It’s known as the historic reversal, and it appears irreversible: Places where the old outnumber kids.
What began in 1995 in a single country, Italy, will spread to 56 nations, economies as diverse as New Zealand and Georgia, by 2030. These are the findings of Joseph Chamie, who spent a quarter of a century studying population patterns at the United Nations in New York and now is an independent researcher.
But much more important is the steep upward trajectory of our long-term debt ”“ which remains as dangerous as ever. In its latest long-term outlook, released in June, CBO projected that the federal debt will climb to 141 percent of GDP by 2046 ”“ by far the highest level on record.
It is just the latest intervention by Christian figures in political debates on the matter. Jozef De Kesel, the Archbishop of Mechelen-Brussels in Belgium, which has the world’s most liberal assisted-dying laws, suggested in January that the country’s church-run hospitals should be allowed to opt out of helping patients end their lives. And in June Pope Francis said to a group of Spanish and Latin American doctors that “true compassion does not marginalise anyone, nor does it humiliate and exclude, much less considers the disappearance of a person as a good thing.” He cautioned against a “throwaway culture that rejects and dismisses those who do not comply with certain canons of health, beauty and utility.” Life is sacred, he added, and should shine “with greater splendour precisely in suffering and helplessness”.
Research shows that religious people are more likely than the non-religious to oppose assisted dying. But there is wide variation between faiths. A survey of Britons, carried out by YouGov in 2013, found that only three in ten Muslims felt the law should be changed to allow close friends and relatives to help people with incurable diseases take their own lives, should they wish to do so. Around half of Hindus and Sikhs surveyed agreed, and six in ten Catholics, Methodists, Baptists and Buddhists. Seven in ten Jews, and 77% of Anglicans, supported such a change in the law. For comparison, 85% of people who claimed no faith were in favour of legalising assisted dying.
Some Anglican leaders are starting to shift their positions. The general synod of the Anglican church in Canada, where doctor-assisted dying was recently legalised, has written guidance on the issue for its congregation. Though it does not go as far as to support doctor-assisted dying, it does not oppose its legalisation, either. “The societal and legal context within which the pastoral and prophetic ministry of the church takes place has shifted,” it notes.
Read it all (their title, it would never be mine).
If there is one certainty, it is that there will be lawsuits. Within days of Bill C-14 being adopted, the B.C. Civil Liberties Association launched a constitutional challenge, saying the “reasonably foreseeable” clause is discriminatory. A group of Christian doctors has challenged the requirement in Ontario that physicians who have a “conscientious objection” to providing assisted death themselves must, minimally, refer patients to another physician who will. (Quebec resolved this debate by allowing objecting physicians to refer to a neutral third party, to a hospital administrator who will, in turn, find a physician who will carry out a patient’s final wishes.)
Almost all of Canada’s 110 Catholic hospitals have also indicated that they will refuse to provide assisted dying, something that will be particularly problematic in small centres with a single hospital.
Quebec law ”“ like federal law ”“ requires a patient to be terminally ill to be eligible for assisted death. It also requires two physicians to sign off on the request, though at the Centre hospitalier de l’Université de Montréal (CHUM), a nurse can provide the second signature. This rule change came because doctors appeared to be rejecting many legitimate requests.
With a heavy heart, retired Anglican priest Mike Gardener is preparing to leave Iqaluit after a lifetime of work in the Arctic.
“It’s not my choice to leave,” says the 85-year-old.
After 61 years of life on Baffin Island and more than 41 years of work with the Anglican church in Kimmirut, Cape Dorset, Pangnirtung and Iqaluit, Gardener is moving to Ottawa next week.
His wife, Margaret, is moving into a special facility for Alzheimer’s patients.
Read it all from the CBC.
In a nod to changing times, the Anglican Church of Canada’s latest report on physician-assisted dying, rather than opposing the practice, recognizes it as a reality. The report offers reflections and resources around assisted dying and related issues, such as palliative care.
The Supreme Court of Canada struck down last year a ban on physician-assisted death for the “grievously and irremediably ill” as unconstitutional, notes the paper, entitled In Sure and Certain Hope: Resources to Assist Pastoral and Theological Approaches to Physician Assisted Dying, released Thursday, June 9.
