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Canada: As desperation leads woman to suicide, husband's fate hangs in balance [EuthaNEWSia, Feb. 24, 2010]
http://www.euthanewsia.ca/archive/2010/02/enid201002240549.4.html

Jobless, homeless and stranded in an unfamiliar city, Yanisa Fonteece decided to kill herself with sleeping pills on a glacial day in Thunder Bay a year ago. She asked her husband not to interfere as she choked and vomited on her motel bed, a picture of Jesus placed near her head. Peter Fonteece, who is legally blind, waited until her body turned cold. Then, after three unsuccessful attempts to kill himself, he reported his wife's death. Mr. Fonteece, 47, will appear this morning before Madam Justice Helen Pierce of the Ontario Superior Court for a sentence hearing. He has pleaded guilty to criminal negligence causing death, and Judge Pierce, a former social worker, will decide whether Mr. Fonteece has to spend time in jail.

Canada: Latimer tragedy gives flight to Dove [Edmonton Journal]
http://www.edmontonjournal.com/Latimer+tragedy+gives+flight+Dove/3012235/story.html
An extract from the introduction to the review of the 1996 play now being performed at the Catalyst Theatre in Edmonton:

Mourning Dove, a play by Emil Sher that's being produced by Edmonton indie company Kill Your Television, is inspired by the true story of Robert Latimer. The Saskatchewan farmer killed his disabled 12-year-old daughter, Tracy, in 1993. Tracy was born with a severe form of cerebral palsy, and Latimer said he ended her life because he loved her and couldn't bear to watch her suffer. He was convicted of second-degree murder and sentenced to life in prison with no chance of parole for 10 years.

The Latimer case sparked a national controversy on the rights of people with disabilities and the definition and ethics of euthanasia. Those themes echo in Mourning Dove, and that's what appealed to Kill Your Television. "One thing we try to connect with is the idea of the story of the other, the person on the outside of society," says director Kevin Sutley. The play "is looking at who decides what is right, what is good." The one-act show revolves around the life of Doug and Sandy Ramsay and their daughter, Tina. As Doug wrestles with his unspeakable dilemma, the play raises difficult questions about mercy killing, familial loyalty and personal ethics versus public morality.

Margaret Somerville: Euthanasia may become normal [Western Catholic Reporter]
http://www.wcr.ab.ca/news/2010/0517/cfcps051710.shtml
In the course of a talk to the annual conference of the Canadian Federation of Catholic Physicians' Societies, Margaret Somerville said:

"Today, the argument for euthanasia is the easiest to make," she said, noting the concern for the autonomous individual. "It's my right, my body. The individual has the right to choose death." The arguments against euthanasia concern its effects on institutions, such as the health care system, hospitals, doctors and society as a whole, she said.

People often argue that we are merciful to dogs by euthanizing them, so why shouldn't we do the same for human beings, she said. "We're not dogs!"

Somerville said one of the biggest challenges is to argue there is something special about human beings without using religious reasons. Traditional religion used to serve as a way of putting talk of death into a context of eternity, she said. "It is very difficult to justify suffering without some form of religious argument."

assisted suicide

Canada

London businessman "persecuted" over partner's suicide in Swiss clinic [This Is London]
http://www.thisislondon.co.uk/standard/article-23833514-london-businessman-persecuted-over-partners-suicide-in-swiss-clinic.do
A retired businessman who accompanied his dying partner to a Swiss suicide clinic demanded today to be taken to court nearly a year after his arrest. Alan Rees, 57, is writing to Keir Starmer, the Director of Public Prosecutions, effectively inviting him to bring criminal charges which could result in a jail sentence of up to 14 years.

Mr Rees, of Hackney, was arrested last June after travelling to Dignitas with Raymond Cutkelvin, who had pancreatic cancer. He faces either a police caution or criminal charges. Mr Rees said he would refuse a caution, adding: "I feel persecuted and I can't get on with my life. I feel, angry, upset, frustrated - I've done nothing wrong, I've not committed an offence. They've not allowed me to grieve and treated me like a criminal. It's been very upsetting. Why can't they come to a conclusion? They've got the staff and all my files." The hearing has been postponed until next month because prosecutors law officers still cannot decide if he broke the law.

