Californians now have right to ‘aid in dying’: How did we get here?

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Californians now have right to ‘aid in dying’: How did we get here? Empty Californians now have right to ‘aid in dying’: How did we get here?

Post by Guest on Sat Jun 11, 2016 3:03 pm

This article Opinion-piece is rather long so I've edited out a large section in the middle; but utilize the link if you need to become updated on the history of Dr. Karvorkian and his years of work and the states that were ruling on those events. 
Californians now have right to ‘aid in dying’:
How did we get here?

06/11/2016 By David Orentlicher, Indiana University for HuffingtonPost

Twenty years ago, no one in the United States could claim a right to “physician aid in dying” (also called “physician-assisted suicide”). Today, more than 52 million Americans can.
On June 9, California became the fifth state to permit its terminally ill residents to obtain a prescription for a lethal dose of medication, as the End of Life Option Act, which the state legislature passed in late 2015, went into effect. Now, with their physicians’ help, patients in California can minimize their suffering at the end of life by hastening their time of death.
Recognition of a right to aid in dying began slowly.
Indeed, early efforts to legalize the practice failed. Residents of Washington state in 1991 and California in 1992 voted against aid in dying when referenda were placed on the ballot. And in 1997, the Supreme Court rejected a constitutional right to aid in dying. While in that same year Oregon became the first state to allow aid in dying, no other state followed suit for more than a decade.
But by 2008, support for aid in dying had grown significantly. Since then, Washington, Montana, Vermont and California have all changed their laws, and we can expect other states to do so in the coming years.
So why have Americans become more receptive to a practice that was rejected throughout the United States until Oregon changed course? Indeed, why did the California legislature pass an aid-in-dying law in 2015 when its voters opposed aid in dying in the 1992 referendum?
Other states looked to Oregon’s model
Once other states saw that Oregon had developed an aid-in-dying law with strong safeguards and that aid in dying could be implemented without evidence of abuse, a right to aid in dying became more attractive.
Most of the states that have recognized such a right closely follow Oregon’s approach. The exception is Montana, where the right to aid in dying resulted from a decision by the state Supreme Court. The court did not include the detailed rules seen in Oregon, Washington, Vermont and California, whose aid-in-dying laws were passed through public referenda or legislative action.
Oregon’s track record was especially important for other states. When the U.S. Supreme Court rejected a constitutional right to aid in dying in 1997, the justices observed that many people were worried about the experience with euthanasia in the Netherlands, and there was no experience with aid in dying in the United States to provide reassurance. But later states had a decade or more of data from Oregon before they enacted their laws.
*******Edited *****
While the laws include a number of safeguards, three are particularly important. Indeed, all five states that have legalized aid in dying include each of the three safeguards.

1. Patients must be terminally ill

Aid in dying is not available until a person has become “terminally ill,” which typically means having a life expectancy of no more than six months, even with aggressive medical care. Thus, in Oregon, almost 80 percent of aid-in-dying patients have a cancer that has become untreatable.
California, Oregon, Vermont and Washington all define terminal illness in terms of a six-month life expectancy, while under Montana aid-in-dying law, one is terminally ill when death is expected “within a relatively short time.”
This stands in contrast to the Netherlands and Belgium, where aid in dying is available to persons who are not terminally ill. In those countries, there is real concern that aid in dying has been used by patients who needed psychological counseling or other treatments that might have restored their desire to continue living.

2. Patients must be mentally competent adults

Aid in dying is not an option for children, persons with dementia or anyone else who lacks the mental capacity necessary to make medical decisions. Aid-in-dying patients must be able to decide for themselves about their medical care, and they must reaffirm their desire for aid in dying over an extended waiting period. As in Oregon, aid-in-dying laws in California, Washington and Vermont require patients to express their wishes multiple times during a 15-day stretch.
Aid-in-dying laws in those four states also require two physicians to determine that the patient can make medical decisions, is acting voluntarily and has made an informed choice of aid in dying. In addition, if either physician finds any evidence of a mental disorder, the doctor must refer the patient for evaluation by a mental health specialist. As a result, we have not seen aid in dying in the United States being practiced on patients against their will, without their knowledge or because their families made the choice for them.

