THE UK

Britain  - euthanasia

  Revealed: full scale of euthanasia in Britain

Hospital deaths inquest begins

 
Coroner is asked to review deaths of nursing home residents

Researching whether Guernsey should legalise euthanasia was time and money well spent.

 Death with dignity -Time for a debate on euthanasia

Doctors step into right-to-life row

Death on doctor's orders  - Euthanasia campaigners are hailing Oregon's right-to-die law as a blueprint for Britain

Hospitals in euthanasia row

An attempt at euthanasia? ... Court documents say caregiver tried to kill her patient

Father held on charge of killing terminally ill son, age ten

Doctor pleads not guilty to murder, drug charges

Euthanasia report reflects BMA stance

  SPUC welcomes Royal College of Nursing rejection of assisted suicide bill, UK

RESEARCHING whether Guernsey should legalise euthanasia was time and money well spent.  

Dr Hazel Biggs, director of medical law at the University of Kent and author of Euthanasia: Death with Dignity and the Law, calculates that at least 18,000 people a year are helped to die by doctors who are treating them for terminal illnesses.

Biggs, who has submitted evidence to the House of Lords select committee which is examining Lord Joffe's private member's bill on Assisted Dying for the Terminally Ill, makes the claim in an article submitted to the European Journal for Health Law .

Her figures will place renewed focus on the doctor-patient relationship, which pro-euthanasia campaigners want changed so that medical staff can help conscious, terminally ill patients in pain to shorten their lives.

Biggs's figures are based on data from countries such as the Netherlands and Australia, which have published research into assisted dying rates, as well as evidence taken from British doctors.

'If you extrapolate from countries that have published data, you're looking at quite a large number of patients who may have had their end hastened, not necessarily with their consent,' she said.

'What this says to me is that we know these practices are going on, but they are completely unregulated. We don't know how many people are volunteers or non-volunteers, and maybe because of that the law ought to be changed so that people can give voluntary consent, which will give them more protection.'

An ageing population has meant that an increasing number of doctors are taking private decisions to aid the early demise of terminally ill patients, usually by increasing drug doses.

Deborah Annetts, chief executive of the Voluntary Euthanasia Society, said there was an urgent need to clarify regulations governing assisted dying: 'We need to shine a spotlight on this. The medical profession doesn't want the public to realise they are making these decisions. It shows the need to make the patient the decision-maker. When it's left to the doctor, there is always the risk of abuse.'

Pro-euthansia groups point out that in Britain the maximum sentence for helping someone to commit suicide is 14 years in prison. 'With the exception of Ireland, no other country in Europe behaves like that,' Annetts said.

Opinion polls show overwhelming public support for law changes that would make it easier for terminally ill patients in pain to request medical help to shorten their lives. In successive surveys, about 80 per cent of people back the move. A survey by the society this month found that 47 per cent of people said they were prepared to help a loved one to die, even if it meant breaking the law.

But a spokeswoman for the ProLife party said: 'Surely the response of a compassionate society is to alleviate the pain, to love and comfort the patient, and to try and restore a sense of self-worth until death comes naturally.'

Politicians have repeatedly deflected moves to change the law on euthanasia, believing it is unlikely to be a vote-winner. But Joffe's bill might find its way through the Lords committee stage and into the Commons, which would alarm religious groups.

In a joint submission to the select committee, Church of England and Roman Catholic bishops said: 'It is deeply misguided to propose a law by which it would be legal for terminally ill people to be killed or assisted in suicide by those caring for them, even if there are safeguards to ensure that only the terminally ill would qualify.'
 

Source: http://www.guardian.co.uk/medicine/story/0,11381,1307970,00.html

Source http://news.telegraph.co.uk/news/main.jhtml?xml=/news/2005/01/18/uhospital.xml

Coroner is asked to review deaths of nursing home residents

London Susan Mayor

A coroner has been asked to look into the deaths of 13 elderly residents who died in a UK nursing home after a review found that standards there raised "serious concerns."

Twenty eight residents died at the Maypole Nursing Home in Birmingham between 2002 and 2003. The home, which has 36 beds, failed to notify care standard officials of 15 of these deaths. It was closed in March 2003 after an inspection by the Commission for Social Care Inspection.

