Friday, October 23, 2009

Ludovic Kennedy Has Died.

The prolific British journalist, writer and activist, Ludovic Kennedy, 89, has died.

From the New York Times:

A lifelong atheist, Mr. Kennedy discussed his objections to religion in “All in the Mind: A Farewell to God, (1999). He also advocated euthanasia and assisted suicide. His book “Euthanasia: The Case for a Good Death” appeared in 1990. He co-founded Britain’s Voluntary Euthanasia Society. In 2001, he ran for Parliament in a campaign to legalize euthanasia; he lost but publicized his cause.

Thanks to AZ for the tip.

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End of Life, The Video Game?

From the ever-erudite Genevieve comes this link to an "interactive fiction" about end of life care and family dynamics:

Someone is rolling my body from side to side. It feels a bit like rocking on the ebb and flow of the sea. I was a Second Electrician's Mate in the Navy. This is a good way to die.


Redefining "Pro-Life."

Using the story of Jesus' healing of blind Bartimaeus' as a metaphor for how "pro-life" supporters must daily open their heart to new ways of seeing and redefine the definition of "pro-life," Father Thomas Rosica writes today at Salt+Light:

Disciples of Jesus have vision problems. How often do we use the metaphor of blindness to describe our inability to grasp the meaning of the suffering we endure? We sometimes describe our blindness as an inability to see the forest for the trees, but that is a rather simplistic analysis. More worrisome is the inherited blindness which so often assumes that there are no lessons left to learn. Arrogance is very often the root of our blindness. We need the miracle of restored sight each day.

What corners of the Church, of society and of our culture need serious healing, restoration and reformation in our time? Where are our blind spots? Where are the big problems with near-sightedness and far-sightedness? How often do we prefer monologue to dialogue, refusing to believe that we might learn from those who oppose us and disagree with us; refusing to engage the culture around us and preferring a narrow, obstinate and angry way of existing? How often do we say that there are no other ways to look at an issue than our way…or the highway!

This promising plea for open minds then trails off into a reminder that abortion is not the only "pro-life" issue on the platform.

If our sight, pro-life energies and efforts are limited only to atrocities against the unborn, it can lead to blindness. We must not ignore the other great challenge faced by humanity today–the serious question of mercy killing, or euthanasia, no longer found in abstract cases and theories. It concerns ordinary people and is debated not only in Congresses or Parliaments but also around dinner tables and in classrooms. Euthanasia is false and misguided mercy.

To say that we are pro-life means that we are against whatever is opposed to life itself, such as any type of murder, genocide, abortion, euthanasia or willful self-destruction. We stand firmly against whatever violates the dignity of the human person such as mutilation, torments inflicted on body or mind, attempts to coerce the will itself, whatever insults human dignity such as subhuman living conditions, arbitrary imprisonment, deportation, slavery, prostitution, the selling of women and children, and disgraceful working conditions where people are treated as instruments of gain rather than as free and responsible persons. All of these things and more destroy human life and poison human society.

I am personally delighted by entreaties by pastors to focus on poverty, imprisonment (though he qualifies "arbitrary"), rights for the impaired, the disabled, the abused. For far too long, "pro-life" has been used to mean anti-abortion. Recent Catholic writings have worked to expand that definition to include "unjust" war and capital punishment as well as other injustices against society's disadvantaged.

Yet Rosica's call for renewing the definition of "pro-life" would be more meaningful to me if it weren't, as I suspect, being used to focus the Church on euthanasia. To be clear, as aid in dying is legal in some parts of the world, it is almost exclusively used for the terminal, in other words, for someone who is already dying from some crippling disease for which there is no cure.

The patient, of sound mind and less than six months to live, is already condemned to death. They probably love life and deeply regret its impending end, yet realize that the end is nonetheless coming. They don't wish to kill themselves - depression is not the cause of their death wish; they wish to end the suffering caused by their disease in a way that is humane and dignified.

I've read a lot of hideous commentary lately about how suffering is redemptive, how it has meaning and makes us better, how it is God's will that we should suffer to emulate his death on the cross, that God does not give us more pain and suffering than we can handle. I find it all blasphemous and degrading to the afflicted patient. It reeks of justification of illness, as illness as punishment by God.

