Connecticut debates assisted suicide
Two doctors ask for a ruling that would allow them,
without fear of prosecution, to issue prescription to patients who wish to end their lives.
Hartfort, Conn, October 8, 2009---Two Connecticut physicians and end-of-life advocates have filed a lawsuit in Hartford Superior Court seeking to clarify whether a decades-old law banning assisted suicide affects doctors who help terminally ill patients die.
Dr. Garry Blik, a Norwalk physician who specializes in treating patients with HIV/Aids, said Wednesday that he and Dr. Ron Levine of Cos Cob , want the court to declare physicians will not face criminal charges. If they provide a prescription to mentally competent patients who want to use medication to end their life peacefully.
Connecticut law makes it a crime to assist another person in committing suicide, which Blick vehemently denies is what he and Levine are advocating.
Connecticut law, which states that a person who "intentionally causes or aid another person, other than by force, duress or deception, to commit suicide" is guilty of second-degree manslaughter, has been on the books since 1969. That law codified a penal code that was written in 1961.
Blick said he's offended by the word suicide being used in these cases, saying he is terminally ill patients don't necessarily want to die. Rather they want to live by their own terms.
But Michael Culhane, executive director of the Connecticut Catholic conference, so the Roman Catholic Church, which teaches the belief that life should be protected from conception to natural death, considers this effort to be about committing suicide.
The suit, filed on Tuesday, names, chief State's Atty. Kevin Kane and prosecutors across the state as defendants.
A bill legalizing physician-assisted suicidewas passed during the year's regular session of the Gen. assembly when it died in committee.
There is been a history in Connecticut of people
being prosecuted for helping terminally ill relatives or friends die.
Credit Susan Haigh Associated Press
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Study finds contentment grows with age.
CHICAGO - - 4/19/2009 - -The Associated Press reports on a new study that debunks the myth that most of us spend our older years alone and unhappy. According to the study done by University of Chicago sociologist YangYang, our appreciation and enjoyment of life gets better with age. In general, older people are more content with what they have, and feel less need to improve on it than their younger counterparts. The University of Chicago research sampled 28,000 Americans ages 18 to 88 in a study conducted from 1972 to 2004. Specifically, the odds of being happy increased 5% with every 10 years of age.
Overall, 33% of Americans reported being very happy at age 88 vs 24% in the under twenty age group. Part of the explanation for their contentment was the fact that people in their 80s were more socially active. They were twice as likely to do at least one social activity every week -- including socializing with neighbors, attending religious services, volunteering or attending group meetings.
Supporting the University of Chicago research is new Duke University research that finds that older adults have lower expectations, less to prove, and they tend to accept what they have achieved.
Credit: Lindsey Tanner, Associated Press
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http://www.mygreenmind.com
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Ohio finds it hard to get advice on death-penalty alternatives
Medical professionals are refusing to take part in a process that involves taking a life
Columbus, Ohio, October, 2009---Ohio was on track this year to execute a record number of inmates. One botched execution and several lawsuits later, the death penalty is temporarily on hold.
The latest challengeis that the state, because of ethical and professional rules, can't find medical professionals willing to advise it on the best way to put condemned inmates to death.
The rules -- which generally prohibit doctors, nurses and others from involvement in capital punishment -- are deterring those professionals from speaking publicly or privately. A bulk alternatives to the state's lethal-injection process, attorney general Richard Cordray said in a court filing.
"A number of small promising leads, have emerged, but identifying qualified medical personnel willing to be able to provide advice to the state regarding lethal-injection options continues to be challenging and time-consuming," Cordray said in the Friday filing in US District Court.
executions have stopped while the state develops new injection policies, following a September 15 execution that was halted because the inmate had no suitable veins.
The state has reached out to judges, police and lawmakers for help in trying to find medical professionals willing to talk to the state, according to the filing written on Cordray's behalf.
Missouri encountered a similar problem in 2006 after a federal judge ordered the state to revamp its execution procedures, including using a board-certified anesthesiologist.
The American Medical Association prohibits its members from participating in executions, including anything that would "contribute to the ability of another individual to directly cause the death of the condemned."
Credit Andrew Welsh-Huggins Associated Press
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Two-thirds Of Americans support the right to die
Wednesday, May 30, 2007
But when asked whether it should be legal for doctors to help terminally ill patients end their own lives, 48 percent said yes, while 44 percent said no.
