New Hampshire: Testimony Against Assisted Suicide Bill at House Judiciary Committee

assisted suicide, dredf, ira byock, Marilyn Golden, New Hampshire, Our News & Commentary Blog

Yesterday, the House Judiciary Committee of the New Hampshire legislature held a hearing on a bill that would legalize assisted suicide in that state.

Diane Coleman, founder and President of Not Dead Yet, wrote about it on the Center for Disability Rights blog yesterday:

Many people know that CDR is active in advocacy on the national level, and provides support and technical assistance in other states. That is also true of Not Dead Yet, which now has its national headquarters in CDR’s Rochester offices. Today, February 19, 2009, the House Judiciary Committee in New Hampshire held a hearing on HB 304 (http://www.gencourt.state.nh.us/legislation/2009/HB0304.html), which is titled “AN ACT relative to death with dignity for certain persons suffering from a terminal condition.” In case the wording leaves you in doubt, this is a bill to legalize assisted suicide.

This particular bill is broader in terms of who would be eligible for assisted suicide than any similar bill introduced in the U.S. so far. Other bills limit “eligibility” to people diagnosed to have less than 6 months to live, but the NH bill actually expands the definition of “terminal” in a way that makes virtually anyone with a significant disability or chronic condition “eligible” for legal help in killing themselves. You can find an analysis of this element of the bill at the Not Dead Yet blog at http://notdeadyetnewscommentary.blogspot.com/2009/01/new-hampshire-poised-to-redefine.html.

If pro-assisted suicide advocates were hoping to dominate the testimony today, they are in for disappointment. New Hampshire activists Bunny McLeod and Tom Cagle offered personal testimony. The Disability Rights Education and Defense Fund (DREDF) submitted written testimony by Marilyn Golden. Dr. Ira Byock, Director of Palliative Medicine at Dartmouth-Hitchcock Medical Center submitted written testimony in opposition to the bill based on his extensive experience as a palliative care physician. I prepared testimony submitted on behalf of Not Dead Yet (NDY).

Read the rest of the entry, including links to the complete text of the testimony listed above.

Journal: Nurse’s research into the ethics of organ donation causes her to reconsider her support

brain death, nursing homes, organ donation, Our News & Commentary Blog

Once in awhile, something comes along that really surprises me. This is one of those times.

The January issue of Nursing2009 not only has an article harshly critical of organ harvesting regulations and protocols, it has made the article available online.

In Speaking up for organ donors (link to html version, with additional link to pdf on the page), Ellen Bridget Linde, RN, BSN explores the values she and other nurses espouse and how they come into conflict with organ harvesting practices.

From the article:

AS NURSES, WE FACE TOUGH ethical dilemmas as we provide end-of-life care, especially when our patients are candidates for organ donation. In this article, I’ll explore two basic issues: how death is defined and who makes decisions for potential organ donors who haven’t made their wishes known. First, let’s look at some basic ethical principles.

Examining your values

Nurses must consider respect for life and bodily integrity in light of the procedure for recovering organs. Nursing is primarily grounded in beneficence (doing good) and nonmaleficence (not doing harm). But nurses interpret these guiding principles in various ways. Some, believing that removing vital organs is what kills the patient, view organ donation performed under current criteria for pronouncing death as an act of killing. Others suggest that organ donation is a “moral duty, an obligation,” considering society’s lack of alternative healthcare resources. But not all nurses are comfortable with a value system driven primarily by the needs of transplant recipients rather than by the needs of the potential donor.

The middle of the article details the various ways in which death has been defined and redefined, partly in response to the demand for more availability of organs for transplantation. Since the article is freely accessible, I leave it to others to go read the exploration of the complications surrounding brain death, non-heart-beating donation, and other matters affecting organ harvesting practices.

Bottom line: there are non-trivial conflicts between traditional values espoused in the nursing profession and organ harvesting practices to make a number of practitioners a little queasy:

Studies indicate that although nurses generally report positive attitudes toward the idea of donation, their unwillingness to donate their own organs or the organs of their family members suggests either some uncertainty or other barriers to donation. Perioperative nurses involved in organ procurement experience a variety of feelings as they participate in the removal of organs from a body that physically appears the same as that of any other surgical patient. Perioperative nurses have described their participation in organ procurement as disrespectful, traumatic, and emotionally draining.

Where do I stand on organ donation? When I started researching this article, I was an avid, outspoken advocate for organ donation, but I’ve since had a change of heart. Shewmon’s study of 175 patients who met the full criteria for whole-brain death led me to conclude that it’s ethically wrong to recover organs from a person who’s still breathing—regardless of whether or not breathing is achieved through mechanical ventilation. Although I’m no longer a potential organ donor, I’m an avid and outspoken supporter of stem cell research because I believe it’s a realistic alternative to organ procurement.

