# Assisted Dying.



## Kirkhill (23 Jun 2016)

I approach with trepidation.  I want to keep politics out of this as much as possible.  If it gets too heated I will ask the moderators to shut this thing down quickly.

I am an orphan.  Both of my parents died in their 50s of cancer.  My father elected treatment. My mother rejected treatment. Both died.  Neither died pleasantly.  My mother had a marginally better end - self-medicating with morphine in a public hospital.

I am of two minds with respect to assisted dying as I suspect most people are.  Some days I understand the need and am accepting.  Some days I reject the need.  Some days I accept the need but reject the accommodation because it can be an overly attractive solution.  

I also have real problems with anybody acting for another person in this matter - proclaiming an ability to understand that person's wishes better than the person themselves is able to voice.  That person is the unfortunate one who cannot be granted relief on exactly the same grounds that the death penalty was abolished. The risk of an "innocent" or in this case "unwilling" person dying is too great.  The guilty must go free.  The sufferer can't be granted release - unless they specifically ask for it at the time.

That is background.

I want to move on to the mechanics of assisting the dying.  The expectation is that medical practitioners will be providing the service mandated by the state, or in fact by the courts, simply because they are by and large employees of the state.  But many practitioners are opposed on moral grounds and all practitioners have taken oaths "to do no harm".  For whatever an oath is worth these days insofar as courts seem to permit people to cross their fingers and change their minds.

To manage the problem of competing oaths I suggest the following:

The return of the Public Executioner.

The Executioner is the person hired to execute the wishes of the state.  Much like a soldier.

Soldiers should not be executioners in this sense.  Equally doctors should not be executioners.

If the state and the courts have determined that society must provide assistance in dying then I suggest it is up to the state and the courts to employ such people as are necessary to execute the wishes of the state and the courts and provide such assistance as they deem appropriate when a citizen requests his or her demise.

Of course, given the current wide interpretation of when assistance is appropriate, it may be that the Public Executioner finds themselves confronted by individuals for whom the prospect of life, 25 years, 15 years, 5 years behind bars is just too hard to bear and are requesting assistance.


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## ModlrMike (23 Jun 2016)

As someone who may at sometime be asked to render such assistance, I admit that I'm still unclear on the idea. 

The thing that most people struggle with is coming to terms with what it means to them. For example, when I admit folks to hospital, I need to have an understanding of their wishes vis-a-vis resuscitation. You would be surprised at the number of families that want their 96 year old, demented and vegetative relative to undergo a full resuscitation. They're clearly making the choice based on their own perspective, and not on their relative's wishes. 

The assisted dying discussion is similar. Everyone has to understand and come to terms with the outcome. It's going to be hard on surviving family members, but by the same token they should not guilt the person suffering into prolonging their situation. To be fair though, the person seeking assistance has to understand the knock on effects of their decision.

Personally, I think the current legislation is poor document.

As to the suggestion of an Executioner... That's a poor term in that execution is something imposed on you, not something you choose for yourself. Semantics perhaps, but an important distinction in this discussion.


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## Kirkhill (23 Jun 2016)

ModlrMike said:
			
		

> As someone who may at sometime be asked to render such assistance, I admit that I'm still unclear on the idea.
> 
> The thing that most people struggle with is coming to terms with what it means to them. For example, when I admit folks to hospital, I need to have an understanding of their wishes vis-a-vis resuscitation. You would be surprised at the number of families that want their 96 year old, demented and vegetative relative to undergo a full resuscitation. They're clearly making the choice based on their own perspective, and not on their relative's wishes.
> 
> ...



Just want to clarify the semantics of the word "Executioner":  as I noted the role of the Executioner was to execute the will of the state, which arrogated to itself to power to kill.  The state now wishes to "lend/donate" that power to willing citizens.  I suggest that they "lend/donate" the services of the Executioner as well.

I particularly like the connotations and associations of the word.  I think it would serve as a reminder of the gravity of the decision and confirmation that the procedure is not a medical one.


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## mariomike (23 Jun 2016)

Saw this in the news,

May 11, 2016 

Suffering from PTSD resulting from sexual abuse? Dutch doctors will euthanize you.
https://www.lifesitenews.com/news/dutch-doctors-kill-sex-abuse-victim-because-of-incurable-mental-suffering
The Dutch decriminalization has been expanded since 2002 to include the mentally ill and those suffering from dementia. Children as young as 12 years old can request euthanasia with the support of their parents, and the Dutch Pediatric Association is publicly advocating the elimination of any minimum age to request it. More than 5,000 people are killed by their physicians or commit suicide with their help every year, according to official statistics.

See also,

Mercy Killing? Euthanasia?
http://army.ca/forums/threads/91849.50.html
3 pages ( Locked ).



			
				Chris Pook said:
			
		

> I want to move on to the mechanics of assisting the dying.


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## jollyjacktar (23 Jun 2016)

I am disappointed that once again the state is acting like a nanny state and getting their face into what I feel is my business and mine alone.  It is my life and I would like to have a mechanism it end it in a dignified manner at a place, method and time of my choosing should I have a need and desire for this path.  Now, I feel that I will have to take a walk into the woods in winter or something if   I must. For once the Senate, much to my shock, was actually leaning more towards how I feel on the subject, unlike the "Sunshine State" that inhabits the Hill.  Another reason to curl my lip at them.


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## mariomike (23 Jun 2016)

jollyjacktar said:
			
		

> Now, I feel that I will have to take a walk into the woods in winter or something if   I must.



Just don't go in too deep. Think of the guys/gals who have to carry you out.


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## jollyjacktar (23 Jun 2016)

Exactly, and one thing among others that would give me pause.


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## mariomike (23 Jun 2016)

jollyjacktar said:
			
		

> Exactly, and one thing among others that would give me pause.



I would be too afraid of botching the job to try.


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## The Bread Guy (23 Jun 2016)

First off, thanks, all, for sharing on a topic that reaches pretty deeply inside of us, whether we realize it or not.



			
				Chris Pook said:
			
		

> ... The expectation is that medical practitioners will be providing the service mandated by the state, or in fact by the courts, simply because they are by and large employees of the state.  *But many practitioners are opposed on moral grounds and all practitioners have taken oaths "to do no harm". * For whatever an oath is worth these days insofar as courts seem to permit people to cross their fingers and change their minds ...


I stand to be corrected by people in the medical field on these boards, but I'll say it:  there are patients in the system getting big doses of morphine "in order to make them comfortable" as part of very-end-of-life care.  This is already happening - I've seen this twice.  In the situations I saw, I had no problem with how it was done.  Can abuse happen?  Yup.  Does that mean we shouldn't come up with rules?  I'd think the opposite.  Is the current law, as is, enough?  I don't think so.

On the oath re:  "do no harm", again, I'd love to hear more from medical practitioners, but the original oath talked about "I will not give to a woman a pessary to cause abortion," and we know such procedures happen, too.  One source that doesn't look crazy says the "original" oath has undergone a certain amount of development.  And when it comes to "doing no harm", is it more harmful to let someone suffer for a longer time, or to stop the suffering sooner?  Each case will have it's own answer, but if the latter is not an option, we'll be stuck with the former until pain management/control gets better.



			
				jollyjacktar said:
			
		

> I am disappointed that once again the state is acting like a nanny state and getting their face into what I feel is my business and mine alone.  It is my life and I would like to have a mechanism it end it in a dignified manner at a place, method and time of my choosing should I have a need and desire for this path ...


