Posts Tagged ‘Euthanasia’

Europe is on its way to widespread euthanasia for the elderly

April 5, 2018

Legalising voluntary and “semi-voluntary” euthanasia is increasingly being seen as a way to alleviate the increasing cost of caring for the elderly.

Even if active euthanasia has only been legalised in a few countries, I suspect it is only a matter of time before most of Europe introduces some form of legal euthanasia for the critically ill and for the aged and the senile. It is already the accepted norm that children have no special or moral or economic obligation for the care of their aged parents. That obligation has already passed to the state. For millennials the care of the aged is entirely a matter for the state. There is a growing sense among the younger in Europe that the elderly and infirm have outstayed their time and are primarily a burden on society. For the state, the elderly are an unwelcome but unavoidable demographic. The compassionate society requires them to be assisted to take care of themselves in their own homes for as long as the costs are not unacceptable. Thereafter they are placed in “homes” for  the elderly where they are largely out of sight and where they are expected to “go quietly”. State run homes always have budget constraints and the level of care gradually deteriorates. Where homes operated by care companies but financed by the state, there is an incentive for the care companies to maximise “turnover”. And “turnover” means exactly what it sounds like. Completely private care apartments or homes probably provide the best care to those who can afford it.

I can see no moral objection to voluntary euthanasia. In the case of dementia, “voluntary” may not be entirely feasible. But what all states and all care homes know very well is that Euthanasia is both profitable and cost effective

In Sweden there have been many articles recently about the increasing cost of caring for the elderly with dementia. It is all just part of the campaign to get a wide moral and political acceptance for euthanasia being introduced  across the EU. The risk is that it will not be just voluntary euthanasia but will also include involuntary euthanasia of the unwanted. The introduction of legalised euthanasia in Belgium has not been without its problems.

Belgian Euthanasia Corruption Exposed

Euthanasia in Belgium has gone completely out of the control — including as just two examples —doctors killing the mentally ill and conjoining the death procedure with voluntary organ harvesting, as well as joint euthanasia deaths of elderly couples who ask to die for fear of future widowhood.

Now, a death bureaucrat named Dr. Ludo Vanopdenbosch has turned whistleblower as he resigned from the euthanasia-review commission. Vanopdenbosch charges his former colleagues with covering up violations of the euthanasia law that, he worries, could discredit euthanasia and reduce its support among the public.

He describes a doctor euthanizing a dementia patient who had not asked to be killed at the request of her family. ……

 ……… people have accepted the premise that killing is an acceptable answer to human suffering. 

Two of my friends have utilised the services of Dignitas. So, for whatever reasons it may come, I do hope that voluntary euthanasia is available to me when my time comes.


 

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“Euthanasia is both profitable and cost effective”

July 28, 2014

I think an individual should be able to choose, and be assisted, to die peacefully and painlessly – provided he is of sound mind and is suffering from a terminal and painful illness.

But I am afraid that part of the building momentum for euthanasia in Europe is cost driven and not driven by a concern for the individual. Countries with aging populations and with well developed public health programs are facing increasing costs for the care of the elderly. In Sweden and the UK for example this care is often “out-sourced” or privatised. Many of these establishments are owned by risk capital companies – which is a little strange – but not fundamentally wrong. But the “quality” requirements they are required to meet are set by the public institutions doing the out-sourcing. Inevitably these “quality” requirements are specified in such a way that the out-sourcing succeeds and contracts are let. To ensure this the requirements always allow the service provider sufficient room to make a profit. There is a clear incentive for the service provider to “increase the throughput” and reduce the cost per person they are tasked to care for. That – in turn – is leading to a deterioration in the care provided especially to the aged who are no longer competent or able to complain about the service received. It is clearly cheaper to allow a general reduction of service, and to only do more than the minimum if and when a complaint from a relative is received. Of course, relatives have only limited opportunities to notice any deterioration of service. The “out-sourcing” itself is driven by cost. There have been many “scandals” (such as this one) associated with the “quality” of service in “privatised” homes for the aged. But it is not by accident that the State and the municipalities and health authorities have pushed these scandals into the “privatised” sphere rather than to be found wanting themselves. Part of the reason for out-sourcing these services has clearly been to also out-source the scandals waiting to come as care of the elderly inexorably deteriorates. The more the care of the aged deteriorates the more attractive a voluntary euthanasia scheme becomes – for all parties involved.

