Monday, March 28, 2011

UK Catholic Medical Association Goes After Palliative Care

The "double effect," supported by the American Medical Association, states that a doctor may prescribe pain medication to a dying patient in doses that are lethal because the intention of the doctor is to relieve pain, not end the patient's life. Palliative medicine, the specialty field that focuses on ways to alleviate pain, is often held to account by opponents of assisted suicide because of what fails to be a "bright line" during the process of dying. How much medicine is too much? Who decides? What if the patient has no advanced directive? Would they want to be in pain or to life a few hours or days longer?

A story in Saturday's The Underground, a UK publication on "Pop Culture from a Christian perspective" quotes the president of the UK Catholic Medical Association (and a lot of excerpts from the U.S. based LifeNews) on the unfounded accusation that "mercy killing" is rampant in that country. A clip from the article, below. Note the muddling of end of life issues by confusing palliative care, hospice, assisted suicide and prevalent Catholic teaching on suffering, along with a restatement of the U.S. case of Terri Schiavo:

One reason for the occurrence of euthanasia, Walker told Scottish Catholic Observer, is that “The standards of medical ethics and of interpretation of existing legislation appear to vary greatly around the country and from one organization to the next, even in the same local area.”

Misuse of LCP

Another reason is the misuse of the Liverpool Care Pathway, which was developed in the 1990s at the Marie Curie hospice and royal Liverpool Hospital, so that palliative care for end-of-life patients could improve, the Scottish Catholic Observer said.

The LCP provides criteria that must be followed before ending life-sustaining treatment and applying palliative care, LifeSiteNews said. However, reports have indicated that LCP has been used in the cases of people who were not dying, such as dehydrating someone to death on the grounds of LCP.

Walker said, “If it is used out of context, then it could be used to the detriment of patients e.g. a patient comes into a resuscitation bay, and it is not always clear if a condition is acute and can be treated,” LifeSiteNews reported.

A recent report on crematorium records showed that 23% of all deaths in one city in the U.K. were people put on LCP without any definite diagnosis of their stage of life, LifeSiteNews said.

LifeSiteNews mentions the case of in the U.S. of Terri Schiavo, who was not dying, but who was withheld hydration, as an example of euthanasia. However, if a person is “actively dying and/or is unable to assimilate H & N, [t]hat person is actually dying and the provision of H & N provides little to no benefit and may cause suffering.” In such case, it would not be euthanasia.

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Ban in Idaho

From The Republic, below, a quick piece on a new ban in Idaho on "helping somebody else commit suicide." I haven't read the bill but wonder what exactly this means. Is the ban against a doctor prescribing fatal doses of a medicine? Yes. LifeNews writes that the bill "would revoke licenses from physicians who prescribe a lethal cocktail of drugs for patients to use to kill themselves. The law also allows people to get injunctions to prevent others from killing themselves with a doctor’s help. If it becomes law, those found guilty face five years in prison." But what is lethal? And who is to say that the doctor is responsible for a suicide? Could doctors be under greater scrutiny for the actions of their patients? Is it an overly-enthusiasitic reaction to "pro-life" efforts to thwart the momentum of the assisted suicide movement? Absolutely. Again from LifeNews:

"David Ripley of Idaho Chooses Life told, “No opposing testimony was presented at the hearing. During the Senate deliberations, the Idaho ACLU testified against the bill. Supporting testimony was provided by Cornerstone Institute, Right to Life, the Idaho Medical Association and attorney Bob Aldridge.”
“This is a tremendous victory for the pro-Life movement in Idaho. Such overwhelming votes should make it clear to the death lobby that they are not welcome in our beloved state,” he added.

Can the ban be used to prosecute those who remove PVS patients like Terri Schiavo from life support? Can the ban be used to punish spouses of those who commit suicide?

The House voted overwhelmingly to send a bill banning helping somebody else commit suicide to Gov. C.L. "Butch" Otter for signature.

Monday's 61-8 vote came after brief debate on the chamber's floor.

Republican Rep. Lynn Luker of Boise argued that outlawing assisted suicide was necessary to help prevent abuse of elderly residents by their caregivers who are seeking to profit from their patients' demise.

Luker says this bill, which foresees penalties of five years in prison for violations, protects "all concerned."

Democratic Rep. Grant Burgoyne complained this is inappropriate government intervention in a private decision.

Burgoyne says, "My life is mine. It's mine for me to decide when and how it should end. It's not the business of the government to tell me when and how I should end it."

Read more here, and here.

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