Problem is that before this law, if you wanted to end it your way, anyone helping you could go to jail.  That said, I agree the current law has a big short-coming - not being able to include such wishes in an advanced directive in the event you become mentally incompetent down the road - that would addresses this bit:


			
				Chris Pook said:
			
		

> ... I also have real problems with anybody acting for another person in this matter - proclaiming an ability to understand that person's wishes better than the person themselves is able to voice ...





			
				Chris Pook said:
			
		

> ... doctors should not be executioners ...


On a practical level, I'd prefer someone who knows how it's done than a technician.
Finally ...


			
				jollyjacktar said:
			
		

> ... Now, I feel that I will have to take a walk into the woods in winter or something if I must ...


... I've heard a number of people say that, and I believe in "I'm the boss of me" as well, but also keep in mind what this option does to those you leave behind -- that's why we need better.


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## Kirkhill (23 Jun 2016)

milnews.ca said:
			
		

> First off, thanks, all, for sharing on a topic that reaches pretty deeply inside of us, whether we realize it or not.
> I stand to be corrected by people in the medical field on these boards, but I'll say it:  there are patients in the system getting big doses of morphine "in order to make them comfortable" as part of very-end-of-life care.  This is already happening - I've seen this twice.  In the situations I saw, I had no problem with how it was done.  Can abuse happen?  Yup.  Does that mean we shouldn't come up with rules?  I'd think the opposite.  Is the current law, as is, enough?  I don't think so.



See my original post re morphine.  

With respect to the making of laws I am very much of the opinion that this is a situation where Common Law triumphs over Civil Code.  Customary practice and precedence is a much more flexible tool than chiseling codes in stone after interminable arguments by blind men over what constitutes an elephant.



			
				milnews.ca said:
			
		

> On the oath re:  "do no harm", again, I'd love to hear more from medical practitioners, but the original oath talked about "I will not give to a woman a pessary to cause abortion," and we know such procedures happen, too.  One source that doesn't look crazy says the "original" oath has undergone a certain amount of development.



Regardless of the original intent, or wording, the issue, surely, is the understanding of those that utter the current words.  And the vast majority of those, I believe, would not find the taking of life to be compatible with their oath.



			
				milnews.ca said:
			
		

> And when it comes to "doing no harm", is it more harmful to let someone suffer for a longer time, or to stop the suffering sooner?  Each case will have it's own answer, but if the latter is not an option, we'll be stuck with the former until pain management/control gets better.



Again, this is why I would prefer a Common Law remedy rather than a Code Civil remedy.




			
				milnews.ca said:
			
		

> Problem is that before this law, if you wanted to end it your way, anyone helping you could go to jail.  That said, I agree the current law has a big short-coming - not being able to include such wishes in an advanced directive in the event you become mentally incompetent down the road - that would addresses this bit:



I think that each case is sufficiently different, and sufficiently grievous, that each decision needs to be thoroughly reviewed after the fact with dire consequences for the practitioner in the case of error.



			
				milnews.ca said:
			
		

> On a practical level, I'd prefer someone who knows how it's done than a technician.



I don't find it hard to contemplate a competent technician specializing in painless death.  Even the old hangmen had notable skills to ensure the clean snap of the neck.



			
				milnews.ca said:
			
		

> Finally ...... I've heard a number of people say that, and I believe in "I'm the boss of me" as well, but also keep in mind what this option does to those you leave behind -- that's why we need better.



And that is the biggest issue of all - and why nobody should be given a free pass from the courts on making these decisions.  Every decision should be the subject of judicial review.


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## The Bread Guy (23 Jun 2016)

Chris Pook said:
			
		

> With respect to the making of laws I am very much of the opinion that this is a situation where Common Law triumphs over Civil Code.  Customary practice and precedence is a much more flexible tool than chiseling codes in stone after interminable arguments by blind men over what constitutes an elephant.


Then you have more faith in how people apply common law (over something a bit more codified)  ;D



			
				Chris Pook said:
			
		

> Regardless of the original intent, or wording, the issue, surely, is the understanding of those that utter the current words.  And *the vast majority* of those, I believe, would not find the taking of life to be compatible with their oath.


Some?  Yes.  Most?  I'm not convinced.  Some surveys say most say no, some surveys say most say OK, but in certain circumstances.  Again, I'd love to hear from any practitioners out there on this one because I'm just guessing based on doctors & other health professionals I've spoken to.



			
				Chris Pook said:
			
		

> I think that each case is sufficiently different, and sufficiently grievous, that each decision needs to be thoroughly reviewed after the fact with dire consequences for the practitioner in the case of error ... And that is the biggest issue of all - and why nobody should be given a free pass from the courts on making these decisions.  Every decision should be the subject of judicial review.


More than fair, which can also be built into a system where the patient can express a choice.



			
				Chris Pook said:
			
		

> I don't find it hard to contemplate a competent technician specializing in painless death.  Even the old hangmen had notable skills to ensure the clean snap of the neck.


Then that might be my own squeamishness, then.  Maybe the term "executioner" as a term?  Mostly because this individual would be carrying out the wishes of the _patient_, not the state.


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## Kirkhill (23 Jun 2016)

I always favour the crowd over the expert.  And as someone that has been paid to be an expert I say that advisedly.  

On the some, most, many question - it doesn't matter if it is one that is being forced to compromise their principles.

And on the "executioner" front:  I want you to be squeamish.

I believe the sequence of events should go something like this:

Doctor to Patient - I can't do any more for you.

Patient to Doctor - I want to die

Doctor to Patient - Here is the phone number of the Public Executioner.


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## medicineman (23 Jun 2016)

Was thinking hard about entering this or not, but like Mike, I too may be faced with this.  Oddly enough, I am actually for it.  "Primum non nocere" means not just don't frig up and do what is right, it also means don't make your patient suffer.  I've watched more than my share of people go through the dying process - both over the long haul and also very short ones - and both are difficult for all around, be that family, friends, care givers.  I've seen some family members that try to drag things out, sometimes because they're trying to control the uncontrollable, others because there are financial or plan old vengeful back stories, and others because of religious reasons.  Whatever the case, if the person is competent to make the decision ahead of time, there is going to be a known and protracted period of suffering ahead of their demise resulting directly from this illness or injury, they should be afforded the dignity to do ask someone to end things for them at a time of their choosing.

One of the little problems about some of our laws is that there are some religious backgrounds around suicide, especially with the Roman Catholic and other Christian churches that our original lawmakers were active members of.  This kind of clouds the objectivity of people when it comes to death.  There are also many folks that walk this earth that figure we can and should prolong people's existence well beyond their best before dates (which, incidentally, we all have).  Fact is that today, people have a very unrealistic expectations of what constitutes "a life" and what doesn't.  If I ever got to the point where I were to end up like some of my PCH patients from my previous job, I'd literally arrange to fall on my katana at home, perhaps more than once.  The reason is this - I am pretty good at keeping people alive that should have died several years ago by tweeking this biochemical or physical parameter in one direction or the other; however, keeping that physical person living a GORK (God Only Really Knows) 'ed out existence, completely unaware of who, what, where and when they are and being completely dependent on others more so than a baby, well that to me isn't a life.  I vividly recall a person that was past 100 years old, with no living friends, who'd wake up each day and look at us and, realising they was still on Earth, would drop their head and ask "Why am I still here??!!".  Not an easy thing to take...

