘worried’. ‘If she was able to clearly state that she was suffering and wanted to die while the point of the euthanasia was the lack of the ability to communicate, then there is a contradiction there. Especially when you consider that semantic dementia is a progressive illness which can’t suddenly improve.’ (..)

The fact that many health professionals had expressed similar doubts ‘could precipitate a discussion about the limits of euthanasia: ending the lives of people who can no longer confirm their wish by people who have no primary involvement, based on subjective interpretation of empty words and earlier living will should not admissible anywhere, including the Netherlands,’ he wrote.

Slippery slope

Professor of cognitive science Victor Lamme wrote in the Volkskrant [in Dutch only] that euthanasia in the Netherlands is on a ‘slippery slope’ and that euthanasia is used to ‘solve other problems than putting an end to unbearable suffering.’

According to Lamme Hannie Goudriaan was ‘under pressure’ to keep to her declaration of intention even though ‘a person with dementia becomes a different person’. He also points to the societal pressure on the elderly. ‘Which problem is euthanasia supposed to solve? The elderly cost time, money and effort. Modern society is unwilling to provide all three,’ he wrote.

There were many who thought the documentary ‘touching and beautiful’. One Volkskrant reader said she thought she had been watching a ‘totally different documentary than many others’: ‘I saw a loving couple grieving because one of them was deteriorating more and more.’

Quick process

According to Volkskrant journalist Maud Efting who has written extensively about the subject of euthanasia, the ‘euthanasia process was shown in the documentary as relatively very quick'.

‘In twenty minutes Hannie Goudriaan came to her end,’ she wrote, implying that this is one of the reasons the film was criticised so vehemently. In her considered piece [behind paywall, Dutch only] on the programme she quotes family doctor Gert Bloemberg as saying that Hannie Goudriaan’s suffering was perhaps not shown ‘sufficiently’.

Tragically the term ‘Huppekee euthanasie’ will now probably enter the language and this is doubly ironic when you consider that it was the lack of language that was at the heart of it.
 
Source: _http://www.nltimes.nl/2016/04/13/no-prison-time-in-murder-of-politician-over-euthanasia-law/

No prison time in murder of politician over euthanasia law

Posted on Apr 13, 2016 by Janene Pieters

Bart van U. is completely insane and can therefore not be held accountable for the deaths of his sister and former politician Els Borst, the court in Rotterdam ruled on Wednesday. With the “insanity” conclusion, Van U. can not be sentenced to prison. The court is however imposing mandatory treatment in a psychiatric prison on the man.

The court considers Van U. “extremely dangerous” and assumes that he will need “very long-term, years long” psychiatric treatment in an institution, according to RTL Nieuws reporter Jeroen Wetzels, tweeting live from within the courtroom.

The Public Prosecutor demanded that Van U. be sentenced to 8 years in prison and mandatory treatment in a psychiatric institution.

Bart van U. confessed to killing both Els Borst and his sister Lois van U. During the trial he told the court that he killed Borst as part of a “divine mission”. God told him to kill those responsible for the euthanasia law.

He also stated that Lois bullied him, wanted him euthanized and was trying to drive him to suicide. The last straw for him was when she offered him flat spongecake dessert treat called “eierkoeken”, while she knew he does not like it.

Similar coverage here: _http://www.dutchnews.nl/news/archives/2016/04/former-ministers-killer-detained-in-secure-psychiatric-unit/
 
Source: _http://www.nltimes.nl/2016/04/19/politicians-killer-who-stabbed-sister-over-cookie-not-completely-insane/

Politician’s killer who stabbed sister over cookie not “completely insane”

Posted on Apr 19, 2016 by Janene Pieters

The Public Prosecutor wants prison time to be added to the sentence against Bart van U. for the murders of former politician Els Borst and his sister Lois. Last week the court declared Van U. completely unaccountable due to insanity and only imposed institutionalized psychiatric care on him.

