Wednesday, 1 July 2015

Liverpool Care Pathway - The Right To Cease To Be

A spanner in the works, a spoke in the wheel or a just a speed hump in the road?

They say it so often happens in threes...

The dominoes have tumbled.

In Canada, the Supreme Court struck down the country’s 1993 ban on assisted suicide.
Liverpool Care Pathway - A 'Right' To Die?
In South Africa, Judge Hans Fabricius decided to grant the right to die.
Liverpool Care Pathway - A Dying Scandal
Now, Radio New Zealand News reports...

A High Court judge has rejected Wellington woman Lecretia Seales' fight to die on her terms.
The legal team for the Wellington lawyer sought clarification in the High Court at Wellington on whether it would be an offence under the Crimes Act for her doctor to be able to help her die, and whether a ban on assisted dying contravened her human rights under the Bill of Rights Act.

But Justice Collins today rejected that.

"I am unable to issue any of the declarations sought by Ms Seales," he said in his finding.

"Although Ms Seales has not obtained the outcomes she sought, she has selflessly provided a forum to clarify important aspects of New Zealand law.

"The complex legal, philosophical, moral and clinical issues raised by Ms Seales' proceedings can only be addressed by Parliament passing legislation to amend the effect of the Crimes Act."
Did the domino fail to topple?

It has fell with an almighty rap on Parliament's door.

Justice Collins says Ms. Seales has provided a forum for debate. Her name will be used as a cudgel to pound on Parliament's door.

Taking up the cudgels for the killing society, an editorial leader from The Economist - 
IT IS easy to forget that adultery was a crime in Spain until 1978; or that in America, where gay marriage is allowed by 37 states and may soon be extended to all others by the Supreme Court, the last anti-sodomy law was struck down only in 2003. Yet, although most Western governments no longer try to dictate how consenting adults have sex, the state still stands in the way of their choices about death. An increasing number of people—and this newspaper—believe that is wrong.

The argument is over the right to die with a doctor’s help at the time and in the manner of your own choosing. As yet only a handful of European countries, Colombia and five American states allow some form of doctor-assisted dying. But draft bills, ballot initiatives and court cases are progressing in 20 more states and several other countries (see article). In Canada the Supreme Court recently struck down a ban on helping patients to die; its ruling will take effect next year. In the coming months bills will go before parliaments in Britain and Germany.
The natural urge to intervene and to jump into the breach, to provide assistance and to draw back from the brink, is being remodelled by the social architects. To stand back, voyeur-like, and quietly observe in perverse fascination or urge on and encourage...?

Surely not, but this is a clinical 'Brave New World'. We may be induced into this life; so, why should we not be induced out of it?

When someone can’t be bothered to live any more, Society will no longer be bothered to rush to the fore with a reason to be but will be happier to provide the reason and the means to cease to be.

Far safer and less mental trauma for all concerned.

A controlled conveyor belt into oblivion.

It is also the cheaper more logical option in an environment of limited and finite resources and when society cannot or does not want to maintain that life.

The Economist argues the 'right' to die.

The European Convention on Human rights was drafted in the wake of the horrors of the Second World War.

Foremost in the minds of those who compiled it was to enshrine some legal protection for the right of citizens to life and liberty. It is doubtful that it was ever envisaged that the convention would be used to demand the right to die.

A 'right' is normally the right to have something which you do not already have, which justice demands that you should have; which you have but which may be taken away from you. These are positive rights. What is being demanded is a negative right; it is the right not to have something.

Doctors have traditionally defended the right to life. The Hippocratic Oath is about protecting life. Is the familiar doctor-patient relationship to be thrown out with the bathwater? What role, then, for the attending physician?

The messy Assisted Suicide Bill that went before the Scottish Parliament recommended the role of a licensed Facilitator to execute the death...

To allow for a "safe and careful execution of the (assisted) suicide"

Now, the Netherlands is playing ‘catch up’ with Belgium.