I well remember reading a bio of Dr Sir William Osler, one of the great medical minds of the 19th and early 20th Centuries (and a Canadian...and someone I sometimes quote at work) where it was clearly written in a patient chart where he'd done a housecall in Montreal during the last big smallpox epidemic and having not much to offer, gave this patient a fairly decent dose of morphine...which not only eased their suffering, but also hastened their demise later that evening.  Using the law of the time (and really not so distant past), by the letter, he should have been strung up from the gallows for murder...however, ethically, I (and many others I'm sure) feel this was merely doing good by his patient, which is what this MAID law is about.  

This law is about empowering people and their caregivers to do what they feel is necessary for them, in a dignified and LEGAL manner.

:2c:

MM


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## mariomike (24 Jun 2016)

ModlrMike said:
			
		

> You would be surprised at the number of families that want their 96 year old, demented and vegetative relative to undergo a full resuscitation.



Or, sometimes they _don't_  want paramedics to resuscitate. The family hands you a DNR order signed by the doctor.

But, in Ontario, when called to respond to a scene where a person has lost vital signs, and in the absence of a Do Not Resuscitate Confirmation Form (DNRCF), _even if a DNR Order is presented to attending paramedics_, under regulations of the MOHTLC, paramedics must begin resuscitative measures.


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## The Bread Guy (24 Jun 2016)

Thanks, medicineman, for sharing an "inside the profession" view.


			
				mariomike said:
			
		

> But, in Ontario, when called to respond to a scene where a person has lost vital signs, and in the absence of a Do Not Resuscitate Confirmation Form (DNRCF), _even if a DNR Order is presented to attending paramedics_, under regulations of the MOHTLC, paramedics must begin resuscitative measures.


And THAT is an important point for people in Ontario to know - thanks for sharing.


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## mariomike (24 Jun 2016)

milnews.ca said:
			
		

> And THAT is an important point for people in Ontario to know - thanks for sharing.



The DNR-CF is the _only_  order Ontario paramedics can accept as a DNR directive. 

Each one has a unique 7-digit serial number.


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## dapaterson (24 Jun 2016)

Which is why some palliative care doctors advise against calling paramedics.  


Medicineman: Anecdotally I have heard of modern-day doctors who have similar approaches to pain management with morphine.  Perhaps with appropriate legislation they can do it "on the books" instead of doing it with a wink and a nudge.


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## The Bread Guy (24 Jun 2016)

mariomike said:
			
		

> The DNR-CF is the _only_  order Ontario paramedics can accept as a DNR directive.
> 
> Each one has a unique 7-digit serial number.


Where does one get one of these forms?  I know people with DNRs and advance directives who live @ home.


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## mariomike (24 Jun 2016)

milnews.ca said:
			
		

> Where does one get one of these forms?  I know people with DNRs and advance directives who live @ home.



I suspect some may not have heard of the DNR-CF, or believe it is necessary. 

Perhaps they could be shown this from THE ONTARIO COLLEGE OF FAMILY PHYSICIANS:
http://ocfp.on.ca/docs/communications/january-21-2008.pdf?sfvrsn=4

Do Not Resuscitate Confirmation Form
Dear Colleague,
Recently, paramedics and firefighters have been authorized to honor the “Do Not Resuscitate” (DNR) orders of a patient. I would like to make certain that you are aware of the new form, The Do Not Resuscitate (DNR) Confirmation Form which will be the only form accepted in Ontario for this purpose as of February 1, 2008.
Like many of you, I care for patients at the end of life who wish to die in their own homes. A DNR order is appropriately obtained, documented and well known by all healthcare providers, caregivers and family involved. On occasion, for various reasons, 911 is called and paramedics and firefighters are required to attend the patient’s home to offer emergency assistance and/or transport the patient to hospital for further care. Currently paramedics are legally obliged under the Ambulance Act’s Basic Life Support Patient Care Standards, Version 2, to initiate life support measures (chest compression, defibrillation, artificial ventilation, insertion of an airway, endotracheal intubation, transcutaneous pacing or advanced resuscitation medications) to all patients irrespective of their personal directives or any current institutional DNR order. As you can well imagine, inappropriate resuscitative procedures often ensure contrary to the patient’s, family’s and physician’s wishes and orders. This often leads to significant detrimental consequences for the patient and family and is inappropriate use of limited human and financial resources.
To address this issue, and to ensure that a standardized process that allows paramedics and firefighters to honor the DNR wishes of patients, a DNR Task Force was convened in September 2003. Its efforts have resulted in the new The Do Not Resuscitate Confirmation Form, which will become the new standard of care in Ontario as of February 1, 2008. When this form has been completed by a physician or nurse (RPN, RN, RN (EC), paramedics and firefighters will now be authorized to withhold life support measures (as defined above). In addition, they will now be authorized to provide comfort (palliative) care as appropriate (oropharyngeal suctioning, O2, nitroglycerin, salbutamol, glucagon, epinephrine, opiods, ASA or benziodiazepines).

To access the enclosed form DNR Confirmation Form, go to the Government of Ontario website:
http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/AttachDocsPublish/014-4519-45~`/$File/4519-45.pdf
It can be ordered by going:
http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/FormDetail?OpenForm&ACT=RDR&TAB=PROFILE&ENV=WWE&NO=014-4519-45
More specific information and details regarding the form and its use can be obtained in the following Ontario Medical Review article:
Verbeek PR, Sherwood C. End-of-life care in the home: How a new procedure for Ontario paramedics and firefighters may affect your patients and your practice. Ontario Medical Review 2007 November; Vol 74 (10):39-42. Please go to: https://www.oma.org/pcomm/OMR/nov/07maintoc.htm
Family physicians will play a pivotal role in the successful implementation of this new standard. It is up to those of us who provide care at home to patients at the end of life who must now make concerted efforts to ensure that this new process will honor our patients’ wishes and prevent the untoward consequences which occur too often despite our best intentions.
Sandy Buchman MD CCFP FCFP
Past President
The Ontario College of Family Physicians


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## medicineman (24 Jun 2016)

dapaterson said:
			
		

> Medicineman: Anecdotally I have heard of modern-day doctors who have similar approaches to pain management with morphine.  Perhaps with appropriate legislation they can do it "on the books" instead of doing it with a wink and a nudge.



One would hope...

In Manitoba, we have a form called "Notice of Anticipated Death at Home" we send to the Chief Medical Examiner's office once someone is into their final days/weeks, so that all that needs to occur is someone to fill out the Certificate of Death with time and date and call the funeral home to remove the body.  The thing that used to annoy the crap out of me was the fact we couldn't do that for PCH residents, even though the PCH was their home - they always became notifiable deaths, so there was a decent amount of paperwork to be done, I had to talk to the Medical Investigator at the ME's office, etc.

