To stop doctors ending their lives, we need to hear from those suffering

The Guardian, 21 March 2017
Author: Ranjana Srivastava
“The revelation that four junior doctors have taken their own lives in recent months obliges us to look at why doctors with mental illnesses don’t speak up. There is ample evidence for the high rates of mental illness in doctors, several times greater compared with other professions and the general population. Armed with knowledge and surrounded by advice, why do doctors commit suicide at an alarmingly high rate?”
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How Do We Protect Patients From False Promises In Right-To-Try Laws?

Health Affairs Blog, 14 March 2017
Author: Ellen Sigal
“Unfortunately, the current federal legislation provides almost no protections for patients. Everyone with a late-stage terminal illness like my sister deserves the chance to try an experimental therapy. However, serious changes to today’s legislative proposal are needed before this law is safe for patients.”
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Donation after brain circulation determination of death

BMC Medical Ethics 2017 18:15
Authors: Anne L. Dalle Ave, James L. Bernat
“In DBCDD, death is determined when the cessation of circulatory function is permanent but before it is irreversible, consistent with medical standards of death determination outside the context of organ donation. Safeguards to prevent error include that: 1] the possibility of auto-resuscitation has elapsed; 2] no brain circulation may resume after the determination of death; 3] complete circulatory cessation is verified; and 4] the cessation of brain function is permanent and complete. Death should be determined by the confirmation of the cessation of systemic circulation; the use of brain death tests is invalid and unnecessary. Because this concept differs from current standards, consensus should be sought among stakeholders. The patient or surrogate should provide informed consent for organ donation by understanding the basis of the declaration of death.”
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Response to ‘A matter of life and death: controversy at the interface between clinical and legal decision-making in prolonged disorders of consciousness’

BMJ Blogs, 3 March 2017
Author: Julian Sheather
“The law has to work in generalities. The prohibitions it imposes and the liberties it describes are set for all of us, or for large classes of us. But we live – like we sicken and die – as individuals. Lynne Turner-Stokes gives a vivid account of an area of clinical practice where these truisms come into conflict. Practice Direction 9E (PD9E) doesn’t sound like much, a piece of dry-as-dust procedure for the Court of Protection, but it governs an area of keen moral concern: for our purposes, decisions relating to the withdrawing or withholding of clinically-assisted nutrition and hydration (CANH) from patients in a persistent vegetative state (PVS) or a minimally conscious state (MCS). According to PD9E, all such decisions should be bought before the Court of Protection.”
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In places where it’s legal, how many people are ending their lives using euthanasia?

The Conversation, 3 March 2017
Author: Andrew McGee
“The Victorian Parliament will consider a bill to legalise euthanasia in the second half of 2017. That follows the South Australian Parliament’s decision to knock back a voluntary euthanasia bill late last year, and the issue has also cropped up in the run-up to the March 11 Western Australian election. With the issue back in the headlines, federal Labor’s justice spokesperson, Clare O’Neil, told Q&A that in countries where the practice is legal, “very, very small” numbers of people use the laws.”
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Ruling on assisted dying drug Nembutal sets important precedent

The Conversation, 28 February 2017
Author: Simon Chapman
“Just before Christmas 2016, the Victorian Civil and Administrative Tribunal (VCAT) handed down a historic judgement in a case brought by the veteran advocate for assisted dying, Dr Rodney Syme. This followed a decision, which was then referred to its immediate action committee by the Medical Board of Australia, to prevent Syme from “engaging in the provision of any form of medical care, or any professional conduct in his capacity as a medical practitioner that has the primary purpose of ending a person’s life”.”
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Nurses should not participate in executions by lethal injection

The Conversation, 21 February 2017
Author: Roger Watson
“In some US states, prisoners condemned to die are killed using lethal injections. This takes place in two steps which make the prisoner unconscious and then stop breathing. Nurses are often present, but do they really need to be present? A group of senior nurses from the UK, Australia and the US recently debated this issue. They concluded that, unfortunately, the international nursing codes of ethics lacks sufficient detail to be helpful to nurses faced with the decision to take part, or not, in an execution.”
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Beyond cultural stereotyping: views on end-of-life decision making among religious and secular persons in the USA, Germany, and Israel

BMC Medical Ethics 2017 18:13
Authors: Mark Schweda, Silke Schicktanz, Aviad Raz, Anita Silvers
“End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping. Our paper confronts the bioethical expert discourse with public moral attitudes.”
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The doctor’s dilemma: is it ever good to do harm?

The Guardian, 9 February 2017
Author: Gwen Adhsead
“Medical knowledge changes swiftly, and technological changes make new and expensive investigations and treatments possible that were only theoretical a few years ago. Life has been extended in length, but not in quality, and the debates about end?of?life decisions show us how much the notion of a “good life” is bound up with the absence of disease, illness and suffering.”
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Palliative care and voluntary-assisted dying: the common ground

MJA Insight, 6 February 2017
Author: Ian Maddocks
“Advocates for palliative care and voluntary-assisted dying (VAD) have been formidable warriors, on opposite sides in the public debate about the legalisation of euthanasia. Now, when there is the prospect of the introduction of VAD legislation in Victoria in the foreseeable future, is it time to explore ways to affirm them both, and to ask whether they are, in some way, complementary?”
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