According to the Public Prosecutor, Bart van U. is not completely insane, though he does have “strongly diminished accountability”, AD reports. A suspect with strongly diminished accountability can still be given a prison sentence. The prosecutor initially demanded 8 years in prison with mandatory institutionalized psychiatric care against the man.

Bart van U. confessed to killing his sister in their home in Rotterdam in January 2015 and former Minister Els Borst in her home in Bilthoven in February 2014. According to Van U., Lois bullied him for his entire life and he decided to kill her when she offered him a cookie she knew he doesn’t like. And with Minister Borst, he was on a divine mission to kill those responsible for the euthanasia law.

The Public Prosecutor believes that Van U. also had real motives for killing the two women, a viewpoint supported by reports from the Pieter Baan Center, where Van U. was examined. The experts saw “islands of health” floating in between serious psychiatric illness, they said in the trial, according to the newspaper.
 
Source: _http://www.nltimes.nl/2016/04/27/euthanasia-cases-rise-four-percent-2015/

Euthanasia cases rise four percent in 2015

Posted on Apr 27, 2016 by Janene Pieters

The number of euthanasia cases increased by 4 percent last year. A total of 5,516 people died by euthanasia in 2015, according to the annual report by the five regional euthanasia review committees, ANP reports.

The most common reason for euthanasia to be requested was cancer. The number of granted euthanasia requests due to dementia increased from 81 in 2014 to 109 last year. And the number of requests granted due to another end-stage psychiatric disorder increased from 41 to 56.

There were four cases where the review committees believe the doctors involved acted negligently. These reports were forwarded to the monitoring bodies.
 
From: http://www.dutchnews.nl/features/2016/05/dutch-conference-on-euthanasia-discusses-controverial-reasons-such-as-depression/

‘With euthanasia, you can say goodbye and it can be a loving memory’

May 12, 2016 Senay Boztas

Chronic depression, tired of life, dementia… an Amsterdam conference discusses controversial reasons for euthanasia as Dutch cases rise 75% in five years, writes Senay Boztas.

The woman had a three year old daughter, and was just 34 years old. But after years of suffering with a personality disorder, PTSD and chronic depression, she didn’t want to live any more.

Because she was in the Netherlands, this woman did not commit suicide. Instead, she said goodbye to her loved ones and prepared a memorial for her daughter to open when she was older. Her euthanasia was administered by psychiatrist Paulan Stärcke at the End-of-Life clinic in The Hague.

‘I interviewed her parents the year after her death,’ says Stärcke. ‘They expressed gratitude that her life could end this way and not in a violent one. The contact between the father and [child’s] grandparents was repaired in the process of the euthanasia. They were sure, and I was as well, that her mother would die by suicide if I didn’t help her die.’

Beautiful

Stärcke, speaking at the Euthanasia 2016 conference in Amsterdam on Thursday, intends to show delegates a video of this, and an interview with the son of an 84-year-old woman, who chose euthanasia due to chronic depression.

‘He felt the way his mother died, funny to say it, was rather beautiful,’ Stärcke says. ‘She was in the midst of her family. Her husband was in the throes of dementia and was very angry at first, but held her hand.’

Euthanasia is a controversial topic, not just in the Netherlands but also abroad. Canada is currently divided by a proposed assisted dying law. Reports of Dutch cases spark outrage in the UK, where it is a crime to help someone die, but one Briton a month travels to the Swiss Dignitas clinic for euthanasia.

Cancer

Although the vast majority of cases in the Netherlands are for cancer victims, those granted euthanasia for mental health problems has risen from just two in 2010 to 56 people last year – alongside a 75% rise in total euthanasia requests in this period, to 5,516 last year. Euthanasia represents 4% of the 140,000 annual deaths.

Earlier this week, Britain’s Daily Mail exploded at the publication of details on one Dutch sex abuse victim granted euthanasia in her 20s, suffering conditions including chronic depression, self-harming, and ‘therapy resistant’ anorexia.

It quoted Labour MP Robert Flello calling the case ‘horrendous’, and adding: ‘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.’