MM


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## mariomike (24 Jun 2016)

medicineman said:
			
		

> In Manitoba, we have a form called "Notice of Anticipated Death at Home" we send to the Chief Medical Examiner's office once someone is into their final days/weeks, so that all that needs to occur is someone to fill out the Certificate of Death with time and date and call the funeral home to remove the body.



In Manitoba, what documentation is with the patient at home?


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## Kirkhill (24 Jun 2016)

Interesting about the Confirmation Form.

At first I reacted to the additional "bureaucracy" but after reading Dr. Buchman's letter I think I get it.

The paramedics offer an emergency response.  A person dying at home and not desirous of resuscitation is not an emergency.  The problem here likely comes from the spouse or kids or grandkids, confronted by their loved one's demise,  and with or without knowledge of the DNR request, putting in a phone call.

The family needs to be at peace as much as the person passing.  And I guess that is true about all parts of this discussion.  It is not just a personal matter.


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## mariomike (24 Jun 2016)

Chris Pook said:
			
		

> The paramedics offer an emergency response.  A person dying at home and not desirous of resuscitation is not an emergency.  The problem here likely comes from the spouse or kids or grandkids, confronted by their loved one's demise,  and with or without knowledge of the DNR request, putting in a phone call.



"The ambulance siren alerts your neighbours. The Call Originator realizes they have made a mistake. But it’s too late. Someone dialed 9-1-1 and triggered the system. Soon paramedics are rushing through the front door and into the bedroom. 

The paramedics attempt to coax life back into the body, a futile effort, and yet, despite your pleas for them to stop, they persist. Then you hear more sirens. Seconds later, you are standing in your driveway, a police officer peppering you with questions, and neighbours, curious about the commotion, peering at you through slits in living room curtains. Your grandfather didn’t want this. You didn’t want this. Nobody wanted this.

So much for a peaceful death at home."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291668/

“People panic and think that calling 911 means they are just calling for help, but what they are doing is triggering a cascade of events.”


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## medicineman (24 Jun 2016)

mariomike said:
			
		

> In Manitoba, what documentation is with the patient at home?



A copy of that, and a copy of the Advanced Care Directive...which actually annoys me when someone with an ACP "C" (comfort care only) gets sent to the ER by PCH staff when they're starting a downward spiral - they should be staying put.  For some reason, the staff get spooked by dying people actually dying in their "own" home as it were :.

MM


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## Cloud Cover (24 Jun 2016)

On the supposed Dutch practice relating to PTSD and mental anguish, and combining that with walking off into the bush in the winter.  I really do believe that there is still not enough being done to treat mental health properly, and many of our social norms and practices actually make it worse. Many people conclude there is no point living any more because they will never feel "free" from whatever triggers them, or simply cannot allow themselves to be happy by setting borders and having a sense of self worth. This is a major, major problem in this country and it hardly discussed much less supported by governments and communities. Psychologists and therapists should not be a delisted service under our health care system. How many people who bear unspeakable memories are walking off into the bush that we don't know about. Death from drug overdose, mental anguish brought about on the persecutory actions of others (our family law system does a great job of that with men), etc. 
Having a state appointed person to perform "the deed" is one thing, but performing "the deed" because a person is suffering from PTSD or another mental health problem is quite another.    In our society, suicide wrongly is considered "selfish", how do we change that moral position?


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## Kirkhill (24 Jun 2016)

medicineman said:
			
		

> A copy of that, and a copy of the Advanced Care Directive...which actually annoys me when someone with an ACP "C" (comfort care only) gets sent to the ER by PCH staff when they're starting a downward spiral - they should be staying put.  For some reason, the staff get spooked by dying people actually dying in their "own" home as it were :.
> 
> MM



Perhaps that goes to what I was suggesting with respect to the "oaths" that the professionals take. 

Is there an acceptance of the concept of "a good death"?


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## Fishbone Jones (24 Jun 2016)

mariomike said:
			
		

> Or, sometimes they _don't_  want paramedics to resuscitate. The family hands you a DNR order signed by the doctor.
> 
> But, in Ontario, when called to respond to a scene where a person has lost vital signs, and in the absence of a Do Not Resuscitate Confirmation Form (DNRCF), _even if a DNR Order is presented to attending paramedics_, under regulations of the MOHTLC, paramedics must begin resuscitative measures.



What if a person had 'Do Not Resuscitate' tattooed on their chest where the paddle goes?

The problem I have with the form, is that it's only good if there is someone there to present it or you are at the place of it being held. If I'm at a restaurant, by myself, they'll attempt to revive against my wishes because I don't have a piece of paper. However, if it's tattooed on me, that was obviously my choice and it should be accepted as my wishes.


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## Gunner98 (26 Jun 2016)

As to the suggestion of an "Executioner", would you prefer Terminator or End of Life Guide?

The main issues IMHO are:
- Past generations are dead,
- Will you or your generation live for ever,
- Should we have a voice in determining how and when we die?  Some people smoke, others participate in dangerous sports/endeavors, do we deem these actions illegal.

What if the granter of wishes for assisting you in dying was your spiritual guide (Priest, Minister, Imam, Rabbi etc.) and for those without one, then it is their immediate family that needs to concede.

I would prefer to have an informed discussion as was the case with my father in which the immediate family gathered at his bedside, he was kept "medication-induced" comfortable until he took his last breath, rather than being told to go get some rest and being called a few hours later that Mom had passed alone.

Is there a moral or ethical difference between assisted dying, suicide, and dying by refusing care in the case of terminal cancer patients?

A key point in the discussion is that under assisted dying laws in other countries such as The Netherlands (also referred to as Euthanasia and Assisted suicide), it is illegal; however, the medical practitioner is not punishable as long as specific guidelines are followed.


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## Kirkhill (26 Jun 2016)

I am agnostic on what the Executioner is called so long as it is not some feel good euphemism like "Spiritual Guide".

I was unaware that the Dutch law still consider the act illegal but allowed it to be justifiable.  In my view that goes a long way to resolving some of my internal debates.

WRT the mode of egress - that is a matter for the individual to decide.  Whether they choose to involve their family or their god is up to them.  

I don't think that anybody should be forced to kill somebody against their wishes.  (and before anybody chirps up with Soldiers! - they volunteer for the job knowing what the job requirements are).


----------



## mariomike (26 Jun 2016)

Chris Pook said:
			
		

> WRT the mode of egress - that is a matter for the individual to decide.



I prefer _not_  to go the DIY route for certain jobs, because I might botch it. Would rather hire a pro to handle it instead.


----------



## Kirkhill (26 Jun 2016)

mariomike said:
			
		

> I prefer _not_  to go the DIY for certain jobs, because I might botch it. Would rather hire a pro to handle it instead.



Me too.  But I don't want somebody doing the job because they have been coerced either.