The report concludes:
A physician, Dr Michael Irwin, is also waiting to be charged by the CPS in connection with the death of Mr Cutkelvin and has also written to Mr Starmer.

VPN providers target censorship-shy Aussies [APCMAG.com]
http://apcmag.com/targeting-filter-vpn-providers-practice-aussie-accents.htm
A report on commercial services advertising VPN Tunnels to avoid Australian Internet censorship for as little as US$8 per month.

Advance Care Study: A Randomized Controlled Trial of "Death Panels" [Palliative Medicine Blog]
http://www.pallimed.org/2010/05/randomized-controlled-trial-of-death.html
Lyle Fettig, MD reports on an Australian study of the impact of a hospital program to intervene and ensure that patients document their end-of-life choices. The key finding: "It was determined that of 25/29 patients who died in the intervention group, wishes were documented and followed versus 8/27 in the control group."

Researchers in Melbourne, Australia conducted a single institution prospective randomized controlled trial to investigate the impact of this advance care planning (ACP) intervention, (Respecting Patient Choices) on end of life care in older patients. BMJ publishes the results.

The intervention was delivered in a hospital setting primarily by a nurse or allied health worker who conducted a conversation to evoke the patient's goals, values, and beliefs, and to discuss and document their future choices about health care. Family members, especially potential surrogates, were encouraged to participate. The creation of advance directive documents was encouraged. In this study, the discussions lasted a median of 60 minutes spanning 1-3 visits. The intervention appears similar to POLST programs in the United States.

Dutch research in use of advanced directives in dementia [World Federation of Right to Die Societies]
http://worldrtd.net/node/980
May 12, 2010: Researchers of the VUmc Amsterdam centre performed a qualitative study in physicians and patients on the use of Advanced Euthanasia Directives (AED) in cases of dementia. This was published in the Dutch Nederlands Tijdschrift voor Geneeskunde (2010;154:A1273).

Notwithstanding the fact that patients with dementia sometimes completely met the requirements for due care as laid down in the Dutch Law, physicians often did not comply with such a (legal!) request, mostly out of fear for legal consequences. The researchers concluded that it seems advisable that more detailed practical guidelines for the use of AEDs in cases of dementia be drawn up, as a first step to more clarity for patients and physicians.

An English excerpt is available from this web page.

USA: Whose Conscience? The Brewing Battle Over Who Makes Your Health Care Decisions [AlterNet.org]
http://blogs.alternet.org/speakeasy/2010/05/11/whose-conscience-the-brewing-battle-over-who-makes-your-health-care-decisions/
Ann Neumann writes in reaction to a recent conservative blog post:

There's a recent post by Peter Wilson at conservative American Thinker that's making the "pro-life" Internet rounds. It addresses the provision in the Patient Protection and Affordable Care Act (the health care bill), Section 1553, that "protects" doctors from participating in assisted suicide (or aid in dying, death with dignity, etc.)…

The clause protects providers who refuse to participate in legal aid in dying - a point that should make "pro-life"groups very happy. No doctor, if asked by a terminal patient to provide a fatal dose of drugs, is obligated to write the prescription. But Wilson, forgetting that many who observed the New Year's Eve Montana Supreme Court decision Baxter v. Montana that determined aid in dying was legal there clamored for a strong conscience clause to protect doctors from having to participate. This clause does so. (Death with Dignity laws in Oregon and Washington, the other two states where aid in dying is legal, already include clear provider refusals that protect doctors from participating.)

Neumann notes that:
Unfortunately, the greatest resources and organization reside in the hands of institutions, churches, and other organizations determined to limit the use of medical technology based on denominational, theological or authoritarian principles. Not to that lone woman who is pregnant, shamed, in a traumatic situation; not to the dying elder who is suffering and no longer wants to be fed through a PEG tube in his belly, not to the rape victim; not to the doctor employed by a Catholic hospital but prevented from telling a troubled teen how to avoid getting HIV.

And Neuman concludes: And here is Wilson's objection to section 1533 of the health care bill: "it reframes the debate as one of civil rights, and brings assisted suicide more into the mainstream." The debate about patients' rights is already about civil rights; and it is already mainstream.