There are Dutch academics who are worried about growing numbers of euthanasia for mental health issues (1% of cases) and with dementia (2%): earlier this year, government guidelines said a ‘living will’ can represent the wishes of someone with advanced dementia even if they can no longer make these clear.

Unbearable suffering

But Dr Erwin Kompanje, assistant professor of clinical ethics at Erasmus University Medical Center, believes ‘unbearable suffering can no longer be measured in a patient with dementia’ and in a psychiatric patient it is ‘difficult to judge [if] everything has been tried in a therapeutic sense’.

Dutch euthanasia law, introduced in 2002, only allows doctors to administer euthanasia, and only under strict conditions.

These include a doctor being satisfied someone is voluntarily requesting a well-considered euthanasia, feels ‘unbearable suffering’ with no hope of relief, and consults at least one other physician (who does not need to agree). Children from 12-18 are covered by the law, and every case is assessed post-euthanasia by the RTE regional review commission. This body can refer those that didn’t meet ‘due care’ criteria to the public prosecutor and health inspectors.

Suicide

Recognition for psychiatric reasons for euthanasia has grown, campaigners say, after the award-winning 2014 documentary (in Dutch) by Elena Lindemans, ‘Mothers don’t jump from buildings’. (see video below) The wrenching film, scheduled at the conference, tells the story of her mother who jumped from a block of flats in 2002 because she was unable to persuade doctors to help her die.

‘There is more understanding in the Netherlands through this film,’ says Jeannette Croonen, co-founder of the campaigning Euthanasia in Psychiatry foundation. Her daughter, Monique, suffocated by tying a bag over her head in 2008, after being refused euthanasia for psychiatric reasons.

‘You feel powerless,’ she says. ‘You see your child in enormous suffering and you can’t help them. I know someone whose son had euthanasia three years ago, and her experience is very different. It grieves me every time I think of the manner of [Monique’s] death. So I keep doing this to stop other people having the same experience.’

Stärcke believes psychiatrists are ‘too hesitant’ about agreeing to requests from mental health patients and euthanasia is widely misunderstood abroad.

It is not execution, she says: ‘It is an execution of the wish of a patient. You can prepare for euthanasia, you can say goodbye and it can be a loving memory, not only hurt. Suicide is only hurt.’


 
From: http://www.dutchnews.nl/news/archives/2016/05/fresh-calls-for-end-of-life-pill/

Fresh calls for ‘end-of-life’ pill for elderly people refused euthanasia

May 23, 2016

Right-to-die organizations have made a fresh call for a ‘last will pill’ to be given to people who no longer wish to live but are turned down for euthanasia.

The Dutch Association for a Voluntary End to Life (NVVE) and centrist-liberal party D66 both say the medicine should be made available to elderly people who want to end their lives. D66 MP Pia Dijkstra told [TV-show] Nieuwsuur she planned to bring a private bill to parliament later this year allowing people over 80 to end their lives voluntarily.

‘There is no doubt that older people, with their experience of a long life, are in a better state than younger people to decide if their life is still worth living,’ she said.

The Last Will Co-operative (Coöperatie Laatste Wil) has gone further, calling for lethal prescriptions to be available for people over the age of 18 under strict conditions.

It highlighted the death of a 31-year-old woman who had suffered from psychiatric illness since the age of 12. Else de Gunst died after refusing food and water for two weeks, after her application for euthanasia was turned down.

Doctors agreed that Else de Gunst was suffering ‘unbearably’ and had no prospect of improvement – the two conditions for euthanasia under Dutch law – but disagreed about whether she was mentally fit to decide her own fate.

Pleaded to die

Else’s mother, Astrid, told Nieuwsuur how she had changed from a ‘happy, contented young girl into a girl we couldn’t reach any more’. Else constantly pleaded to be allowed to die despite the interventions of numerous doctors, psychiatrists and therapists.

The NVVE argues that a ‘last will pill’ should be an option for people over the age of 75 who have been refused euthanasia, if it is approved by their doctor. The Last Will Co-operative wants to trial a similar medicine for its members over the age of 18, without the involvement of a doctor.