----------



## mariomike (26 Jun 2016)

I suppose one could become a Suicide Tourist and fly to Switzerland on a one-way ticket,

Zurich voters keep 'suicide tourism' alive
http://www.foxnews.com/world/2011/05/15/zurich-voters-suicide-tourism-alive.html
Voters in Zurich have overwhelmingly rejected calls to ban assisted suicide or to outlaw the practice for nonresidents

Or do it on the cheap at a pet shop in Mexico,

Euthanasia tourists snap up pet shop drug in Mexico
http://www.reuters.com/article/us-mexico-euthanasia-idUSN0329945820080603?sp=true
Elderly foreign tourists are tapping Mexican pet shops for a drug used by veterinarians to put cats and dogs to sleep that has become the sedative of choice for euthanasia campaigners.

Clutching photos of the bottled drug to overcome a lack of Spanish, they have maps sketched by euthanasia activists to locate back-street pet shops and veterinary supply stores near the U.S. border. There they can buy a bottle for $35 to $50, enough for one suicide, no questions asked.

Nine myths about euthanasia in the Netherlands

Euthanasia is really easy is in the Netherlands 

Elderly Dutch people prefer to go to hospitals abroad for fear of being murdered by doctors in hospitals in the Netherlands

Children can use euthanasia to get rid of their elderly parents in order to get their hands on the inheritance

A Dutch clinic is to open where you can end your life

One telephone call and a mobile team turns up to end your life

Dutch people go around with wristbands saying they don’t want to be euthanized

Ten percent of Dutch deaths are down to euthanasia and many people are forced into it 

Everyone can come to the Netherlands in order to have their life terminated

Parents can get rid of their handicapped child
https://www.rnw.org/archive/nine-myths-about-euthanasia-netherlands


----------



## mariomike (17 Sep 2016)

Sep 17, 2016 

Belgian minor granted euthanasia for first time ever
http://www.680news.com/2016/09/17/belgian-minor-granted-euthanasia-for-first-time-ever/
Belgium is the only country that allows minors of any age assistance in dying, De Gucht said. In Holland, the lower age limit for euthanasia is 12 years.


----------



## mariomike (1 Dec 2017)

recceguy said:
			
		

> What if a person had 'Do Not Resuscitate' tattooed on their chest where the paddle goes?



Canadians vacationing in Florida may find this of interest,

1 Nov., 2017

Man has 'Do Not Resuscitate' tattooed on his chest. Doctors at the University of Miami Hospital Emergency Room honored it.
http://www.nejm.org/doi/full/10.1056/NEJMc1713344#.Wh84KQwAH0s.twitter


----------



## commander-cb (1 Dec 2017)

When my dad died a couple years ago
He had strokes at " the end " .he was not doing well. And likely was done for.
But he was a tough guy a I -suspect- the nurses did everybody a favour and kinda tipped the scales


----------



## mariomike (5 Dec 2017)

We used to joke about what we would do if we ever saw a DNR tattoo, but I never saw one.

Dec. 4, 2017
Tattooed wish for withholding treatment not good enough, doctors say
https://ca.news.yahoo.com/tattooed-wish-withholding-treatment-not-good-enough-doctors-191018739.html

See also,

DNR Order  
https://army.ca/forums/threads/67123.0


----------



## expwor (5 Dec 2017)

Just a couple quick thoughts from the civie side of the street.  Recently I had a Stroke, well mini Stroke, well more accurately a TIA (transient ischemic attack) for which thank God I made a full recovery.  Anyhow one of the first things I did was get a Medic Alert.  Couldn't for someone in the Canadian Forces who wants a DNR get a Medic Alert. There is a section on the on line form for "Special Needs" and the person could enter DNR. And the person could attach the Medic Alert medallion to the chain holding their identity disk. On top of that there would be a wallet card issued by Medic Alert for medical personal to look at
And second thing about what to call someone who ends a patient's life who has a DNR order.  Instead of executioner, how about executor or DNR Executor
Anyhow posted for whatever it's worth

Tom


----------



## mariomike (5 Dec 2017)

The Do Not Resuscitate Confirmation Form ( attached ) is the only order ( Ontario ) paramedics can accept.


----------



## mariomike (24 Dec 2017)

Aid-In-Dying Process Not as Graceful as Imagined ...By The Phrase 'Not As Graceful' They Mean It Is A Prolonged Gruesome Death.
https://www.usnews.com/news/best-states/colorado/articles/2017-12-23/aid-in-dying-process-not-as-graceful-as-couple-imagined

At some point someone will take the dose, it will not go as expected or panic will set in and EMS will be called. One Heck of a job to go to.


----------



## Cloud Cover (2 Jan 2018)

WRT the post above that there are people in NL that are being euthanized against their will  - what is the hard, verifiable and reliable proof of this? It seems to me if this is the case, the Ministry of Justice is not enforcing the law.
That being said, the practice  of assisted suicide (different and distinct from euthanasia) is a reality whose time has come in Canada, and the courts have confirmed this, there is no going back.

Re: DNR, why not a secure NFC medallion that authenticates the identity of a person who  can choose to wear it (or not). In Ontario, the e Healthcare records system should be able to handle this.


----------



## mariomike (2 Jan 2018)

whiskey601 said:
			
		

> WRT the post above that there are people in NL that are being euthanized against their will  - what is the hard, verifiable and reliable proof of this?



The post above is about Colorado. If you quote the post, we can answer your question.



			
				whiskey601 said:
			
		

> Re: DNR, why not a secure NFC medallion that authenticates the identity of a person who  can choose to wear it (or not). In Ontario, the e Healthcare records system should be able to handle this.



Interesting idea. This is the law in Ontario if paramedics arrive on scene,

"In Ontario, paramedics can only follow DNR Orders in the presence of a form issued by the Ontario Ministry of Health and Long Term Care. Called “Do Not Resuscitate Confirmation Form” (Ontario Publication Number 4519-45 (07/10)). This document is the only order paramedics can accept as a true medical directive—one that allows them to NOT initiate resuscitative measures when a person loses vital signs outside of a healthcare facility. It is important to note that the DNR Confirmation Form is not a DNR order—but rather confirms the existence of a duly filled and signed DNR order.

When called to respond to a scene where a person has lost vital signs, and in the absence of a confirmation form (DNRCF), even if a DNR Order is presented to attending paramedics, under regulations of the MOHTLC, paramedics must begin resuscitative measures. 

With an expectation from family members that paramedics will follow the final wishes of their loved ones, the absence of the DNRCF can result in a massive case of misunderstanding and a lot of pain and stress for family members."
http://www.health.gov.on.ca/en/pro/programs/ehs/docs/ehs_training_blltn108_en.pdf


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## pbi (24 Jan 2018)

This subject is close to me as in the last few years I have dealt with the prolonged dying of three people I loved. Two cases played out within a year each, but were very painful and distressing. The third took several years, but subjected the person to an "existence" rather than a "life": something I know very clearly that person had said, over and over again, they would never want. Death, when it finally came, was a release.