3. Aid in dying is not euthanasia

Critically, aid-in-dying patients must perform the life-ending act themselves. Family members or friends can help prepare the lethal drink (typically the prescription medication dissolved in water), but the patients must ingest the drink on their own. No one can do it for them, nor can physicians or other persons inject a lethal drug into an aid-in-dying patient.
By requiring the patient to perform the life-ending act themselves, states can prevent aid in dying from being performed by someone else without the patient’s consent. Whether to bring about death remains under the patient’s control until the very end.
Experience elsewhere illustrates the importance of a distinction between aid in dying and euthanasia. Much of the controversy about end-of-life practices in the Netherlands reflects concerns that euthanasia is performed inappropriately on children or adults who cannot make their own medical decisions.

Aid in dying is safe, legal and rare

All of the safeguards have ensured that aid in dying remains a safe and rare event.
After nearly 20 years of legalization in Oregon, aid in dying accounts for less than one-half of one percent of deaths in the state. In addition, aid in dying has not put patients who are minority, uninsured or uneducated at risk. The typical aid-in-dying patient is white, insured and well-educated.
For many patients, a right to aid in dying provides comfort even when not fully exercised. Among patients in Oregon who have received a prescription since 1997, about 35 percent died without taking the medication. Those patients benefited from knowing that they had the option to take the pills if their suffering became intolerable, relieving them of the psychological stress that can accompany the prospect that one’s terminal illness will impose even greater suffering.
Allowing aid in dying seems much more like letting seriously ill patients refuse ventilators or other life-sustaining treatment than letting depressed persons choose suicide.
Just as usual end-of-life laws allow patients to bring an end to the dying process by declining chemotherapy, dialysis, and feeding tubes, so aid-in-dying laws allow patients to bring an end to the dying process by taking a lethal dose of drugs. But aid-in-dying laws do not extend their rights to people who might want to end their lives because of psychological distress.
With their important safeguards, aid-in-dying laws have helped dying persons minimize their suffering while protecting against a slide down the slippery slope toward abuse.Californians now have right to ‘aid in dying’: How did we get here? Count
David Orentlicher, Professor of Law and Co-Director of the William S. and Christine S. Hall Center for Law and Health, Indiana University. Dr. Orentlicher previously served as a state representative in Indiana and currently is running for the Democratic nomination in Indiana’s 8th Congressional District.
http://www.huffingtonpost.com/the-conversation-us/californians-now-have-rig_b_10415552.html
Sadly, people with severe mental health issues will still find 'OTHER' methods of ending their life and as always that's meant self-inflicted means of suicide ...regardless of any safety nets - number of counseling sessions - number of clinical therapy locations - numerous unique physicians and interventions ...those determined to snuff out their life will succeed at some point in time.
Men are far more efficient in this endeavor then women.


Last edited by 4EVER2 on Sat Jun 11, 2016 7:15 pm; edited 2 times in total

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Post by eddie on Sat Jun 11, 2016 4:18 pm

A big step, and one that needs close monitoring.
I'm all for assisted dying and I agree, it has to be for mentally competent people.
Unfortunately, some of the saddest people are those trapped in dementia and Alzheimer's, who can't be considered for this.

If people could tick a box that allowed them to choose to die if they got one of those above diseases, I'm betting most would tick "yes" to their families being able to choose for them. I know lots of people who say they wouldn't want to live if they became mentally impaired as in the case of severe dementia

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Post by Guest on Sat Jun 11, 2016 7:06 pm

Not just California it seems either that has made the right step forward to make assisted suicide legal.

