Re: Euthanasia

On Tue, 11 Oct 2005 10:43:50 +0200, Alan Hope
<not.alan.hope@xxxxxxxx> wrote:

>Peter Parry goes:
>
>>Killing people who need care is enormously attractive to any
>>government, and none more so than the present one. In Holland some
>>20% of deaths are now killings by physicians, there are few hospices
>>and no effective palliative care provision - the choice is pain or
>>die. The cash advantages are huge.

>The point about hospice care is not true. See for example
>www.palliatief.nl/nationaal/.

Holland has a population of about 16m and has about 500 beds
available for hospice care, 30 of which are in three units for
children. UK has a population of about 60m and 3,200 hospice beds.
There are 255 childrens beds in 33 childrens units.

Holland has 30 palliative care teams in the country. In the UK there
are 320 hospital based palliative care teams, 340 home care teams and
about 200 day care palliative services.

The driving force behind the developing hospice movement in the
Netherlands are religious groups with objections to killing. The
single largest group of hospice care beds in Holland, about 200 in
all, are in small volunteer run units with no specialised nursing or
medical care - the local GP provides medical cover and the equivalent
of the district nurse comes in to provides nursing. The next largest
comprises units in nursing homes. It is only in the last few years
that the Dutch government has slowly started to develop palliative
care largely because of the pressure brought upon them by these same
religious groups.

>>To qualify to be killed you don't even need a painful or terminal
>>illness. You don't even get to make a choice. You simply need a
>>physician to declare your life isn't worthwhile any more.
>
>There's no evidence of these hysterical claims either.

"2. LIFE-TERMINATING ACTIONS WITHOUT EXPLICIT REQUEST

The survey confirms that the intentional shortening of patients'
lives without explicit request remains far from uncommon. Nine
hundred patients had their lives ended without explicit request in
1995, representing 0.7% of all deaths, only a slight decrease on the
0.8% so terminated in 1990. In other words, of the 4,500 (3,200 + 400
+ 900) cases in which doctors admitted they actively and
intentionally terminated life, one in five involved no explicit
request.

The main reason for not discussing the issue with the patient was
stated to be the patient's incompetence (due, for example, to
dementia). But not all patients whose lives were terminated without
an explicit request were incompetent. In 15% of cases where no
discussion took place but could have, the doctor did not discuss the
termination of life because the doctor thought that the termination
of the patient's life was clearly in the patient's best interests.

Furthermore, in a third of the 900 cases, there had been a
discussion with the patient about the possible termination of life,
and some 50% of these patients were fully competent, yet their lives
were terminated without an explicit request.

Moreover, in 17% of the 900 cases, treatment alternatives were
thought to be available by the attending physician.

The physicians thought that life was shortened by one to four
weeks in 3% of cases but by more than a month in 6%. Finally,
physicians had not discussed their action with a colleague in 40% of
cases, with a close relative in 30% of cases, and with anyone at all
in 5%."
(http://www.cg.its.tudelft.nl/~rafa/pl/jochemsen.htm)

"5. NEONATES

The survey reports that over 1,000 newborns die in the Netherlands
before their first birthday and estimates that the lives of about 15
are actively and intentionally terminated by doctors. The figure of
15 seems however, a significant underestimate.

The survey shows that in ten cases (1%) doctors administered a
drug with the explicit intention of shortening life. But it also
reveals a further 80 cases in which, also with the explicit intention
of shortening life, doctors administered a drug and withdrew or
withheld a life-prolonging treatment. In total, therefore, it appears
to have been the explicit intention of doctors to shorten the lives
of 90 neonates, not 15.

Moreover, in no fewer than 41% of the 1,000 cases, treatment was
withdrawn or withheld with the explicit intention of shortening life.
In a significant proportion of these cases, life was terminated
because the babies' lives were not thought bearable. Forty-flve per
cent of these babies were expected to live more than four weeks, and
some of them more than half a year.

In around a fifth of cases in which doctors intentionally withheld
or withdrew treatment with the explicit purpose of shortening life
because the baby's life was thought unbearable, there had been no
discussion with the parents. Doctors said that in most cases this was
because the situation was so clear that discussion was unnecessary or
because there was no time, though these reasons are not elaborated.

Finally, doctors reported hardly any cases of the intentional
shortening of neonatal life to the authorities."
(http://www.cg.its.tudelft.nl/~rafa/pl/jochemsen.htm)


"A person may qualify for euthanasia or assisted suicide if the
doctor "holds the conviction that the patient's suffering is lasting
and unbearable." [Chapter II, Article 2, 1b] There is no requirement
that the suffering be physical or that the patient be terminally
ill."
(http://www.internationaltaskforce.org/hollaw.htm)

"The Dutch define "euthanasia" in a very limited way: "Euthanasia is
understood [as] an action which aims at taking the life of another at
the latter's expressed request. It concerns an action of which death
is the purpose and the result."

This definition applies only to voluntary euthanasia and excludes
what the rest of the world refers to as non-voluntary or involuntary
euthanasia, the killing of a patient without the patient's knowledge
or consent. The Dutch call this "life-terminating treatment."

"Some physicians use this distinction between "euthanasia" and
"life-terminating treatment" to avoid having a patient's death
classified as "euthanasia," thus freeing doctors from following the
established euthanasia guidelines and reporting the death to local
authorities. One such example was discussed during the December 1990
Institute for Bioethics conference in Maastricht, Holland. A
physician from The Netherlands Cancer Institute told of approximately
30 cases a year where doctors ended patients' lives after the
patients intentionally had been put into a coma by means of a
morphine injection. The Cancer Institute physician then stated that
these deaths were not considered "euthanasia" because they were not
voluntary, and that to have discussed the plan to end these patients'
lives with the patients would have been "rude" since they all knew
they had incurable conditions."
(http://www.internationaltaskforce.org/fctholl.htm)


>>>From killing the elderly this has now been extended to killing children
>>with deformities and those of all ages with mental illness.

"University Medical Center Groningen 10 december 2004 Paediatricians
at academic hospitals in the Netherlands have called for the
formation of a national committee to draw up a nationwide protocol
for life ending treatment for newborns who are so ill and suffering
so severely that they have no prospect of a future."
(http://www.azg.nl/azg/nl/english/nieuws/45613)


>If so, the text of the Dutch law can be found here:
>http://www.internationaltaskforce.org/hollaw.htm

The chasm between law and reality has probably never been greater
than in the case of this piece of legislation.

"Voluntary euthanasia under control? Further empirical evidence from
The Netherlands
H Jochemsen and J Keown Lindeboom Institute for Medical Ethics, The
Netherlands. (J Med Ethics. 1999 Feb;25(1):16-21.)

This paper outlines the main statistical findings of this survey and
considers whether it shows that voluntary euthanasia is under
effective control in the Netherlands. The paper concludes that
although there has been some improvement in compliance with
procedural requirements, the practice of voluntary euthanasia remains
beyond effective control."

from that report

" It will be recalled that the purpose of the reporting procedure
is to allow for scrutiny of the intentional termination of life by
doctors and to promote observance of the legal and professional
requirements for euthanasia. The undisputed fact that a clear
majority of cases (59% according to the survey, at least 77% on our
calculations) still goes unreported, serves only to reinforce doubts
about the ability of the procedure to fulfil its purpose and to
undermine Dutch claims of effective regulation, scrutiny and control.
Further, even those cases which are reported are reported by the
doctor, and one may wonder whether the doctor's report is any more
likely to disclose evidence of wrongdoing than is a tax return to
disclose evidence of undeclared earnings."

--
Peter Parry.
http://www.wpp.ltd.uk/
.

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