This is Bioetica -
“We feel that an arbitrary age limit such as 12 should be changed,” said Professor Eduard Verhagen, of Groningen University, a long-time champion of euthanasia for children. “Each child's ability to ask to die should be evaluated on a case-by-case basis.”

Belgium has already removed the age limit on euthanasia and the Netherlands is lagging behind. Under the current rules, children between 12 and 16 must have parental approval, while euthanasia is banned for those under 12 – except for children under 12 months, who can be euthanased involuntarily.
Laura is someone who can’t be bothered to live any more...

A report in De Morgen 
She has good friends, loves good coffee and theatre. And she wants to die. Ever since childhood Laura (24) has felt: "Life, that's not for me." 
This summer, euthanasia will proceed to end her life full of inner conflict, depression and self-destruction.
 I met the West Flemish Laura at the presentation of the book 'Libera me' euthanasia for psychological reasons. Writer Lieve Thienpont is one of the psychiatrists who gave Laura a positive opinion for euthanasia. As Laura speaks about it, I see a calm, deliberate, confident young woman. That she, meanwhile, is busy planning her death seems unreal.

Laura is to cease to be. Quite simply, this is ‘rational suicide’.

Who will it be who executes this assisted suicide? Margo's Assisted Suicide Bill promoted the role of facilitator or assister who...
would have no personal connection to the person being assisted, unlike friends and family members who may feel motivated to try to interfere with the autonomous decision of the individual (either by encouraging someone to commit suicide or by attempting to dissuade them from doing so).
In writing risk assessments, prior suicide attempts must be taken account of. However, in a world where suicide is considered a valid option for the client to address their mental health, where does this leave the assessor?

In a long article in The New Yorker, Rachel Aviv discusses death as treatment.

Godelieva De Troyer’s condition was non-terminal but enduring. What help she sought would provide treatment but no solution. Then she met Wim Distelmans who provided her with the final solution.
Wim Distelmans, an oncologist and a professor of palliative medicine at the Free University of Brussels. Distelmans was one of the leading proponents of a 2002 law in Belgium that permits euthanasia for patients who have an incurable illness that causes them unbearable physical or mental suffering. Since then, he has euthanized more than a hundred patients. Distelmans, who wears leather coats and boots and artfully tossed scarves, has become a celebrity in Belgium for promoting a dignified death as a human right, a “tremendous liberation,” and he gives talks at cultural centers, hospitals, and schools around the country.
Godelieva left a family behind her...
In his mother’s living room, Tom found an article about Distelmans in De Morgen, a leading Flemish newspaper, which featured a large photograph of him sitting on a bed, wearing jeans, a patterned shirt, and a silver bangle bracelet. The reporter described Distelmans as a doctor who “cannot stand injustice.” Distelmans spoke about his disdain for doctors who assume that they know what their patients need, and told the reporter that the “euthanasia law has such a symbolic value. People have a voice.” 
Tom also discovered a booklet, produced by LEIF (Life End Information Forum), an organization founded by Distelmans, that outlined the medical and legal options available to people who are dying or want to die. On the final page, the authors introduced an excerpt from “Utopia,” by Thomas More, who describes a world in which “officially sanctioned euthanasia is regarded as an honorable death.” In More’s ideal society, government officials and priests visit suffering invalids and say, “Why don’t you break out and escape to a better world?”

Will the social architects, hard at their work, produce a Werther Effect? May we expect a mass suicide to enter this “better world”? Have we not seen this already in the manifestation of cult suicides?

What value, then, is human life? If life is a such a tedious matter, why bring children into this world to endure it? By these rationale, should we all not seek out that final EXIT?

Additional reading -
Liverpool Care Pathway - A New Hope...?
Liverpool Care Pathway - And "Rational" Suicide 
Liverpool Care Pathway - The Pro-Death Advocacy 
Liverpool Care Pathway - The Werther Defectives

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