Birmingham and Black Country Strategic Health Authority then coordinated a wide ranging review, which found that the home was failing to meet many of the required national minimum standards and regulations. These included failures of general management, nursing and general care, physical standards, staffing and recruitment, and recording and reporting. The authority also worked with the General Medical Council, the Nursing and Midwifery Council, the Commission for Social Care Inspection, and the police during its investigations.

The authority said in a statement last week: "All investigations arising from this case are now complete, with the exception of the General Medical Council, the Nursing and Midwifery Council, and the coroner. The police are not actively investigating, but it remains open, pending advice and guidance from the coroner."

Thirteen of the deaths have been referred to Aidan Cotter, coroner for the city of Birmingham and the borough of Solihull. He said that he was currently taking advice from doctors involved in the case before deciding on further action. Deaths are generally reported to coroners when no doctor has treated the deceased person during his or her last illness or when the death was sudden, unexpected, or unnatural. Coroners have a duty to find out the medical cause of all deaths reported to them.

After inspection of the home in March 2003 South Birmingham Primary Care Trust referred the two family doctors who looked after the residents to the General Medical Council. Dr Jamalapuram Hari-Gopal and his wife, Dr Pratury Samrajya Lakshmi, of the Philip Clarke Medical Centre, Kings Heath, were also temporarily suspended by the trust, pending the outcome of investigations.

A review of Dr Hari-Gopal’s suspension was carried out in December 2003, when it was agreed that he should return to work at the centre in January 2004, with additional support, including locum cover, provided by the trust. After a comprehensive review of her professional services Dr Lakshmi remains suspended by the GMC.

In June 2004 the GMC decided to hold a public hearing into the professional conduct of both doctors. This is yet to take place. Seven nurses employed by the home are also facing an investigation by their regulatory body, the Nursing and Midwifery Council.

As a result of the review, South Birmingham Primary Care Trust said: "We have shared serious concerns and referred 13 of the 23 deceased residents to the coroner. The coroner, who has been kept informed during the progress of the investigation, will now consider whether he needs to investigate."

RESEARCHING whether Guernsey should legalise euthanasia was time and money well spent.

Advocate Gill Dinning, who headed the Death with Dignity working party, said that although the majority decided there were overwhelming reasons not to go ahead, it was still a worthwhile exercise.  ‘When you do that sort of thing, change laws like that, it has a profound effect on society and we didn’t feel it was appropriate, but that is not to say it was not worth examining,’ said Advocate Dinning. 

‘I can understand that pro-euthanasia people will probably think that no real effort was made, but I don’t think you can level that criticism at us. A huge amount of work was done so people could have an informed discussion.’  Advocate Dinning added that some panel members went in with one view and came out with another.  ‘I hope no one thinks we did not debate things – we had some very passionate discussions. Once you get into a subject like this you realise how complex it is. By the end the committee was very well informed.  ‘On a personal level, I don’t think I’ve ever read so much paperwork on a subject – and I’m a lawyer.’
Most of the panel were uncomfortable moving from the present situation, she said.

‘I think the majority felt it was a step too far for a variety of reasons. A lot of people struggled with the definite decision to end life and there was concern that once it was allowed, where it would end.’  She said legalising euthanasia was too great a leap for many countries to consider, not just a small jurisdiction like Guernsey.
‘I would question whether the UK changes its mind.’ Advocate Dinning fully understood why fellow panel member Deputy Peter Roffey produced a minority report outlining the case for euthanasia for the terminally-ill.  It is supported by deputies Hunter Adam – a retired doctor – and Francis Quin, two of the three other politicians on the working party.  ‘Having chaired the committee, I can see that people’s views were clearly very sincerely held. There is an obvious temptation to take a shot at politicians but, having debated with them, I know how passionate they are in their beliefs rather than [in] making a political statement.’  Deputy Roffey said it was a matter of regret that the working group members had not looked at how a law permitting voluntary euthanasia could be drafted. Advocate Dinning said they had not been asked to, rather they looked at whether there should be a change in the law.  ‘We felt it was more appropriate for the States to debate this in general. If they debate it and decide they would like the law, it is for someone to draft. ‘We did not want to hijack the debate. Group

Source:  http://www.thisisguernsey.com/code/showarchive.pl?ArticleID=011921&year=2004&category=news

Doctors step into right-to-life row

Click here: CBHD: Euthanasia: Who Needs It? - Sharon A. Falkenheimer
http://www.cbhd.org/resources/endoflife/falkenheimer_2005-01-31.htm

 Death on doctor's orders - Euthanasia campaigners are hailing Oregon's right-to-die law as a blueprint for Britain

Jo Revill
Sunday December 5, 2004
The Observer

When Karen Yanoch was ready, 18 of her closest friends and relatives came to sit around her bedside at her home in Eugene, Oregon. Each of them had received a formal invitation to be with her in her final moments.