I have a clear perception that in Sweden the quality of public medical and palliative care for the elderly is already driven by cost considerations. It is illegal in Sweden but age discrimination is endemic. We hear about procedures and expensive treatments being denied to the elderly for many ostensible reasons, but in reality because the patients are – in the judgement of the care-providers – just too old and too big a drain on costs. For public medical and palliative care, a form of unwritten age-discrimination is already in place. The aged patient has little recourse except to opt for private treatment and then euthanasia may be a much more cost effective solution..

The euthanasia debate is picking up steam in Europe but my fear is that though much of it is carried out under the guise of concern for an individual’s right to die, much of the debate is actually being driven by public health cost considerations. Many of the statements by politicians seem to me to be trial balloons or electoral posturing – but they have an underlying smell of preparing for curbing the costs of caring for the increasing number of the elderly.

It may be very cynical but I note that a healthy growth rate in voluntary euthanasia among the aged has many public and social and economic benefits. The cost of health care for the aged is both capped and reduced. The demographic of the ratio of elderly to working population is improved. Medical resources are freed for the more valuable, younger patients. And the aged patient gets what he or she wants.

A true win-win!

BioEdge: 

Euthanasia might be needed for poor people who cannot access palliative care, the new Lithuanian Health Minister has suggested. Rimantė Šalaševičiūtė was sworn earlier this month, but already she has made waves by backing an open discussion of the legalisation of euthanasia.

Without making any specific proposals, she told local media that Lithuania was not a welfare state with palliative care available for all and that euthanasia might be an option for people who did not want to torment relatives with the spectacle of their suffering.  

The minister has also raised the idea of euthanasia for children. She noted that this option had been approved for Belgian children after a long public debate. It was an option which might be appropriate in Lithuania as well after public debate.

Ms Šalaševičiūtė will face an uphill battle in her campaign to introduce Lithuanians to euthanasia. Many doctors and the Catholic Church oppose it. Dr Andrius Narbekovas, who is both a priest and a doctor, and a member of the Health Ministry’s bioethics commission, told the media:

“The Ministry of Health should protect health and life, instead of looking for ways to take life away. It goes without saying that it is … profitable and cost effective … But a democratic society should very clearly understand that we have to take care of the sick, not kill them.”

Lithuania merely reflects the debate all over Europe which is probably most advanced in Belgium where even involuntary euthanasia (is that not murder?) has been proposed.

Politicians and many aged sufferers could find this irresistible: “Euthanasia is both profitable and cost effective”.

Two of my friends have utilised the services of Dignitas. So, for whatever reasons it may come, I do hope that voluntary euthanasia is available to me when my time comes.

UK embraces being “cared to death”

November 1, 2012

I have posted earlier about the disturbing ethical questions with the “Care Pathways” in the UK  which operate in the grey zone between euthanasia and execution.

But it is more than just disturbing when UK hospitals run by NHS trusts apparently get financial benefits if they increase the number of terminally-ill patients who are put onto the so-called “Care Pathways”. Once someone is “put on a Care Pathway” they are effectively written off. Medication may be withdrawn, water and food may be withheld and any chance of continuing to live or of any recovery are removed – intentionally – from the equation.  “Care” is provided but now with the intention of causing death. The sooner such patients die the better the use of resources!

I cannot see how any “Care Pathway” where there is an incentive to ensure that a patient dies and dies quickly can be anything other than an intentional termination of life. But is it euthanasia or is it murder or is it an execution?

