Wednesday, 14 August 2013

Liverpool Care Pathway - Changing Minds

Choice is never easy, never final and never certain. There are things we choose to happen and there are things which just...

As Ben Franklin said, there is nothing certain in life except death and taxes...

Lee fought for the right to die -
New York Daily News
A financial manager at Bank of America, Lee was training for the New York City Marathon last year when she fell ill and was diagnosed with brain cancer.

She suffered a seizure last month and was rushed to North Shore, where she lost her ability to move, eat and speak clearly.

In the following weeks, she begged doctors to remove life support, they have said.

As the hospital was preparing to disconnect her last week, Lee’s parents intervened.

Lee, 28, with her face draped in anguish, told a Daily News reporter earlier in the week that she wanted her battle with brain cancer to end.

“I want to die,” she said Wednesday.

The Manhattan banker has been on a respirator since last month, unable to eat or breathe on her own. Her devout parents, who believe she’ll go to hell if she pulls the plug, have been trying to block Long Island’s North Shore Hospital from honoring her request to die.

But with the appellate court ruling, Lee is now free to make her own decision.

“Whatever little power this poor lady has left, she feels empowered that the court has clearly now recognized that this is up to her and only up to her,” Smith said after delivering the news to Lee.

But, when  you want it to be over, that doesn't mean you want it to be over. Hope, in the face of the absence of hope, may give hope and consolation and the strength to carry on.

Last wishes are never last wishes.

New York Times
And Lee changed her mind. The story is taken up by New York Times -
A terminally ill Queens woman who won a court battle against her parents to allow a hospital to disconnect a breathing tube has decided that she wants to live out the rest of her life, the woman’s lawyer said Saturday.

That decision represents a striking change in direction for SungEun Grace Lee, 28, a bank financial manager who is now paralyzed from the neck down and forced to communicate by blinking — once for yes, twice for no — or by mouthing words.

Her parents said that she was being pressured by doctors who were able to influence her because she was heavily medicated.

Do you heed the Quislings. Do you just line up to be shot rather than face the cruel uncertainty of the battle?

When the line is drawn in the sand, do you permit that line to be crossed? Is hope so easily relinquished?

Permit the legions to cross the Rubicon and you open the door to a different world...

In that different world, Nikki Kenwood would not be here.

Nikki reports her experience on msn news -

The fact is my friends, the world would be a different place with euthanasia.

In Oregon we have “death doctors”. In the Netherlands we have the Groningen Protocol for babies not thought to be perfect.

We now have Medicaid offering euthanasia instead of treatment that prolongs the lives of those with cancer.

More recently we have the Belgian Parliament with legislation that gives poorly children, yes children, the right to request to die. Wouldn’t that be some conversation, some slippery slope there?

So let’s hope Keir Starmer, the DPP, keeps his head and then I and people like me can keep ours.
And let's hope Alison Saunders, the new DPP keeps hers.

Turn euthanasia into a charity and it is already accepted and acceptable.

The British Voluntary Euthanasia Society was founded in 1935 -
In 1935, Lord Moynihan and Dr. Killick Millard founded the British Voluntary Euthanasia Society (later known as EXIT and now as Dignity in Dying) which produced A Guide To Self Deliverance giving guidelines on how a person should commit suicide. Publication was delayed amid controversy because of the Suicide Act of 1961 which states that the legal system can allow up to 14 years in prison for anyone that assists in a suicide. Therefore, it was unclear whether the Society could be held accountable for assisting in suicide because of its publication.In 1980, the Scottish branch (now called Exit) broke off from its original society in order to publish How to Die with Dignity which became the first publication of its kind in the world.Wikipedia
Presentation is everything. Change the name; change the image; retain your goals but present yourself differently.

Compassion in Dying is the charitable arm of Dignity in Dying.

The King's Fund and Age UK have both published a biased report released by Compassion in DyingSee these pages.

What is Age UK doing publishing any report released by pro-euthanasia activists?

We are all really excited in Compassion in Dying to have put together some new promotional leaflets. Following a number of requests for materials for GPs surgeries, end-of-life events, community noticeboards and other charities' referral teams, we now have an Information Line leaflet and an Advance Decision leaflet.

Cutting costs means cutting care means downsizing care means downsizing care expectations, achieving the impossible by making it desirable.

     Dying is a positive life choice.
     Let's talk about it...

Anything can be made to appear desirable if presented in the right way. The groomed have themselves become the groomers. In Scotland, they openly use psychometrics in the programme to limit life.

The Dundee Dignity Care Pathway is a psychometric questionnaire designed to groom the patient into accepting palliative care in place of curative options.

It is all about changing minds.

Here is the East London Advocacy page on Compassion in Dying -

It is co-hosted by East London Age UK. It is funded by the National Lottery in association with the Daily Mail.

Mail Online reported this two years ago -

A right-to-die pressure group has announced plans to sponsor the UK's first helpline aimed at speeding the terminally ill towards 'a good death'.