Yanoch, who was terminally ill with liver cancer, had decided to end her life by drinking a bitter solution of a lethal barbiturate. She took several small sips and then a final big gulp.

Three minutes later, lying in her bed wearing her favourite striped socks, she told those around her: 'I think I'm going to sleep now,' as she lapsed into a coma before dying shortly afterwards.

Yanoch's death last April was hard for her friends to take but they understood why she had opted to depart in her own way at a time of her choosing. She could do so only because the state where she lived had a law, the Death with Dignity Act, which allows what is known as physician-assisted suicide.

This week, an influential committee of the House of Lords will fly to Oregon to study how this law is working. At present, the committee is scrutinising a private members' bill which would legalise assisted deaths for the terminally ill.

The crossbench peer Joel Joffe, a retired human rights lawyer, is hoping to steer the bill through the Lords. If he succeeds it will be debated by MPs who are far less convinced of the case for voluntary euthanasia. It has already sparked off fierce debate about how society can best help the dying.

Joffe's proposals centre around the concept that voluntary euthanasia would be made available to patients in 'unbearable pain' who have less than six months to live. They would have to undergo psychiatric and medical examinations and there would be a cooling-off period to allow them to change their minds. Tory peers vehemently oppose the bill which attracted 100,000 submissions of evidence during its consultation process, which ended earlier this year.

The bill is completely at odds with the present British law, which makes it a criminal offence, punishable by imprisonment, to assist anyone who tries to kill themselves.

But the peers have chosen to go to Oregon to look at how doctors there administer the scheme, and the kind of ethical dilemmas it raises.

On Friday they will meet Dr Nick Gideonse, a family doctor in Oregon's largest city, Portland. The softly-spoken Gideonse has helped five patients die using the Death with Dignity Act.

'Every case has its own complexities, and there are always mixed feelings about the process,' he said. 'But what I'm increasingly aware of is that the law, as it's designed, works well. It gives people an open avenue of communication about the things they care about, such as the ideas they have about what dying might be like as well as for the much smaller numbers who use the law.'

The figures on this back him up. Since the Act was introduced six years ago, nearly 180 people have been helped to commit suicide, but that is only around 1 per cent of the number who have requested information about it.

The latest figures show that most of the patients, like Yanoch, were terminally ill with cancer. Around 20 per cent had motor neurone disease.

Their median age at the time of death was 70, much older than some critics of the act had predicted. They have tended to be college graduates, better educated than the majority of the population.

The doctor says the people who use the law tend to have a long history of independence and self-reliance. 'It takes courage and quite a lot of strong will to do this, particularly when these people are really quite ill and have low reserves of energy,' Gideonse said.

The Oregon law is framed to allow adults with terminal diseases who are likely to die within six months to obtain lethal doses of drugs from their doctors.

They have to talk through the process with the doctor, and agree to have a full interview with a second physician to make sure that they are mentally competent. There is then a 15-day cooling off period when they can think about their decision. If they decide to go ahead after that, they have to see another doctor before approval is given.

But the Oregon law has provoked controversy in others parts of the United States. It has been fiercely opposed by President George Bush, whose stance has the backing of conservative Christian groups.

The American Appeal Court recently upheld Oregon's Act, ruling that the Attorney General, John Ashcroft, had overstepped his authority by trying to punish doctors in the state who had prescribed suicide drugs.

And while there is still strong opposition around the country to laws such as Oregon's, support within the state has grown over the years. Its voters have approved the Act in two separate referendums, and even some former opponents say the widespread abuses forecast initially have not taken place.

Yet there remain many across the States who detest it. Physicians For Compassionate Care, a group which is campaigning for repeal of the law, argues there have been cases of depressed and mentally ill patients being helped to die - a claim strongly denied by state officials. The group also says, more persuasively, that good palliative care can do an enormous amount to alleviate pain but that often this avenue isn't open to patients.