It is the disease, which we have failed to cure, that causes the suffering. It is the disease which has determined the terminal patient's end. It is the disease which has struck them down and ended their vitality. And it is the disease that will cost them quality of life, dignity, and comfort.

Rather than see the Catholic Church promote the ghastly suffering of afflicted patients, I would prefer they focus on scientific research into the causes of these diseases, into the corporate deregulation that has allowed the polluting of our water and environment, into the medical industry that over-treats and over-medicates us so as to turn a grotesque profit on our pains.

Yet, I know that my definition of "pro-life" will have no effect on the great Catholic Church or it's teaching, I am encouraged by those denominations that do understand that "pro-life" should also include work to end suffering. These denominations espouse the true meaning of life. They are the religious left. It is their message that I find most uplifting as we face new diseases, work to end continued injustices, and challenge society to alleviate the suffering of "the least of these."

Unfortunately, the Catholic Church continues to be hindered by its own blindness.

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IBD Gets Panties in a Bunch Over Gun Research.

Cause, you know, studying something or asking questions is a bad thing cause the results may disprove your position. Quoting Joe Barton, the conservative paper notes:

More than a decade ago Congress, seeing it as a backdoor assault on the 2nd Amendment and the right to keep and bear arms, voted to cut funding for firearms research by the Centers for Disease Control. Such research was viewed as one-sided and based on flawed assumptions that all gun use was bad, even that which saved lives and deterred crime.

The National Institutes of Health seemed to have picked up the baton by funding similar studies of gun violence as a public health issue.

"It's almost as if someone's been looking for a way to get this study done ever since the Centers for Disease Control was banned from doing it 10 years ago," said Rep. Joe Barton, R-Texas, of one of the NIH studies. "But it doesn't make any more sense now than it did then."

Note the commenter who finds inconsistency in the "culture of death" dems pushing abortion and euthanasia but not wanting citizens to wave guns around....

Disclosure: During the 90s I worked in the marketing department of Investor's Business Daily

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Discerning Coercion or Abuse Under the Death with Dignity Act.

Margaret Dore is a very new acquaintance. I posted a rebuttal to her article in Washington State Bar News; she called me and vigorously contested my points. And then she emailed me a number of times to make sure she had been clear and understood.

As someone who works to eliminate elder abuse, Dore's issue with the Death with Dignity Act in Oregon boils down to three main points, as I can discern:

1. a family member, perhaps one who is working to coerce their loved one into Death with Dignity, can act as one of two witnesses to the Death with Dignity document

Dore contends that allowing one of the two required witnesses to be a family member opens the door to elder abuse and coercion.

2. a patient, according to her interpretation of the Act, is not required to self-administer the lethal medication

The language regarding self-administration seems clear enough to me but Dore insists that "self-administration" is defined as "ingest" and therefor allows someone else to inject the medication into a feeding tube or to administer the medication in another way, perhaps for their own nefarious purposes. (See above link for more of our exchange.)

3. the act does not require that a witness be present at the time the lethal medication is ingested

Again, Dore insists that this opens the door for elder abuse. Her concern is that most abuse of the elderly is perpetrated by family members. A "loved one" who wishes to end the life of a patient can, without supervision, achieve that goal once the patient has received the medication. Dore contends that the Act serves as an alibi for the acting family member, that no investigation is likely if the patient has successfully fulfilled the qualifications for Death with Dignity and has received the lethal medication.

How this witnessing differs from the common practice of assigning a medical proxy is unclear to me.

Today Dore writes a letter to the ConcordMonitor:

Re "Doctors shouldn't facilitate suicide" (Monitor Opinion page, Oct. 16):

I am an attorney in Washington state, where assisted suicide was recently legalized via a citizens' initiative. Voters thought that they were voting for "choice." Our new law is instead a recipe for elder abuse. Your proposed assisted suicide bill, House Bill 304, has the same problem.