The latter organization says Dutch pharmacies should be allowed to make up deadly prescriptions or dispense the ingredients for a ‘lethal cocktail’ to its members under strict conditions. ‘People can always take their own lives, but in the Netherlands you have to do it in an awful way or break the law by getting the materials from abroad,’ said spokesman Gert Rebergen.

For similar coverage, see: http://www.nltimes.nl/2016/05/23/calls-tests-end-life-pill-renewed/
 
For archiving purposes: https://www.sott.net/article/320538-Canada-passes-assisted-suicide-bill-that-critics-say-will-still-trap-patients-in-intolerable-suffering

Canada has adopted a law permitting assisted suicide for terminally ill adults whose death is "reasonably foreseeable." Some critics say the law prevents those with degenerative conditions such as Alzheimer's from seeking medically-assisted death.

Caving in to pressure by Justin Trudeau's Liberal government after weeks of rigorous parliamentary debate, senators finally approved the so-called Bill C-14 in a vote of 44 to 28 on Friday. The Canadian Medical Association said it was "pleased that historic federal legislation on medical aid in dying is now in place."

The law was originally proposed after Canada's Supreme Court overturned a ban on doctor-assisted suicide in 2015. The court's decision extended to adults suffering from intolerable physical or psychological pain and untreatable medical condition.

Critics, including politicians, patients and human rights activists, have been up in arms over the new restrictive law, which allows the luxury of assisted dying exclusively to adults suffering from an "incurable'' disease or disability, "in an advanced stage of irreversible decline.''

"The government's bill will trap patients in intolerable suffering and takes away their hard-won charter right to choose assistance in dying," Josh Paterson, executive director the British Columbia Civil Liberties Association, told Canadian Press.

Many fear that the bill, which received royal assent less than two hours after the Senate vote, will fail to protect vulnerable Canadians.

"The biggest question is, can this bill as written right now actually protect somebody who is either depressed, having mental illness issues, or is incompetent," executive director of the Euthanasia Prevention Coalition, Alex Schadenberg told LifeSiteNews. "And the answer is no."

He said that under Bill C-14, "the decision of the nurse practitioner or the doctor is only based on whether or not they are 'of the opinion' that you meet the criteria."

"This is, in fact, a very horrific bill as it's written. It is worse than the Belgian law; it is worse than the Netherlands," Schadenberg added.

Medically-assisted suicide is legal in the Netherlands, Switzerland, Albania, Colombia and Japan, as well as in the American states of Washington, California, Vermont, Montana, Oregon and New Mexico.

"Medical assistance in dying is a difficult, complex and deeply personal issue," Canada's Justice Minister Jody Wilson-Raybould and Health Minister Jane Philpott acknowledged in a joint statement, adding that the legislation succeeded in striking "the right balance between personal autonomy for those seeking access to medically assisted dying and protecting the vulnerable."
 
Today SOTT carries a very sharp and in depth analysis of the current Dutch euthanasia practices and the dangerous long term developments therein, from free lance writer Flavia Dzodan:

https://www.sott.net/article/322109-A-Dutch-policy-of-eugenics-How-a-soft-death-is-forced-on-the-people-in-times-of-great-need

Main referenced scientific source article (JAMA Psychiatry. 2016;73(4):362-368. doi:10.1001/jamapsychiatry.2015.2887) (behind paywall):

Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014

ABSTRACT
Importance Euthanasia or assisted suicide (EAS) of psychiatric patients is increasing in some jurisdictions such as Belgium and the Netherlands. However, little is known about the practice, and it remains controversial.

Objectives To describe the characteristics of patients receiving EAS for psychiatric conditions and how the practice is regulated in the Netherlands.

Design, Setting, and Participants This investigation reviewed psychiatric EAS case summaries made available online by the Dutch regional euthanasia review committees as of June 1, 2015. Two senior psychiatrists used directed content analysis to review and code the reports. In total, 66 cases from 2011 to 2014 were reviewed.