My wife and I are both Christians (me being perhaps rather a struggling and backsliding one, but, anyway...): she is a Catholic and I am Anglican. Neither of us regard suicide lightly. We have discussed this issue at length, but we have come to share the same views:

-your life is your life: when an adult of sound mind decides they don't want to go on, we should respect that. And, I specifically mean "an adult of sound mind"-not a minor or a person who is mentally unfit;

-people need to plan for their deaths (most people don't want to do this but, believe me, it is one of the kindest things you can do for your survivors);

-you must make sure you appoint a Power of Attorney for Care, in writing, while you are still of sound mind and body. This allows the PoA to make important decisions. Without PoA you actually have very little or no legal status (a surprising thing I learned);

-you should tell your family what you want. Everybody dies: get over it, and sort it out with your family;

-no doctor should be forced against their belief to participate in assisted death. (And, some suggestions above to the contrary, I don't think any jurisdiction in Canada actually forces this on medical professionals);

-we should be very careful to avoid laws that are susceptible to such loose interpretation that we can easily pull the plug on Uncle Bill just to get our hands on the cash.

I'm not familiar with the situation in NL but it seems to me their law is too permissive and thus open to abuse. But that is only my opinion.


----------



## Colin Parkinson (26 Feb 2018)

Sadly we have a friend dying of ALS who is likely to take this option in the next 3-4 months based on his rate of decline. Terrible things happen to nice people  :'(


----------



## mariomike (26 Feb 2018)

pbi said:
			
		

> I'm not familiar with the situation in NL but it seems to me their law is too permissive and thus open to abuse. But that is only my opinion.



For reference to the discussion,

Euthanasia in the Netherlands
https://en.wikipedia.org/wiki/Euthanasia_in_the_Netherlands


----------



## pbi (26 Feb 2018)

mariomike said:
			
		

> For reference to the discussion,
> 
> Euthanasia in the Netherlands
> https://en.wikipedia.org/wiki/Euthanasia_in_the_Netherlands


Now that I've read the provisions, I agree with all of them except the one allowing minors to select euthanasia. I'm not comfortable with that bit, although I note the requirement for parental consent.



> ...the patient's suffering is unbearable with no prospect of improvement
> the patient's request for euthanasia must be voluntary and persist over time (the request cannot be granted when under the influence of others, psychological illness or drugs)
> the patient must be fully aware of his/her condition, prospects, and options
> there must be consultation with at least one other independent doctor who needs to confirm the conditions mentioned above
> ...


----------



## mariomike (28 Mar 2018)

Thinking of getting a DNR tattoo?

QUOTE

March 27, 2018 

Beware: Hospitals think ‘do not resuscitate’ means you don’t want to live

When you’re admitted to a hospital, you’re routinely asked if you want to sign a Do Not Resuscitate order. Don’t assume it’ll apply only in extreme circumstances.

New research shows having those three letters — DNR — on your chart could put you on course to getting less medical and nursing care throughout your stay. Fewer MRIs and CT scans, fewer medications, even fewer bedside visits from doctors, according to the Journal of Patient Safety. A DNR could cost you your life.

They misconstrue DNR as Dying Not Recovering.

They even hesitate to put DNR patients in the ICU when they need intensive care.

No wonder patients with DNRs have far worse recovery rates than patients with identical conditions and no DNRs, new findings in Critical Care indicate. Women are especially affected, data show.

END QUOTE

More at the link.
https://nypost.com/2018/03/27/beware-hospitals-think-do-not-resuscitate-means-you-dont-want-to-live/

See also,

DNR Order  
https://army.ca/forums/threads/67123.0/nowap.html


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## mariomike (16 Apr 2018)

Users would first take an online test to determine whether they were sane. If they cleared the test, they would be sent an access code, valid for 24 hours. They would then get into the capsule, close the door & press a button to have the nitrogen pipe in.

15 April, 2018
https://www.washingtonpost.com/news/worldviews/wp/2018/04/15/a-euthanasia-expert-just-unveiled-his-suicide-machine-at-an-amsterdam-funeral-fair/?utm_term=.5997ef2fd012


----------



## jollyjacktar (16 Apr 2018)

How about this?  I've always liked it.


https://youtu.be/EbmQxZkSswI


----------



## Kirkhill (14 Nov 2022)

We're not the Good Guys.   Right up there is China's One Child Policy?

It might be comforting to dismiss the Canadian experience as an aberration and Canada as an alien country inhabited by a barbarous people. 



Canada's harrowing euthanasia experiment should be a warning to the world
Parliament is now calmly discussing whether disabled children could be euthanised by doctors. In other words, infanticide

YUAN YI ZHU
14 November 2022 • 1:40pm
Yuan Yi Zhu

The representative of the medical regulator spoke in a straightforward, unemotional voice, as though his statements were self-evidently true. Sick children between the ages of 14 and 17, he told the parliamentary committee, should be allowed to choose to commit suicide with medical assistance.

Parents of babies who are born with severe disabilities should be allowed to kill them. Elderly people for whom “life no longer makes any sense” should also be able to end theirs. And so should the mentally ill, and so on and on. Members of the committee ask some follow-up questions, but no one pushes back.

Ever since it burst into the public consciousness almost a year ago, details of Canada’s assisted suicide scheme, known euphemistically as MAiD — medical assistance in dying — have shocked and astonished people around the world in equal measure. Harrowing tales of disabled poor people choosing to end their lives because they could not survive on paltry benefits have since proliferated, as have horror stories of doctors and bureaucrats trying to pressure patients into ending their lives.

Yet the parliamentary committee charged with reviewing the regime seemed to take for granted that access to euthanasia should be expanded to include even more people. The only remaining question will be by how much.

True, there had been warnings that once euthanasia became legal in Canada, its scope would widen rapidly beyond the initial target group of terminally ill people, as had happened in almost every country where it had been legalised. But the Canadian supreme court loftily dismissed these concerns as a “slippery slope” fallacy when it struck down the criminal prohibition on assisting suicide in 2015.

Then a Quebec court ruled that to limit euthanasia access to those whose deaths were “reasonably foreseeable” discriminated against those whose illness were not terminal — euthanasia was, after all, a human right according to the courts.

Fast-forward a few years, and the Canadian parliament is now calmly discussing whether disabled children could be euthanised by doctors. In other words, infanticide. Nor will euthanasia be limited to physical illness: from next year, mental illness will become a qualifying condition. Already, depressed teenagers on social media are speaking about applying to die once they turn 18.

It might be comforting to dismiss the Canadian experience as an aberration and Canada as an alien country inhabited by a barbarous people. But Canada is a country with a culture much like that of the UK, with an overextended healthcare system, a social care system that is perpetually near collapse, a strained exchequer, and an ageing population.

The perverse incentives which led to Canada’s predicament, in other words, are all present in the UK as well. As is the same heightened culture of human rights discourse, whereby any rights-based claim is given automatic deference, and which has made opposition to euthanasia so politically toxic in Canada. No politician, after all, wants to be seen as taking away rights from the people.

Indeed, the cultural centrality of the National Health Service may make the UK an even more fertile ground for abuse. “Protect the NHS” was a powerful unifying message during COVID, but it is not difficult to see how a society in which such a slogan kept people from receiving cancer treatment might also be fertile ground for euthanasia-related abuse.

And one only needs to remember the Liverpool Care Pathway scandal, when elderly patients were denied basic medical care and even food and water without their consent, to see how catastrophic systemic failure may easily happen once again and shorten many lives. 

The Scottish Parliament will shortly be debating a bill to legalise euthanasia. Its proponents will make the same usual arguments about choice and autonomy, trot out heart-rending cases, and talk about the ironclad safeguards within their proposed system. 