NEW YORK (AP)--More than two-thirds of Americans believe there are circumstances in which a patient should be allowed to die, but they are closely divided on whether it should be legal for a doctor to help terminally ill patients end their own lives by prescribing fatal drugs, a new AP-Ipsos poll finds.
The results were released yesterday, just days before Dr. Jack Kevorkian is freed from a Michigan prison after serving more than eight years for second-degree murder in the poisoning of a man with Lou Gehrig’s disease. Kevorkian's defiant assistant-suicide campaign, which he waged for years before his conviction, fueled nationwide debate about patience’s right to die in the role that physicians should play.
Though demonized by his critics as a callous killer, Kevorkian--who was to be released Friday--maintains relatively strong public support. The AP-Ipsos poll found that 53% of those surveyed thought he should not have been jailed; 40% supported his imprisonment. The results were similar to an ABC news poll in 1999 that found 55% disagreeing with his conviction.
The new AP-Ipsos poll asked whether it should be legal for doctors to prescribe lethal drugs to help terminally ill patients and their own lives--a practice currently allowed in Oregon but in no other states. Forty-eight percent said they should be legal; 44% said it should be illegal.
More broadly, 68% said there are circumstances when a patient should be allowed to die, while 30% said doctors and nurses, in all circumstances, should do everything possible to save the life of the patient.
A majority of respondents--55%-- said they would not consider ending their own lives if ill with a terminal disease. Thirty-five percent said they would consider that option.
Oregon’s physician-assisted suicide law took effect in 1997. Through last year, 292 people--mostly stricken with cancer--have died under its provisions, which allow terminally ill, mentally competent adults to administer life-ending medication prescribed by a physician.
In addition to Oregon, three European countries--Switzerland, Belgium and the Netherlands--authorize assistance by doctors in the deaths of patients.
Oregon's law has been reaffirmed by state voters and has survived intense legal challenges, but has yet to be emulated in any other state. Bills have been defeated by lawmakers in Vermont, Hawaii, Wisconsin and Washington; ballot measures to allow physician-assisted death have lost in Washington, California Michigan and Maine.
The AP-Ipsos poll showed that religious faith is a significant factor in views on the subject.
Only 34% of those who attend religious services at least once a week think it should be legal for doctors to help terminally ill patients and their own lives. In contrast, 70% of those who never attend religious services thought the practice should be legal.
Just 23% of those who attend religious services at least weekly would consider ending their own lives if terminally ill, compared to 49% of those who never attend religious services.
The AP-Ispos poll involved phone interviews with 1,000 randomly chosen adults
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Thanks to APA -
REPRINTED FROM WWW.APA.ORG
Aging lessens tendency to
take others' perspectives.
As adults grow older they decreasingly see the world through others' eyes, according to a new study published in the Journal of Experimental Psychology: Applied (Vol. 11, No. 1, pages 53–60). In particular, normal adults over the age of 75 may find it particularly difficult to factor in another person's values when making a decision from that person's point of view, says one of the study authors, Etienne Mullet, PhD, a psychology professor and director of studies at the Ecole Pratique des Hautes Études in Paris.
Mullet and his colleagues found this effect by presenting 27 written scenarios to 18- to 90-year-old French adults. The scenarios described a dilemma that another adult faced: whether to take a pain medication. The severity of the pain experienced by the patient, the amount of trust the patient placed in the doctor and the severity of side effects all varied by scenario.
Additionally, participants learned the importance the patient placed on one of these factors--for example, by reading that the patient "is known for placing no importance on side effects."
After digesting this information, the adults rated the likelihood the patient would take the medication.
Participants ages 75 to 90 years old tended to predict that the more severe the side effects, the less likely the patient would take the medication--regardless of the patient's reported values. In comparison, younger adults ages 18 to 25 years old generally predicted that patients who didn't care about side effects would be equally likely to take the medication, regardless of the severity of the side effects. Middle-aged adults' scores fell in between those of the younger and older groups.
The researchers found similar effects when the participants predicted the likelihood of medication-taking among those extremely concerned about side effects.
"Elderly people may be less likely to make these changes in judging because reordering the way information is processed requires a high level of executive functioning and, as a result, is not an easy task for them," says Mullet.
However, Mullet and his colleagues hope to develop methods for training older adults to make these perspective adjustments, which could lead to more harmonious relationships between them and their caregivers, he says.