Where the patient truly wishes to die it is effectively euthanasia. But where the patient would wish to live if he could only get better we get into a dangerous zone between euthanasia and execution. Can all attempts to “make the patient better” be abandoned by a hospital because someone other than the patient has decided that the patient cannot get better? When it is relatives who are pushing to get the patient onto a “Care Pathway” it comes close to murder. And when it is the hospitals or the hospital staff who are “incentivised” to get the patient onto the “Care Pathway” it gets close to being an execution. The decision to put someone onto a “Care Pathway” is itself then an irrevocable sentence of death. Why not – having passed sentence –  just give them a quick, quiet lethal injection after putting them on a “Care Pathway”? Why go through the charade of care while ensuring the patients rapid demise? The 33 hours these patients survive on average after being put on a “Care Pathway” could be reduced to zero. Why not provide incentives to hospitals to

  • maximise the number of patients put onto a “Care Pathway”, and then
  • minimise the amount of time spent on such a Pathway?

This could get rid of many hundreds – if not thousands – of problematic and elderly patients who only absorb resources, no longer provide any useful contribution to society and are just a pain for their relatives. It would not be a very large step to converting the corpses to Soylent Green.

The Telegraph: 

The majority of hospitals in England are being given financial rewards for placing terminally-ill patients on a controversial “pathway” to death…

Almost two thirds of NHS trusts using the Liverpool Care Pathway have received payouts totalling millions of pounds for hitting targets related to its use, research for The Daily Telegraph shows.

The figures, obtained under the Freedom of Information Act, reveal the full scale of financial inducements for the first time.

They suggest that about 85 per cent of trusts have now adopted the regime, which can involve the removal of hydration and nutrition from dying patients.

More than six out of 10 of those trusts – just over half of the total – have received or are due to receive financial rewards for doing so amounting to at least £12million. 

At many hospitals more than 50 per cent of all patients who died had been placed on the pathway and in one case the proportion of forseeable deaths on the pathway was almost nine out of 10.

Last night the Department of Health insisted that the payments could help ensure that people were “treated with dignity in their final days and hours”.

But opponents described it as “absolutely shocking” that hospitals could be paid to employ potentially “lethal” treatments. ……

The Liverpool Care Pathway: Euthanasia? Or is it execution of the elderly – for convenience?

October 17, 2012

An article in The Telegraph caught my eye while watching the US Presidential debate at my hotel.

A rather disturbing development in the UK and I don’t  like the ethics of the situation. Euthanasia is voluntary but I am not sure that the Liverpool Care Pathway is. It is a pathway which leads to the death of the patient /victim in about 33 hours. I wonder who this pathway serves? At first sight it seems to be primarily for the benefit of hospitals and doctors and health care system costs. Perhaps for relatives.

The Telegraph:

Mary Cooper, 79, died a few days after being put on the Liverpool Care Pathway at the Queen Elizabeth Hospital in King’s Lynn, Norfolk.

The pathway, originally designed to ease the suffering of terminally ill cancer patients in their very last days, is being used more and more widely in NHS hospitals.

The idea behind the LCP is to give patients a ‘good death’ by avoiding unnecessary and burdensome medical interventions.

However, there have been accusations it hastens death because it can involve the removal of hydration and nutrition.

The LCP leads over 100,000 people to death every year – just in the UK. It smacks of execution of the elderly for convenience.

Daily Mail:

There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP. …. Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’.

An assisted death for someone who does not wish to die is an execution.

Belgium introduces euthanasia for prisoners

September 15, 2012

Belgium allows euthanasia under very stringent conditions and now permits prisoners also to choose euthanasia.

If you agree with the concept of euthanasia  then the idea of allowing prisoners to opt for euthanasia would seem perfectly rational. There are ethical questions here which I am still thinking my way through but I think there are some dilemmas to be faced. However I cannot help feeling that a prisoner – almost by definition – is inevitably subject to some level of coercion. Within an isolated and vulnerable prison population where individuals are probably subject to the additional pressures of group phobias and pressure, I am not sure that an apparently voluntary choice can ever be a completely free choice.