While our sympathies will be with those at the end of their lives suffering from great pain, the Canadian experience should serve as a warning to anyone who thinks euthanasia will be confined to those cases. After all, the idea that the murder of disabled children could become legal was once far-fetched in Canada too.









						Canada's harrowing euthanasia experiment should be a warning to the world
					

Parliament is now calmly discussing whether disabled children could be euthanised by doctors. In other words, infanticide




					www.telegraph.co.uk
				





Conservatism comes in all sorts of shapes.


----------



## Brad Sallows (14 Nov 2022)

That old slippery slope down which we surely will never slide... Assisted Suicide for Poverty.


----------



## Eaglelord17 (14 Nov 2022)

It is only a issue if you view suicide as a sin.

My issue with the arguments against euthanasia is basically we don’t believe people have the right to die usually based off a religious conviction of some sort (life is sacred, etc.).

Personally I tend to fall a lot closer to the Futurama suicide booth set up. To me suicide isn’t always a bad thing and can be honourable in some cases (ex. your becoming a burden and you have no prospects of getting better, etc.). Not to mention I believe its your life therefore you should have the right to end it if you wish.

Most the euthanasia legislation simply provides the option for individuals who wouldn’t be able to on their own or would be forced to do it in a cruel manner.


----------



## OldSolduer (14 Nov 2022)

Brad Sallows said:


> That old slippery slope down which we surely will never slide... Assisted Suicide for Poverty.


Right.

We - Canada - needs to tread with caution


----------



## Kirkhill (14 Nov 2022)

Eaglelord17 said:


> It is only a issue if you view suicide as a sin.
> 
> My issue with the arguments against euthanasia is basically we don’t believe people have the right to die usually based off a religious conviction of some sort (life is sacred, etc.).
> 
> ...



My problem is with "power of attorney", "in loco parentis", "ward of the state".

I can't see inside another mind.


----------



## mariomike (14 Nov 2022)

See also,









						Assisted Dying.
					

I approach with trepidation.  I want to keep politics out of this as much as possible.  If it gets too heated I will ask the moderators to shut this thing down quickly.  I am an orphan.  Both of my parents died in their 50s of cancer.  My father elected treatment. My mother rejected treatment...




					army.ca


----------



## Brad Sallows (14 Nov 2022)

The problem is when people start nudging other people and the process is permissive rather than obstructive.


----------



## OldSolduer (14 Nov 2022)

I am an ASIST facilitator and this discussion comes up every time. We try to steer the discussion away from this and towards your "typical" suicidal person.


----------



## daftandbarmy (14 Nov 2022)

Brad Sallows said:


> The problem is when people start nudging other people and the process is permissive rather than obstructive.



Like in Holland?

*Historically, the Netherlands was the first European country to decriminalize euthanasia and assisted suicide by a law passed in 2001. The number of individuals who have been euthanized has grown steadily every year, constituting a worrisome cultural shift, which is especially troubling for the most vulnerable in society.*

This report provides an in-depth review of the current situation, including statistical data, existing laws, and laws currently being debated to broaden its scope. This report examines the main ethical infringements observed, demonstrating an increasingly loose interpretation by the supervisory bodies, to the point that even the United Nations is concerned.

Euthanasia has been legal in the Netherlands for over 15 years, since the April 12, 2001 law was passed, and came into vigor on April 1, 2002. Historically, the Netherlands was the first European country to authorize euthanasia. Since legalization, euthanasia has more than tripled. The figures presented each year by the regional euthanasia review committees also show an increasing number of infringements, and a looser and looser interpretation of the stipulations of the 2001 law.

Even though the precise conditions established by law have not changed _“stricto-sensu”_, their very extensive interpretation has created increasingly disputable situations. For example euthanasia on people with psychiatric disorders, dementia, those who are very old, or those suffering from several pathologies, has nothing to do with the initially established legal requirements. Other opinions are being voiced, notably by some doctors who deplore that euthanasia has been trivialized.

While some denounce the infringements of the law, others wish to broaden the conditions of access to euthanasia and the practices. Parliament is being pressured to allow assisted suicide for people over age 70 requesting it, with no other motive but their age and “being tired of life”. Thus, the association “By Free Will” (_Uit vrije will_) organized a citizen’s initiative petition early in 2010, in order to force a Parliamentary debate. A draft bill tabled by the government in October 2016 is currently being studied.









						Euthanasia in the Netherlands - Alliance VITA
					

Facebook Twitter LinkedIn




					www.alliancevita.org


----------



## Dana381 (14 Nov 2022)

They are also making it so children who are considered "mature minors" can get assisted suicide without parents knowledge. 

Your 15 year old could go to school and tell someone they are depressed, go to a hospital and commit suicide and you would be left wondering why they didn't come home on time 

Madness!


----------



## daftandbarmy (14 Nov 2022)

Dana381 said:


> They are also making it so children who are considered "mature minors" can get assisted suicide without parents knowledge.
> 
> Your 15 year old could go to school and tell someone they are depressed, go to a hospital and commit suicide and you would be left wondering why they didn't come home on time
> 
> Madness!



This article suggests that kids over 12 need 'parental permission', you know, like for the typical school out trip 


*The Dutch government has approved plans to allow euthanasia for terminally ill children aged between one and 12.*

On Tuesday, Health Minister Hugo de Jonge said the rule change would prevent some children from "suffering hopelessly and unbearably".
Euthanasia is currently legal in the Netherlands for children older than 12, with mandatory consent from the patient and their parents.
It is also legal for babies up to a year old with parental consent.









						Netherlands backs euthanasia for terminally ill children under-12
					

The Dutch government approves plans to allow euthanasia for some terminally ill children.



					www.bbc.com


----------



## dapaterson (14 Nov 2022)

Dana381 said:


> They are also making it so children who are considered "mature minors" can get assisted suicide without parents knowledge.
> 
> Your 15 year old could go to school and tell someone they are depressed, go to a hospital and commit suicide and you would be left wondering why they didn't come home on time
> 
> Madness!


Have you reviewed the MAiD processes?  Or are you just spewing FUD?


----------



## Dana381 (14 Nov 2022)

daftandbarmy said:


> This article suggests that kids over 12 need 'parental permission', you know, like for the typical school out trip
> 
> 
> *The Dutch government has approved plans to allow euthanasia for terminally ill children aged between one and 12.*
> ...



So this is where I got my original information.




I thought I had verified it but I guess I was still too mad to think clearly. Now every link I find on the subject that isn't from Fox suggests the GOC is planning to study the mature minor eligibility criteria and one even mentioned that there is a 10 day waiting period for any one of any age.

I fully believe that mature minors will be allowed eventually as they are allowed an abortion without their parents knowledge. More and more it seams that medical professionals see parents as an obstacle to children blindly believing and following their medical advice.


----------



## Kirkhill (14 Nov 2022)

Dana381 said:


> So this is where I got my original information.
> 
> 
> 
> ...



Time to reset the clock - you get to get married, vote, go to war and harm yourself any way you please after your Bar/Bat Mitzvah.   13 was the age of majority for English runaways at Gretna Green in Scotland.