In Britain the arguments about euthanasia were brought into the open last week. A High Court judge cleared the way for a husband to help his wife, referred to only as Mrs Z as her anonymity is protected by a court ruling, travel to Switzerland so she could be helped to die. The couple had been stopped from going to Zurich by the local authority which provides care for her.

Mrs Z could not go by herself as she suffers from an incurable brain disease, but her husband had agreed to help her to get to Dignitas, an organisation which helps people to commit suicide. Last Wednesday, immediately after the court ruling, the woman flew to Zurich where she took a lethal dose of barbiturates in a flat accompanied by a doctor, nurses and a lawyer .

The British court had ruled that the law should not interfere with 'the rights' of the wife to die. The case appears to weaken the barriers that prevent assisted suicide in English law, under which it is a criminal offence punishable by up to 14 years in jail.

Whether more British people will now travel to Switzerland to end their lives remains to be seen, but euthanasia has again started to become a real public concern.

Health staff have shifted their positions on this issue. The Royal College of Nursing has moved from being steadfastly against assisted dying to a stance of neutrality. In 1996, 54 per cent of 1,000 doctors polled favoured legalising it in some circumstances. Three per cent of GPs had helped terminally ill patients to die.

But one of the big surprises of the Oregon law is that the patients who choose their own time to die are not so much depressed as determined. Linda Ganzini, a psychiatry professor at Oregon Health Sciences University, led a survey of 35 doctors who had been asked for suicide drugs, and found them describing the patients as feisty and unwavering.

When patients gave their reasons for seeking assisted suicide, their greatest concern appeared not to be fear of pain but fear of losing their autonomy.

This was cited by 87 per cent of those who went on to take their lives with the drugs. Only 22 per cent gave their reason as fear of inadequate pain control.

'The standard version of care says, in effect, "We're going to take care of you",' said Ganzini. 'But for these people, the real problem is just that - other people taking care of you.'

Related links
www.prolife.org.uk  The mainly anti-abortion party also takes a robust line against voluntary euthanasia

 Hospitals in euthanasia row

By Lech Mintowt-czyz, Evening Standard  13 December 2004

Four London hospitals are allowing elderly patients to request that they be allowed to die, it emerged today.

Doctors are allowed to mark down any request by patients that they be allowed to die if they become critically ill. Hospital managers have told them they can follow any such instruction should the circumstances arise.

A spokesman for the Hammersmith Hospitals Trust, which has launched the initiative, said doctors did not ask patients for their views and only marked their notes should they make a specific demand.

Patients at each of the trust's four hospitals - Hammersmith, Charing Cross, Ravenscourt Park and Queen Charlotte's and Chelsea - are understood to be affected.

The spokesman denied the policy amounted to allowing patients to make a "living will" but reports in today's Daily Mail drew savage criticism from pro-life campaign groups.

Phyllis Bowman of Right to Life said: "You tick the box and you are ticking your life away. Elderly people are very easy to coerce, especially when they are on their own, confused and sick in a hospital bed."

Julia Quenzler, of the SOSNHS campaign group, added: "If ever the elderly and vulnerable needed confirmation that they are considered expendable, this is it." Lib-Dem health spokesman Paul Burstow said: "If this is what Hammersmith are doing they need to rethink.

"At no point should it be acceptable for the purpose of a doctor to be to hasten someone's death.

"There are far too many assumptions made about a person's ability to recover and enjoy life on the basis of their birth date."

The controversy comes as MPs prepare for a row over the issue of "living wills" during tomorrow's debate on the Government's Mental Capacity Bill.

More than 100 MPs from both sides of the House are said to oppose the Bill, which critics call a charter for euthanasia.

The Bill proposes to give legal backing to living wills in which individuals specify how they would be treated should they become incapacitated and unable to communicate.

As "treatment" includes provision of nutrition and water by tube, this could involve allowing death by starvation or dehydration.

Over the weekend medical expert Baroness Warnock fuelled controversy by declaring she did not want to be a "burden" on her family.

The 80-year-old peer said: "In other contexts sacrificing oneself for one's family would be considered good. I don't see what is so horrible about not wanting to be an increasing nuisance." Age Concern branded her stance "outrageous".

Source http://www.thisislondon.co.uk/news/articles/15284596?source=Evening%20Standard

 An attempt at euthanasia? ... Court documents say caregiver tried to kill her patient

Originally published Sunday, December 19, 2004
By Sandra Wisecaver Times-News correspondent

GOODING -- A Hagerman woman who court documents paint as a caregiver with a twisted sense of divinity has been charged with attempted first-degree murder.