"Past research has shown that in the case of daughters helping aged mothers, one of the most important predictors of each's satisfaction was their ability to perceive accurately the other's feelings about the helping relationship," Mullet notes.
--S. DINGFELDER
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Physicians and health care practitioners. Here is a useful article that may help with one of your most difficult patient challenges.
Is there a good way
to deliver bad news?
BY STEPHANIE BEASLEY
THE BALTIMORE SUN, 10/1/2006
I never understood what it felt like physically, until I had to go through it. It’s like a pain in your chest,” says Dr. Rhonda S. Fishel, associate chief of surgery at Sinai Hospital in Baltimore, who has a rare cancer. She says that patients often remember more about how their doctor broke painful news than they do the diagnosis.
When her partner, Mickey Barron, was diagnosed with breast cancer in 2001, Dr. Rhonda Fishel accompanied her to the oncologist’s office. As an experienced surgeon, Fishel was no Stranger to the delivery of bad news. She was the one who jotted notes furiously as the doctor discussed treatment options, while Barron’s mind struggled just to get past the word “cancer.”
“He was going on about treatments, and I was gone,” Barron recalled. “I was too Stressed out.”
Four years later, when Fishel was diagnosed with a rare cancer called uterine sarcoma, it was Barron’s turn to listen carefully as her partner sat numbly.
“I never understood what it felt like physically, until I had to go through it. It’s like a pain in your chest,” said Fishel, 51, who has reduced her hours as associate chief of surgery at Sinai Hospital in Baltimore and director of its intensive care unit since being diagnosed and treated.
Fishel is convinced that patients often remember more about how their doctor broke bad news than they do about their diagnosis.
“You go into these rooms knowing that you’re going to destroy people’s lives,” Fishel said. Yet she has heard of colleagues who deliver bad news from the doorway of a patient’s hospital room and then quickly back out.
It’s a concern shared by other physicians who have developed a protocol for delivering news that they know will be devastating. “It acknowledges the fact that giving bad news is very hard and doctors aren’t taught those skills,” said Dr. Walter Baile, chief of psychiatry at the MD
Anderson Cancer Center in Houston. terminology at their patients. Baile said it’s also critical to choose a location that’s comfortable for the patient and to pay attention to the patient’s emotions as he receives the information
“The most important thing is to make an empathetic statement, to say something like, ‘I can see that you weren’t expecting bad news,’ or ‘wish’ statements like, ‘I wish there was something I could do.’ That’s very different from saying, ‘There’s nothing I can do,’ because that’s abandonment,” he added.
Fishel relies heavily on the SPIKES Philosophy in a presentation she gives to young doctors and medical students titled, “Giving and Receiving Bad News: Lessons I’ve Learned.”
Fishel learned of SPIKES from a friend — an oncologist using it with her own patients. Fishel developed her talk after a nephew in medical school asked her to speak to his class last summer. Having received her own cancer diagnosis by this time, she decided to develop something more substantive than the usual jargon-filled lecture accompanied by the gory pictures that medical students love.
“I thought a more relevant talk for young, upcoming physicians was bad news,” she said.
Here she parts company with Baile, who said he’s reluctant to give presentations to young medical students who don’t have the experience to put SPIKES into context.
“If you teach it too early in the medical career, before they’ve had patients, it really doesn’t make much sense to them. I think that students can learn it, but whether they retain it is the question,” Baile said.
Jay Bhatt, president of the American Medical Student Association, disagreed. “I don’t think that it’s ever too soon to understand human interactions, human emotions and how that impacts people’s health,” he said.
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KNOWN AS SPIKES, which stands for “Setting, Perception, Invitation, Knowledge, Empathy and Strategy/summary.” It emphasizes skills that Baile says are useful for physicians who have to deliver bad news.
As part of the six-step process, Baile says, physicians should take their time when delivering news to ensure that patients understand what is being said. Too many doctors, he says, toss too much medical
This is the protocol developed by oncologists and psychiatrists for delivering bad news to patients:
S — Setting Pick a private location.
P — Perception Find out how the patient views the medical situation.
I — Invitation Ask whether the patient wants to know.
K— Knowledge Warn before dropping bad news.
E — Empathy Respond to the patient’s emotions.
S — Strategy/summary Once they know, include patients in treatment decisions. |