Under HB 304, someone else is allowed to talk for the patient during the lethal dose request process. This someone else could be an heir or new "best friend" who will benefit from the death. There are also no required witnesses at the death. Without disinterested witnesses, the opportunity is created for someone other than the patient to administer the lethal dose to him without his consent. Even if he struggled, who would know? The lethal dose request facilitated by the heir or new "best friend" would provide the alibi.

Don't make Washington's mistake. Protect yourself and your family. Keep assisted suicide out of New Hampshire.



Without betraying my private communications with Dore, I feel it necessary to say that no Death with Dignity advocate wishes to promote elder abuse or coercion. In fact, advocates state repeatedly that their efforts are to ensure patient and elder rights and choice at the end of life. My interpretation of the Act - and the state's, and voters' - is that necessary safeguards are in place to prevent coercion or elder abuse.

I am clearly not a lawyer, but I wonder if use of the Act removes motive from any nefariously acting family member. The patient must verbally state their desire for Death with Dignity, then restate it again within 15 days. The attending physician must determine that the patient is terminal and mentally competent and a consulting physician must concur. The request must then be made in writing. Someone other than the family member must also witness the signing. A period of 48 hours must pass before the prescription is written. The physician must deliver or see to the delivery of the prescription. Any doctor working in compliance of the Act must determine that no coercion or abuse is present and the Act states that both coercion and facilitation of the medication is prosecutable. The patient may at any time, whether mentally competent or not, choose not to use the prescription.

If a patient is determined qualified for Death with Dignity, is dying, and has stated repeatedly a wish to die, I wonder if this removes motive from a coercing or abusive family member? Getting to one's inheritance a few days, weeks, or months sooner is cause to act in this situation, at the threat of prosecution? According to Dore, we don't know because the Act, as she says, provides the coercing family member with an alibi.

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The British Debate Over Assisted Suicide.

Currently, assisted suicide is illegal in Britain. The recent case of Debbie Purdy, a multiple sclerosis patient who petitioned the courts to allow her husband, Omar, to help her leave the country for assisted suicide and be exempt from prosecution when he returned, has caused the Director of Public Prosecutions, Keir Starmer, to revise prosecutorial laws for those who assist suicide.

CommunityCare offers an informative outline and civil discussion on the recent revision of British assisted suicide laws. It gives Care Not Killing Alliance, an anti-assisted suicide group, and Dignity in Dying, an end of life patient rights group, equal space to make their cases.

The new prosecution guidelines require that:

1 The victim is under 18.

2 The victim's mental capacity was adversely affected.

3 The victim did not have a clear, settled or informed wish to commit suicide.

4 The victim did not indicate unequivocally to the suspect that she wanted to commit suicide.

5 The victim did not ask personally on their own initiative for the suspect's assistance.

6 The victim did not have a terminal illness, a severe and incurable physical disability, or a severe degenerative physical condition.

7 The suspect was not wholly motivated by compassion.

The converse of 3-7 are among the most important factors against prosecution.

Peter Saunders of Care Not Killing Alliance writes:

Three of the individual criteria listed are particularly open to objection - that a more lenient view of assistance with suicide might be taken if it is given to people with terminal or degenerative illnesses or with incurable disabilities; or to people with a history of suicide attempts; or if it is provided by spouses or close family members. These criteria which are said not to favour prosecution single out groups of people for special category status. In a civilised society, people who are seriously ill or suicidal should be protected by the law, not fast-tracked for suicide. Parliament has twice declined to change the law to allow assisted suicide for terminally ill people, yet here we have a criterion from the DPP that would facilitate it for them and for a range of other unwell people.

The suggestion that spouses and family members might receive more lenient consideration as assisters is based on the facile notion propagated by euthanasia campaigners that such people are invariably "loved ones". The reality is different: most violence and abuse takes place within families. These guidelines need further work before they can be considered fit for purpose.

Jo Cartwright of Dignity in Dying writes:

Although these guidelines are helpful, they only partly resolve the problem.

The guidelines clarify the law for the loved ones of those asking for assistance, but they cannot and do not provide a safeguarded means of assisted dying in the UK. Therefore, we continue to export our terminally ill abroad to die or condone suicides behind closed doors. This status quo is unacceptable and, fundamentally, the law needs to change.

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