Police say Kathleen Marie Allen, 47, tried to kill the 65-year-old man in her care with a potentially lethal dose of morphine.

Court documents related to the case describe a chilling attempt at euthanasia that came to a head on Feb. 25.

When police responded to Allen's home at 340 Orchard St. in Hagerman that night, they found Allen's patient, Jack Duane Reed, comatose. He was transported to the hospital for medical attention and to be taken out of Allen's care.

The investigation that ensued would eventually lead to Allen's arrest seven months later.

Christine Funk, a woman related to Reed, called police the night of Feb. 25 because Allen was out of control, yelling and telling Reed to die, court documents say.

Funk had been concerned about the care being provided to Reed. Three days earlier, Allen telephoned Funk to say Reed was dying and she was making funeral arrangements, Funk told police. And on Feb. 24, Allen told Funk she had signed a do not resuscitate order for Reed that Funk objected to, the court documents say.

Funk, an employee with the Gooding County Ambulance District, told police she went to Allen's residence on Feb. 24. Funk said Reed's pupils were dilated to the point where there was no visible color to his eyes.

At about that time, the court documents say, "Allen started yelling that she was God and it was time for Jack to die."

Others corroborate events

Gooding County Prosecutor Philip A. Brown filed a criminal complaint against Allen in 5th Judicial District Court on Nov. 1.

She's also been charged with grand theft by embezzlement of currency and property in connection with the sale of some of Reed's antique guns and the tampering of his bank account.

Allen was released from the Gooding County Jail on Nov. 3. A preliminary hearing in her case has been set for Feb. 17.

Reed, who has since turned 66, remains in Funk's care today and is doing fine, Funk recently told The Times-News.

Others interviewed by Hagerman police and Idaho State Police corroborated the accusations against Allen, court documents indicate.

Madlyn Shepherd, a Hospice employee who cared for Reed in August of 2003, told investigators that Reed had some medical problems due to his age but seemed in good health before going under Allen's care.

Shepherd was again assigned through Hospice to assist in Reed's care this past January at the Allen home in Hagerman. At that time Shepherd said Reed could walk and talk, court documents say.

But Reed soon developed breathing problems, and Shepherd requested blood tests to determine if he was getting the proper medication. Those tests showed a very low level of lithium, which had been prescribed for Reed, court documents say. If properly medicated, Reed's lithium level should have been higher.

Shepherd also said she learned that Allen had contacted Reed's doctor and demanded he prescribe Roxanol -- a form of liquid morphine.

Certified Nurses Assistant Merelda Okelberry, another Hospice employee, gave police another disturbing description of Allen's method of care.

On Feb. 25, Okelberry said Allen came to her and requested she give Reed enough Roxanol to knock him out.

When Okelberry questioned Allen about her intentions, Allen replied, "You might as well just kill him and get it over with. It's not fair. God wants him dead and he's fighting it," court documents say.

During her interview with investigators, Okelberry further quoted Allen as saying, "Give him the whole thing. Let's get this over with. Jack is supposed to die."

The case of embezzlement

In an April 7 interview at the Funk home, Reed was able to walk and talk again.

According to court documents, Allen told Shepherd she was caring for Reed in her home, free of charge.

But Allen told authorities that Reed had agreed to pay her and Phil Dawson, Reed's ex-husband, $2,500 per month for his needs, care and food. Allen said Reed's medical insurance covered medication.

Court documents say that in August 2003, Reed granted Dawson and Allen power of attorney and access to his bank account. Bank records show Reed received $2,971.70 per month and that Reed had in excess of $3,000 in August 2003.

On Feb. 24, a transfer of $1,419.58 to the Kathleen Allen Easy Street Assisted Living account left the Reed account with a $0 balance.

Firearms from Reed's antique gun collection also were sold and pawned by Allen and Dawson, court document say.
NewsTracker
* Last we knew: Hagerman resident Kathleen Marie Allen, 41, appeared in Gooding County District Court on felony charges of attempted first-degree murder and grand theft.
* The latest: Allen was appointed a public defender, but requested a continuance so she could hire a private lawyer.
* What's next: Allen's preliminary hearing is scheduled for Feb. 17.

Source http://www.magicvalley.com/news/localstate/index.asp?StoryID=13339