The free phone line, to be set up by a charity called Compassion in Dying, will 'promote greater patient choice and control where possible'.

The charity is an offshoot of euthanasia campaign Dignity in Dying and is led by the right-to-die group's chief executive.

Its plan to provide advice on the rights of the desperately sick sparked protests from antieuthanasia activists, who said the helpline would be used to shorten lives. The charity says it exists to highlight 'existing end-of-life rights' and will pass on information to callers.

However, it comes against a background of growing tolerance of assisted suicide by prosecution authorities, increasing political pressure for the legalisation of assisted dying, and a rising toll of Britons travelling to the Dignitas suicide clinic in Switzerland to end their lives.

It is all about changing minds.

In her article, Institutionalising Homicide, Vested Interests and Freedom of Conscience, published by Thomas More Institute, Dr. Laing makes arguments of significance and consequence.

Extracts follow:

Institutionalising Homicide, Vested Interests and Freedom of Conscience 
By:  Dr. Jacqueline Laing— 

Food and Fluids: Human Law, Human Rights and Human Interests

England and Wales has seen radical alteration of the law of homicide and assault. The Mental Capacity Act 2005 (which comes into force in 2007) will soon govern the removal of “treatment” which, after Airedale NHS Trust v Bland [1993] AC 789, includes food and fluids delivered by tube, and in certain cases also, by spoon. It does so by introducing binding advance decisions, attorneys empowered to make certain treatment decisions on behalf of the patient and a new version of the Court of Protection which will replace the jurisdiction of the ordinary courts. It also consolidates and extends recent case law permitting sterilisation and abortion on those considered incapacitated. It permits non-therapeutic research on nonconsenting mentally incompetent adults. By recognising the binding nature of the advance decision, it sets up the conceptual apparatus for introduction of routine administration of the lethal injection. It introduces the notion of an attorney newly empowered to make certain “treatment” decisions on behalf of the patient. Given the abuse and homicide it arguably invites, it is possible to see the legislation as a responsibility-shifting exercise designed to foster new socially useful but fundamentally unjustly won ends.

The Mental Capacity Act 2005 needs to be read in conjunction with other legislation that has appeared recently. The Human Tissue Act 2004 (which came into force in 2006) permits inter alia use of tissue from non-consenting patients. The Medicines for Human Use (Clinical Trials) Regulations 2004 (S.I. 2004/1031) allows for clinical drug trials on non-consenting patients on the authority of novel representatives. The Mental Capacity Act 2005 also expressly permits non-therapeutic research on the non-consenting on the authority of novel third parties. As we shall see, these proposals exist against an intellectual background that can be described as broadly utilitarian. In successive volumes of The Lancet, senior medico-legal figures (Hoffenberg et al., 1997, pp. 1320–1321) representing the International Forum for Transplant Ethics make the case for removal of organs from non-consenting patients in permanent vegetative state for use in transplantation. They also recommend societal opt-out organ “donation” as a way of increasing the stock of organs available for transplant (Kennedy et al., 1998, pp. 1650–1652). For non-utilitarian bio-ethicists these suggestions might highlight the aims, driving interests and moral limits of the legislation. It is also worth remembering too that some twenty years earlier in 1984, at the 5th Biennial Conference of the World Federation of Right to Die Societies held in Nice, Australian bioethicist Dr. Helga Kuhse suggested a strategy for the implementation of euthanasia by lethal injection: “If we can get people to accept the removal of all treatment and care—especially the removal of food and fluids—they will see what a painful way this is to die and then, in the patient’s best interest, they will accept the lethal injection” (Marker, 1993, pp. 94, 267). It is widely argued that this law reform is progressive, fosters patient autonomy and clears the way for necessary scientific research. An alternative, more realistic reading is that these radical alterations in the law of assault and homicide create contradictory and unworkable obligations for health professionals and fundamentally compromise the human rights and bodily integrity of the vulnerable.

The Mental Capacity Act 2005 The Mental Capacity Act 2005 (hereafter, the 2005 Act) has significant implications for mentally incapacitated patients in England and Wales 1. It constitutes the culmination of efforts by successive governments proceeding from the Law Commission Draft Bill on Mental Incapacity 1995, to enact legislation in respect of the 4 Food and Fluids 79 care and treatment of the mentally incapacitated. Read in the light of existing case law, certain sections of the 2005 Mental Capacity Act have profound consequences. Most notably they give a catalogue of new actors power to withhold and withdraw “treatment” including artificial nutrition and hydration from patients who, it should be highlighted, may not be dying. These new decision-makers include donees under lasting powers of attorney (attorneys) and those purporting to bear the advance decisions of mentally incapacitated patients. In addition, wide-ranging powers are established in respect of a virtually unrecognisable Court of Protection now empowered to make life and death decisions governing removal of “treatment” as well as decisions to perform research on, remove tissue from, sterilise and abort the young of mentally incapacitated patients.
It is all about changing minds.

Change the mindset and, ten years down the line...?

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