Assisted Suicide Is Now Legal in Canada — And One Province Is Providing Free Drugs to Do It
11th June 2016 news.vice.com | Humans
It’s now legal for doctors and other healthcare providers in Canada to help patients die.
The federal government missed its June 6 deadline to implement its assisted death legislation, Bill C-14, so provinces across Canada are taking things into their own hands when it comes to regulating how and when people can end their own lives.

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Post by Guest on Sat Jun 11, 2016 7:32 pm

Eddie stated > Unfortunately, some of the saddest people are those trapped in dementia and Alzheimer's, who can't be considered for this.

If people could tick a box that allowed them to choose to die if they got one of those above diseases, I'm betting most would tick "yes" to their families being able to choose for them. I know lots of people who say they wouldn't want to live if they became mentally impaired as in the case of severe dementia
Well, it may be emotionally far harder and sad for those on the outside {close family & friends} that are being forgotten and misnamed as the dementia/Alzheimer's disease takes hold ...but as far as a 'PAIN' factor for the patient, that's not a quantifier for a life ending choice. 

As the stages of dementia/Alzheimer's progress from minor confusion to frustration and anger outburst - the patient often just becomes a very mellow silent observer of life; waiting to be told and prompted for directions as to their next duty/chore or scheduled event.

Sleep - hydration - eating - toilet and repeat that process is what they basically do in a repetitive non-stop cycle.  Finding those triggers that might stimulate a buried memory are what the activity therapy specialist do wonders with ...but as the patient ages and the mind forgets to tell the major organs what they need to do to sustain the human body - then yes, things tend to become a medical problem! But not until that stage and 'THAT' stage is uniquely different for every Alzheimer patient.

But to allow a family member to snuff out a parent/relative because their elder parent/relative/custodial human was diagnosed with 'dementia/Alzheimer's' --- affraid
Californians now have right to ‘aid in dying’: How did we get here? 2187004795 I foresee many a legal issue over the right to life VS the families desire for the life insurance/cash assets ...before that lovely old human burned though their  inheritance before the old codger finally DIED, due to the cost of his/her/their care!

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Post by eddie on Sat Jun 11, 2016 9:54 pm

A good post.
Have you seen the film or read the book (I've done both) "Still Alice"?
Very good description of a woman going through early onset Alzheimer's.

I watched senile dementia happen to my grandmother, she kept asking for my grandfather and I used to say "he's just given you kiss and gone to make tea"

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Post by Guest on Sat Jun 11, 2016 10:11 pm

eddie wrote:A good post.
Have you seen the film or read the book (I've done both) "Still Alice"?
Very good description of a woman going through early onset Alzheimer's.

I watched senile dementia happen to my grandmother, she kept asking for my grandfather and I used to say "he's just given you kiss and gone to make tea"

No, I've had the last 3 years of my dear mothers dementia to struggle/learn/research the best methods to help her live with those memories that just bubble up from the underworld like something repressed from long ago and 'POP' here it is once again to be relived and the pain just as fresh and deeply grieved as it was the first time around.
She'd buried: my father - my dearest oldest sister - her last closest baby brother - her 2 other close brothers and their wives - my dear brother - my husband all in those years where her dementia was slowly evolving into Alzheimer's. 

So anytime she'd asked; 'why, she wasn't hearing from _______' and then the realization that she'd forgotten their passing was reliving that tragic circumstances all over again. Some from just old age - my siblings from some horrific event - it was always tenuous as to what photo's needed to be kept out and what family album should be placed into her hands upon her request. 

I'll admit; I began fudging story lines and history ...because watching her suffer repeat mourning for her children was just far to hard to deal with ...and when she started calling me 'MOMMA' and introducing me to nursing staff as 'have you met my mom' --- that was a DEEP BREATH MOMENT.  Role reversal and things my 'sandwich generation' weren't warned about; but we just suck it up and get on with taking care of them because it's what they'd do for us. pale

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