And I have an additional dimension of nagging concern when organs for transplantation are harvested from euthanasia subjects:

BioEdge reports:

For the first time, a Belgian prisoner has been euthanased. A man identified as Frank V.D.B, who had spent 20 years in prison for two murders and rapes, died recently. The date is not clear from media reports, but it took place outside the prison. The death only became known because it was revealed by a politician, Senator Louis Ide, who was complaining about the lack of social services in Belgian jails. He seems to have been tipped off by a prison official.

The case has provoked a controversy in the media –not over euthanasia but over the violation of the prisoner’s right to privacy. All of the conditions for euthanasia in Belgium were carefully fulfilled: the prisoner had a terminal illness, he had made repeated requests for death, and three doctors had independently ratified the request. ….. 

Last year Belgian surgeons revealed that they had been harvesting organs obtained from persons who had requested euthanasia.

Indian Supreme Court: Active euthanasia is illegal but supervised passive euthanasia can be allowed

March 7, 2011
The supreme court of india. Taken about 170 m ...

Supreme Court of India: Image via Wikipedia

In a keenly-awaited verdict, the Supreme Court on Monday dismissed a plea for mercy killing on behalf of a 60-year-old nurse, living in a vegetative state for the last 37 years in a Mumbai hospital after a brutal sexual assault.

A bench of justices Markandey Katju and Gyan Sudha Mishra dismissed the plea filed on behalf of KEM hospital nurse Aruna Ramachandra Shanbaug, saying that while active euthanasia (mercy killing) was illegal, yet “passive euthanasia” can be permissible in exceptional circumstances.

The apex court said that as per the facts and circumstances of Ms. Aruna’s case, medical evidence and other material suggest that the victim need not be subjected to euthanasia.

The bench, however, said since there is no law presently in the country on euthanasia, mercy killing of terminally ill patient “under passive euthanasia doctrine can be resorted to in exceptional cases.”

The bench clarified that until Parliament enacts a law, its judgement on active and passive euthanasia will be in force. Ms. Aruna, who is now nearly 60-years-old, slipped into coma after a brutal attack on her at Mumbai’s King Edward Memorial Hospital by a staffer on November 27, 1973…..

During the arguments, the government had taken the stand that there is no provision either under the statute or the Constitution to permit euthanasia.

Her attacker was found guilty and served out his 7 year sentence and was freed.

“Passive euthanasia”is usually defined as withdrawing medical treatment with the deliberate intention of causing the patient’s death. For example, if a patient requires kidney dialysis to survive, the doctors disconnect the dialysis machine, allowing the patient to die soon.

This form of euthanasia is different from “active” euthanasia, or simply euthanasia, where the death is caused by the use of lethal substances. It is widely considered to be criminal homicide, but voluntary passive euthanasia is considered non-criminal in several countries.

Euthanasia conducted with the consent of the patient is termed “voluntary euthanasia”, which is legal in Belgium, Luxembourg, the Netherlands, Switzerland, and the U.S. states of Oregon and Washington.

When the patient brings about his or her own death with the assistance of a physician, the term “assisted suicide” is often used. If euthanasia is carried out on a patient, who is not in a condition to express his or her desire to die, it is called non-voluntary euthanasia. Examples include child euthanasia, which is illegal worldwide but decriminalised under certain specific circumstances in the Netherlands under the Groningen Protocol.

It’s also legal in Albania if three or more family members consent to the decision.

Although both forms of euthanasia are illegal in Switzerland, assisted suicide is penalised only if it is carried out “from selfish motives”.

In 1995, Australia’s Northern Territory had approved a euthanasia bill. It went into effect in 1996, but the Australian Parliament overturned the bill the next year.

In Colombia, the Supreme Court ruled in favour of mercy killing in 1997 and recommended removing penalties over it. But, the ruling has not gone into effect as the Colombian Congress is yet to approve guidelines for it.

It is illegal for anyone to actively contribute to someone’s death in Ireland. However, it is not illegal to remove life support and other treatment if a person requests for it — in other words, passive euthanasia is legal.

In Mexico, active euthanasia is illegal but since 2008 the law allows the terminally ill to refuse medication or further medical treatment to extend life.



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