The Shewmon study referred to showed that many individuals meeting the full criteria for brain death were still alive in ways that this nurse considered meaningful.

Neither the Shewmon study nor this article come close to talking about some even more disturbing aspects of brain death determination.

More about that next week. –Stephen Drake

(thanks to Nancy Valko for pointing this article out)

NJ: Woman Finds Aneurism + Medicaid = SOL*

access to health care, Medicaid, Our News & Commentary Blog

*”SOL” is an acronym. If you don’t know what it stands for, you can look it up.

From the Hudson Reporter:

After being diagnosed with a medical condition that threatens her life, a Union City woman was forced to spend two critical months searching for a doctor willing to help her.

Peggy Albedhady, 47, learned she had a 6-millimeter brain aneurysm, an abnormal bulging of an artery in her brain, last November. She said that since then, she has been discharged too early from two prominent area hospitals and denied appointments with dozens of doctors.

The reason for so many rejections, she said, is her insurance: Medicaid.

Medicaid, a state and federally funded program, provides healthcare coverage for disabled individuals and people with little to no income.

“I don’t have a lot of money,” she said last week. “Does that give me the right to die?”

That’s what I’d call a rhetorical question. The answer is obvious, isn’t it?

Dying is cheap, doesn’t demand much of bureacracies, and no one has to worry about you filing a complaint in regard to the lack of follow-up care – or its quality.

When she collapsed on the way to the bathroom, her daughter told her it was time to go to the hospital. They went to Hoboken University Medical Center’s emergency room, but there was a very long wait, said Albedhady, so her daughter suggested they go somewhere else. They decided to go to a hospital with a great reputation, so they went to Hackensack University Medical Center.

Albedhady was admitted to the hospital. Tests revealed she had a brain aneurysm, as well as Hepatitis A and B. She was scheduled for further testing, but five days later, she said, she was abruptly discharged without the tests or an explanation.

“[They] discharged me like I can’t describe it,” said Albedhady. “Like you got tired of your animal, you got tired of your pet, and you just throw it out in the street.”

Albedhady’s description of the treatment of pets is somewhat different than some views we’ve discussed on the blog recently. Peter Baume, Dr. Gifford-Jones, and Thaddeus Mason Pope all recently embraced the idea that humans would benefit from the “kindness” we humans show our pets.

Albehady’s experienced some of the “kindness” firsthand and doesn’t seem to think much of it.

To be fair, the article says that there are medical professionals – including specialists – who will take Medicaid patients where Albedhady lives. It would be nice to think that the hospitals who threw her out gave her a list of them, but they didn’t. Apparently, they don’t think it’s their job to make locating the appropriate physician any easier for a patient with a critical condition. When she was finally able to locate an appropriate specialist, the only opening to see her was months away. That will be a relief to her – if she lives that long.

There are a lot of people out there who have concerns about limits to care under plans to get something close to universal health coverage in this country. Some of those concerns may even be justified.

But it’s hard to imagine a system in which Peggy Albedhady would fare worse than the one that she’s in right now. –Stephen Drake

Texas: David Coronado Breathing on His Own, Off Ventilator

abuse, crime and punishment, david coronado, futile care, Our News & Commentary Blog, Surrogate Decisions & Guardianship, texas

About 3 weeks ago, this blog reported on the case of young David Coronado, a 6-month-old infant allegedly beaten severely by at least one of his parents. Initially, a court-appointed guardian planned to petition for removal of life-support. The scheduled hearing to hear the petition was cancelled due to unspecified “new information.” (We received detailed reports of developments thanks to attorney Jerri Ward, who agreed to represent the Texas NDY chapter in any hearings on this matter.)

There’s some good news today regarding David Coronado, at least enough to give rise to cautious optimism. David is now breathing on his own – which means that his condition has improved, lessening the threat of moves to end his life by his court-appointed guardian.

From the Dallas Morning News:

Just last month, attorneys were considering whether to withdraw life support from 7-month-old David Coronado Jr., whose parents are accused of inflicting scars too numerous to count.

Now the brain-damaged Dallas boy is breathing on his own, and authorities are looking into who might eventually get custody of David should he survive.

“He is off life support at this time, but the prognosis is still uncertain,” Michael Kotwal, an attorney representing Child Protective Services, told a judge Friday morning at a status hearing in Dallas County juvenile district court.

“We’re asking for about 90 days to see exactly what’s going to happen,” Kotwal said. “And possibly if there’s any – not that the child is ready to be moved or transferred to any kind of relative placement – but if the child’s condition does improve and that becomes an option, we need some time to explore the possibilities.”