Main Outcomes and Measures Clinical and social characteristics of patients, physician review process of the patients’ requests, and the euthanasia review committees’ assessments of the physicians’ actions.

Results Of the 66 cases reviewed, 70% (n = 46) were women. In total, 32% (n = 21) were 70 years or older, 44% (n = 29) were 50 to 70 years old, and 24% (n = 16) were 30 to 50 years old. Most had chronic, severe conditions, with histories of attempted suicides and psychiatric hospitalizations. Most had personality disorders and were described as socially isolated or lonely. Depressive disorders were the primary psychiatric issue in 55% (n = 36) of cases. Other conditions represented were psychotic, posttraumatic stress or anxiety, somatoform, neurocognitive, and eating disorders, as well as prolonged grief and autism. Comorbidities with functional impairments were common. Forty-one percent (n = 27) of physicians performing EAS were psychiatrists. Twenty-seven percent (n = 18) of patients received the procedure from physicians new to them, 14 of whom were physicians from the End-of-Life Clinic, a mobile euthanasia clinic. Consultation with other physicians was extensive, but 11% (n = 7) of cases had no independent psychiatric input, and 24% (n = 16) of cases involved disagreement among consultants. The euthanasia review committees found that one case failed to meet legal due care criteria.

Conclusions and Relevance Persons receiving EAS for psychiatric disorders in the Netherlands are mostly women and of diverse ages, with complex and chronic psychiatric, medical, and psychosocial histories. The granting of their EAS requests appears to involve considerable physician judgment, usually involving multiple physicians who do not always agree (sometimes without independent psychiatric input), but the euthanasia review committees generally defer to the judgments of the physicians performing the EAS.
 
Today SOTT carries an RT article about euthanasia in Canada:

https://www.sott.net/article/327270-Over-120-Canadians-opted-for-euthanasia-since-law-passed-in-June

Some 120 people have opted for doctor-assisted death, or euthanasia, in Canada since the State Senate passed a controversial law, allowing patients to voluntarily end their lives. The actual number may be higher as the government has not started an official count.

According to the broadcaster CBC News, which tried to obtain data from all 13 of Canada's provinces, most of the cases were recorded by coroners in Ontario (49) and British Columbia (46), with Alberta, Manitoba and Saskatchewan reporting 27 medically assisted deaths between them.

However, the actual figures may be significantly higher, as the remaining eight provinces were unable or did not agree to share the information citing the possible "infringement of confidentiality or distress for families who may identify with the numbers."

Official figures have not been drawn up, as Canada's federal government has not started officially tracking assisted suicides. The authorities have also yet to come up with regulations as to what information should be recorded when a person demands a medically assisted death.

"These regulations could include specifying the kind of information to be provided, the body that would analyze the information, and how often reports would be published," a spokesperson for Health Minister Jane Philpott said.

The numbers obtained by CBC also allegedly show a mere 10 percent of cases in which Canadians have demanded medical help to end their lives since the procedure became legal on June 17.

continued...
 
Source: http://www.bbc.com/news/world-europe-37395286

Belgium minor first to be granted euthanasia

17 September 2016

A terminally-ill 17-year-old has become the first minor to be helped to die in Belgium since age restrictions on euthanasia requests were removed two years ago, officials say.

The head of the federal euthanasia commission said the teenager was "suffering unbearable physical pain".

Belgium is the only country that allows minors of any age to choose euthanasia.

They must have rational decision-making capacity and be in the final stages of a terminal illness.

The parents of the under-18 year olds must also give their consent.

Euthanasia commission head Wim Distelmans said the teenager was "nearly 18". He said doctors used "palliative sedation", which involves bringing patients into an induced coma, as part of the process,

"Fortunately there are very few children who are considered [for euthanasia] but that does not mean we should refuse them the right to a dignified death," he told the Het Nieuwsblad newspaper.

Mr Distelmans told Reuters news agency the case had been reported to his committee by a local doctor last week.