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## Dana381 (14 Nov 2022)

Kirkhill said:


> Time to reset the clock - you get to get married, vote, go to war and harm yourself any way you please after your Bar/Bat Mitzvah.   13 was the age of majority for English runaways at Gretna Green in Scotland.


This hits close to home as me and more than one of my friends went through states of depression as teenagers. 
When I was 15 I was in really bad shape, now I'm 43 with 8 kids of my own and my oldest is 15. Thankfully they are much happier than I was at their age. Had we been allowed this without our parents knowledge I'm sure some of us would have done it.


----------



## mariomike (14 Nov 2022)

Most of the suicides I encountered on a professional basis were past the point of discussion.  

But, I do recall what one young woman said to me when I asked her why she had attempted. She said if just one person had smiled at her, in what was to have been her final hour, she would not have attempted it.


----------



## Blackadder1916 (14 Nov 2022)

Dana381 said:


> . . .. More and more it seams that medical professionals see parents as an obstacle to children blindly believing and following their medical advice.



Accepting the decisions of a mature minor is not something that evolved from the whims of the medical profession but rather from legal/judicial opinion and legislation.  Even so, informed consent is not something that is taken lightly and, while it may seem pro forma when providing consent to a medical procedure, considerable thought (and experience) is involved when seeking consent to treatment.

Some quick and easy (Alberta specific) resources to remind medical professionals the steps to take


			https://www.albertahealthservices.ca/assets/info/hpsp/if-hpsp-phys-consent-summary-sheet-minors-mature-minors.pdf
		



			https://www.albertahealthservices.ca/assets/info/hp/phys/if-hp-phys-consent-mature-minors-algorithm.pdf
		



			https://extranet.ahsnet.ca/teams/policydocuments/1/clp-med-assist-in-death-hcs-165-01.pdf
		



			https://cpsa.ca/wp-content/uploads/2020/06/AP_Medical-Assistance-in-Dying.pdf
		


And a search on CanLii using "informed consent mature minor" provides a number of discussions about the legal basis including some dealing specifically with MAiD.


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## daftandbarmy (15 Nov 2022)

Dana381 said:


> This hits close to home as me and more than one of my friends went through states of depression as teenagers.
> When I was 15 I was in really bad shape, now I'm 43 with 8 kids of my own and my oldest is 15. Thankfully they are much happier than I was at their age. Had we been allowed this without our parents knowledge I'm sure some of us would have done it.



Dude... I only have 2 kids. If I had 8 I'd be signing myself up for an 'Edward G. Robinson' tomorrow


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## brihard (15 Nov 2022)

Blackadder1916 said:


> Accepting the decisions of a mature minor is not something that evolved from the whims of the medical profession but rather from legal/judicial opinion and legislation.  Even so, informed consent is not something that is taken lightly and, while it may seem pro forma when providing consent to a medical procedure, considerable thought (and experience) is involved when seeking consent to treatment.
> 
> Some quick and easy (Alberta specific) resources to remind medical professionals the steps to take
> 
> ...


Back to this later as I literally wrote a paper on this for class this past summer, but at present, to the best of my knowledge, we have no ‘mature minor’ case law in the context of MAiD. Is it coming? Yeah, potentially. But, at present, the foreseeable evolution in the law is a step or two shy of this. Major minors are, at present, an academic discussion, not yet a legal one in the sense that any cases I know of before the courts would decide that at any jurisdictional level. The law will soon need to decide what difference there is that allows a mature minor to decline cancer treatment that will result in their death, and deciding to choose MAiD for an irremediable medical condition. Not sure how that’ll play out.


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## Blackadder1916 (15 Nov 2022)

brihard said:


> Back to this later as I literally wrote a paper on this for class this past summer, but at present, to the best of my knowledge, we have no ‘mature minor’ case law in the context of MAiD. Is it coming? Yeah, potentially. But, at present, the foreseeable evolution in the law is a step or two shy of this. Major minors are, at present, an academic discussion, not yet a legal one in the sense that any cases I know of before the courts would decide that at any jurisdictional level. The law will soon need to decide what difference there is that allows a mature minor to decline cancer treatment that will result in their death, and deciding to choose MAiD for an irremediable medical condition. Not sure how that’ll play out.



Seen.

My response was a general comment on informed consent of mature minors and not specifically in reference to MAiD.  It was a reply to address the portion (that I excerpted and quoted) of @Dana381's post that suggested it is the medical profession that is expanding the ability of minors to consent to medical treatment that may be contrary to the wishes of parents/guardians.


----------



## Dana381 (15 Nov 2022)

daftandbarmy said:


> Dude... I only have 2 kids. If I had 8 I'd be signing myself up for an 'Edward G. Robinson' tomorrow



I must admit I don't understand the reference?


Blackadder1916 said:


> Seen.
> 
> My response was a general comment on informed consent of mature minors and not specifically in reference to MAiD.  It was a reply to address the portion (that I excerpted and quoted) of @Dana381's post that suggested it is the medical profession that is expanding the ability of minors to consent to medical treatment that may be contrary to the wishes of parents/guardians.



Or knowledge of. My fear with this is that the only counseling a child may get is from someone who is not allowed to discourage it. One article I read said the current practice in some cases is to offer suicide as a treatment option I.e. "you can have chemo, radiation, or MAiD". What if that same pattern happens to a child with crippling depression? "Your options are medicine, counseling, or MAiD." Because the practicioner isnt allowed to leave MAiD out untill specifically asked for. Then let's say the whole process goes on without the parents knowledge. Like with abortions now. 

Loving parents can miss things in their kids, my mom was a good mom and loving, but she had no idea what I was going through untill she found some stuff I had written. Then things changed and she worked hard to help me and here I am today.


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## daftandbarmy (15 Nov 2022)

Dana381 said:


> I must admit I don't understand the reference?



Probably because you're not as old or irrelevant as I am 

_*Soylent Green*_ is a 1973 American ecological dystopian thriller film directed by Richard Fleischer, and starring Charlton Heston, Leigh Taylor-Young, and Edward G. Robinson in his final film role. It is loosely based on the 1966 science fiction novel _Make Room! Make Room!_ by Harry Harrison, with a plot that combines elements of science fiction and a police procedural. The story follows a murder investigation in a dystopian future of dying oceans and year-round humidity caused by the greenhouse effect, with the resulting pollution, depleted resources, poverty, and overpopulation.[2] In 1973, it won the Nebula Award for Best Dramatic Presentation and the Saturn Award for Best Science Fiction Film.

Roth is so shaken by the truth that he decides to "return to the home of God" and seeks assisted suicide at a government clinic. Thorn rushes to stop him but arrives too late. Before dying, Roth tells his discovery to Thorn. Thorn moves to uncover proof of crimes against humanity and to bring it to the attention of The Supreme Exchange in order that the case be brought to the Council of Nations to take action.









						Soylent Green - Wikipedia
					






					en.wikipedia.org


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## mariomike (20 Nov 2022)

Regarding MAID.

I received an invitation from my retirement organization to attend: 
*Understanding Medical Assistance in Dying (MAID): The Ontario Experience*​I wonder if that is something being sent to other "boomers"? 😲


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