Primary Care Physicians Face Ethical Conflicts With Religious Hospitals, Study Finds [ AAFP News Now (American Academy of Family Physicians)]
http://www.aafp.org/online/en/home/publications/news/news-now/clinical-care-research/20100511hosp-ethics.html
About one in five primary care physicians who have practiced in religiously affiliated hospitals have experienced conflicts deriving from those institutions' religiously based patient care policies, according to a recent study conducted by researchers at the University of Chicago.

Nearly one-fifth of primary care physicians who practice in religious hospitals report having experienced conflicts that involved those facilities' religiously based patient care policies. If a patient needs a medical intervention that is prohibited by such a hospital, most physicians surveyed for the study said they would refer the patient to another institution. Physicians practicing in medically underserved communities, however, could find making such referrals difficult because these areas typically offer fewer health care facility options, say the study's authors.

The study, "Religious Hospitals and Primary Care Physicians: Conflicts Over Policies for Patient Care," was published online in April in the Journal of General Internal Medicine. AAFP member and study author Debra Stulberg, M.D., instructor of family medicine and of obstetrics and gynecology at the University of Chicago, told AAFP News Now that this initial study was intended to present a "10,000-foot-high view" of whether ethical conflicts arise between primary care physicians and religiously affiliated hospitals and, if so, what impact such conflicts have on patient care.

The study revealed that not only did such conflicts arise, they most commonly involved hospital policies governing reproductive health care —  for example, emergency contraception — and end-of-life care, such as terminal sedation.

Ireland: Treatment of the dying revealed in shock report [Medical Futility Blog]
http://medicalfutility.blogspot.com/2010/05/treatment-of-dying-revealed-in-shock.html
The Irish Hospice Foundation has released a new report revealing "harrowing ordeals endured by the dying and lack of respect given to the dead." (Irish Independent) The forum has proposed a comprehensive action plan which calls for a national strategy for end of life, covering a range of areas, including advanced care planning, which would direct how they should be treated at the end of their life. The public has until June 18 to comment on the plan. Posted by Thaddeus Mason Pope, J.D., Ph.D. at 3:19 PM

Dignity New Zealand Trust National Conference announcement [World Federation of Right to Die Societies]
http://worldrtd.net/node/982
Dignity NZ Trust announces its Inaugural National Conference on Assisted Dying "Dignity Havens - from Concept to Reality" scheduled to take place on October 14th and 15th in Wellington, New Zealand. Details with full information and registration will be available on www.dignitynz.co.nz from May 15, 2010….

Although this Conference is not an extension of the World Federation Conference as such it has been scheduled specifically to provide World Federation delegates attending the Melbourne Conference with the opportunity to extend their travel to not only participate in a Conference focused on a practical pathway to our mutual goals but also to enjoy all that New Zealand has to offer.

Idaho should legalize doctor-assisted suicide [Idaho Press-Tribune]
http://www.idahopress.com/opinion/bestread/article_33bd155a-57d5-11df-80af-001cc4c03286.html
Sasha Perry writes:

Terminally ill patients spend nearly 40 percent of their total health care expenses in the last month of their life, which is also when they suffer the greatest. Because these patients must unwillingly suffer vast amounts, physician-assisted suicide, which is currently illegal in all but one state, should be legalized in Idaho.

Terminally ill patients must endure unconscionable amounts of pain and trauma in their time of illness. Incurable sickness leads them to lose all will to live. These suffering patients should be given the right to end their life when they so desire (within reason). This option should be given to patients who know their end result will be death within six months (like the Death by Dignity Act, which allows citizens of Oregon to receive physician-assisted suicide), regardless of the modem medicine used to artificially prolong their life and pain…

Aid In Dying in Idaho [Compassion and Choices]
http://compassionandchoices.org/blog/?p=1007
Compassion & Choices Director of Legal Affairs, Kathryn Tucker, has a featured article in the latest ACLU of Idaho newsletter. Ms. Tucker's piece entitled Aid In Dying in Idaho discusses how the state is especially qualified to allow physicians to offer legal aid in dying subject to the medical standard of care developed by the medical profession…

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