The court-appointed guardian who originally petitioned for removal of life-support isn’t quoted in this article, but she’s mentioned:

On Jan. 12, the baby’s court-appointed attorney, Holly Schreier, filed a motion asking a judge to allow doctors to remove David from life support. While noting his parents had not consented, she said it would be in his best interest.

But the next week, Schreier withdrew the motion, citing a change in the baby’s condition. She did not return a call for comment Friday.

Who knows – perhaps Schreier still feels that dying would have been in David Coronado’s best interests. It would be nice to think there might be a day in the future when David himself might be able to venture an opinion on that.

Meanwhile, there’s another case sadly similar to David Coronado’s. An infant, severely abused, and there are deliberations going on regarding just who gets to make decisions regarding that infant’s life-support. We’ll see what, if any, lessons have been learned from David Coronado. –Stephen Drake

Reality Vs. Myths of Pet Euthanasia (Part 2)

Australia, euthanasia, Nitschke, Our News & Commentary Blog, pets, reality check

Last week, there was a small burst of the “we’re kinder to animals than to humans” crap in the Australian press, courtesy of Peter Baume, a former Senator and an emeritus professor of Community Health at the University of New South Wales.

Baume was part of a panel discussion on euthanasia in Sydney, Australia. The panelists were covered and quoted in a way that revealed some pretty obvious bias on the part of the Sydney Morning Herald‘s Matt Buchanan. Here’s a relevant example of the less-than-objective wording describing Baume’s remarks:

Professor Peter Baume, speaking with quiet authority, said: “Dogs and horses have it better than us. We don’t let them suffer but we do let humans suffer.”

Just to make sure Baume’s points were driven home, the Herald also pubished an essay by him in the same edition, titled “We do not let dogs and horses suffer as we allow humans to suffer.” In the essay, he makes the same claim that we don’t “allow” dogs and horses to suffer, implying that euthanasia of pets is always an act of relieving the animal’s suffering – when in fact, many, if not most, killings of household pets have to do with the animal being old and harder to take care of, having a condition to expensive to treat, peeing indoors – or outside the litterbox, or maybe being more moody and prone to snapping once in awhile.

Baume wouldn’t have to ask me for evidence of this, he could have asked fellow panelist Philip Nitschke, affectionately known in Australia as “Dr. Death.” He’s been leading the public charge for legalization of euthanasia in Australia. As the most prominent pro-euthanasia activist in Australia, Nitschke has been personally involved with most of the figures in the movement – including Max Bell, who comes close to filling the role of a “martyr” for the movement there.

For a short time 1n 1996, voluntary active euthanasia was legalized in Australia’s Northern Territory. Max Bell, a taxi driver with stomach cancer, contacted Nitsche. Bell wanted to take advantage of the new law. Bell lived quite a distance from Nitsche and had to drive for 6 days to make the entire trip. Below, from an account by Nitschke, is a summary of Bell’s preparation for his travel to the Northern Territory:

So he put his house on the market, had his two dogs put down, organised himself to drive to Darwin and set out.

Given the current context – from Peter Baume, Gifford-Jones, and even Thaddeus Mason Pope – perhaps we should examine that throw-away line from Nitschke regarding Max Bell and his dogs.

How do we evaluate the “mercy killing,” “euthanasia,” “putting to sleep,” etc. of Max Bell’s dogs? Was Bell the victim of some ghastly cosmic coincidence so that not only he, but his two dogs were suffering from terminal illnesses?

Nitschke doesn’t tell us, but it doesn’t seem likely, does it?

Here are some alternative explanations:

  • Max Bell was too sick and pressed for time to find a home for his dogs;
  • Max Bell couldn’t find an alternative home for his dogs;
  • Max Bell didn’t try to find a home, believing that the dogs would be better of dead than having to live without him.

None of this means that Bell was cold or callous towards his dogs, but, like most people, had different beliefs about his commitments regarding animals than he might (presumably) have toward humans.

Personally, probably most of the people I’ve know have had their pets euthananized when they were neither terminally ill nor suffering. They often involved the increased expense and work that can accompany the chronic conditions aging animals develop. Cats that miss the litter box. Dogs that snap at owners when surprised. Expensive medical treatments. Failing hearing and eyesight. Animals, who live in the moment, don’t spend time dwelling on the “good old days” when they could run like the wind and mourn the loss. That’s a human characteristic – and something we like to project on our pets – so we can tell ourselves and our friends that we had them “put to sleep” because they suffered, avoiding the messier truth.

In the name of thoughtful debate and respect for critical thinking, can we put this issue to sleep? Because when individuals such as the ones addressed in this entry use this argument, only two explanations for the tactic come to mind:

  • They’re so entrenched into the myths surrounding pet euthanasia, they’ve set their critical thinking skills aside;
  • Their critical thinking skills are indeed intact, but use this argument to exploit the lack of critical thinking in others.

Surely they can do better. –Stephen Drake