The case occurred in Flemish-speaking Belgium, reports RTBF (in French), the public broadcaster for Belgium's French-speaking community.

The Netherlands also allows euthanasia for minors, but they must be aged over 12 years old.

Belgium lifted the age restrictions in 2014. The law passed by parliament said the child would have to be terminally ill, face "unbearable physical suffering" and make repeated requests to die before euthanasia is considered.

Many people, including church leaders and some paediatricians, questioned whether children would be able to make such a difficult choice.

Senator Jean-Jacques De Gucht said he was proud the legislation had passed.

He said having the possibility to ask about euthanasia "makes a big difference to many people".


Where is assisted dying permitted?

The Netherlands, Belgium and Luxembourg permit euthanasia and assisted suicide
Switzerland permits assisted suicide if the person assisting acts unselfishly
Colombia permits euthanasia
California last year joined the US states of Oregon, Washington, Vermont and Montana in permitting assisted dying
Canada passed laws allowing doctor-assisted dying in June of this year

How old must the patient be?

Only the Netherlands and Belgium permit euthanasia for patients under the age of 18.

In the Netherlands, a competent patient between the ages of 16 and 18 may request euthanasia or assisted suicide. The parent or guardian does not have a veto, but must be consulted. Competent patients aged between 12 and 16 may also qualify, but only if their parent or guardian consents.

In Belgium, a competent patient under the age of 18 may request euthanasia with parental consent. Additional scrutiny of the child's competence is required, and suffering based on a psychiatric disorder is excluded.

How many people take this option?

The rate of euthanasia in the Netherlands has remained fairly stable at 2.8% of all deaths (in 2010), according to Penney Lewis, Professor of Law at King's College London.

The most recent survey of doctors in the UK was in 2007-08. The rate of euthanasia was reported to be 0.21% of all deaths, and a similar rate has been reported in France (in 2009), even though euthanasia remains illegal in both countries.

In contrast, research carried out in Flanders, Belgium found the rate prior to legalisation was unclear, with separate surveys reporting rates of 0.3% of all deaths in the region (in 2001-02) and 1.1% (in 1998). The rate has risen steadily since legalisation in 2002 to 4.6% of all deaths in the most recent survey in 2013.

What do the different terms mean?

Euthanasia is an intervention undertaken with the intention of ending a life to relieve suffering, for example a lethal injection administered by a doctor

Assisted suicide is any act that intentionally helps another person kill themselves, for example by providing them with the means to do so, most commonly by prescribing a lethal medication

Assisted dying is usually used in the US and the UK to mean assisted suicide for the terminally ill only, as for example in the Assisted Dying Bills recently debated in the UK.
 
Similar report on SOTT now (via RT):

https://www.sott.net/article/328555-17-year-old-euthanized-in-Belgium-in-1st-ever-underage-case
 
Source: http://www.nltimes.nl/2016/09/19/expert-child-euthanasia-center-imminent-netherlands/

Expert: Child euthanasia center imminent in the Netherlands

Posted on Sep 19, 2016 by Janene Pieters

Within the next year a [research] center for [knowledge and expertise about] euthanasia in children will open in the Netherlands, professor of pediatrics Eduard Verhagen predicted to Dutch newspaper AD (in Dutch), who calls him the authority in the field of child euthanasia.

Under current Dutch legislation, euthanasia can be applied for infants up to a year old and kids over the age of 12, if they suffer unbearably. Kids between the ages of 1 and 12 years are considered incapable of making such an important decision for themselves and are not eligible for euthanasia.

But according to Verhagen, doctors are already investigating the practice of life-end decisions for kids between the ages of 1 and 12 years. “We think that some children under the age of 12 are well able to make such important decisions”, he said.

He adds that the Netherlands is keeping a close eye on Belgium for developments. “The Belgians have in their system given younger children a major say in the evaluations of [a] child psychologist or child psychiatrist. We are thus wondering what methodology is used to determine the mental competence.”

Note: quote slightly modified [] for clarity and hyperlink added
 
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