In the wake of this decision, the paper states, “public debate concerning the legal ban on physician assisted dying is in some ways over.”
As a result, the authors continue, “our energy is best spent at this time ensuring that this practice is governed in ways that reflect insofar as possible a just expression of care for the dignity of every human being, whatever the circumstances.”
Looking at married couples who were together less than 20 years and couples together for more than 50, Mejia and her colleagues have found striking similarities between partners who have spent decades together, especially in kidney function, total cholesterol levels and the strength of their grips, which is a key predictor of mortality. They presented their findings at the annual meeting of the Gerontological Society of America.
The data came from 1,568 older married couples across the United States. The couples were part of a larger dataset that included information on their income and wealth, employment, family connections and health, including information based on blood tests.
One obvious reason for partner similarity is that people often choose partners who are like them ”” people from the same stock, with similar backgrounds. But that didn’t explain why there were more similarities between the long-time partners, compared to the others.
Although Bill C-14 unavoidably damages the value of respect for life and puts vulnerable Canadians at risk, its goals include, as its preamble recognizes, maintaining respect for human life at both individual and societal levels and the protection of vulnerable people. Achieving those two goals demands another goal be explicit in the preamble: not allowing medically assisted suicide to become part of the norm for how we die.
So how can we, as far as possible in the current circumstances, achieve these three goals?
The conditions legislated for qualification for hastened death will be critical. They must be very limited and strictly controlled; they underline that it is an exceptional intervention, limited to adults competent at the time of death, terminally ill from a physical disease or disability, in unbearable suffering and giving their informed consent.
I spend most of my time in the company of my cherished wife. I think there is truth in the old line that older marrieds tend to resemble each other as time goes by. I enjoy visits with friends as well, but I have a rule: None of us can speak more than three sentences about medical news. I am certain my problems have limited interest, and so, I fib a lot when I am asked how I am doing.
To me, old age seems to be the art of keeping going. Speed and direction are not important. Movement is. I swim but slowly. I barely walk. I write, but with acute knowledge that my values and opinions are outdated. I still think duty, honor and country should be the national mantra. I know better.
The very best thing about growing older is that I no longer try to change anyone’s mind. I can easily accept disagreement from friends and even critics. I also have long since surrendered any hope of impressing others, or of being impressed by them. In these final innings I want to stay at bat, even if I know I cannot expect to get a hit.
Canada’s doctors are pleading with the federal government to put specific guidelines in its medically assisted dying law regarding patients who want to end their lives because of psychological suffering.
“There are still a lot of grey areas, and a lot of unknowns,” said Jeff Blackmer, vice-president of medical ethics at the Canadian Medical Association.
“Before we sort of open that Pandora’s box, we need to have a lot more clarity as to what would qualify, and exactly what the process would be.”
A majority of people killed by euthanasia in the Netherlands for so-called psychiatric reasons had complained of loneliness, a new study has found.
Researchers in the U.S. found that loneliness, or “social isolation”, was a key motivation behind the euthanasia requests of 37 of 66 cases reviewed, a figure representing 56 per cent of the total.
The study by the National Institute of Health also revealed that the Netherlands was operating a de facto policy of euthanasia on demand, with patients “shopping” for doctors willing to give them a lethal injection for the most trivial of reasons.
[Dolores Westfall]…endures what is for many aging Americans an unforgiving economy. Nearly one-third of U.S. heads of households ages 55 and older have no pension or retirement savings and a median annual income of about $19,000.
A growing proportion of the nation’s elderly are like Westfall: too poor to retire and too young to die.
Many rely on Social Security and minimal pensions, in part because half of all workers have no employer-backed retirement plans. Eight in 10 Americans say they will work well into their 60s or skip retirement entirely.
Irwin Weiner felt so good after heart surgery a few weeks before turning 90 that he stopped for a pastrami sandwich on the way home from the hospital. Dorothy Lipkin danced after getting a new hip at age 91. And at 94, William Gandin drives himself to the hospital for cancer treatments.
Jimmy Carter isn’t the only nonagenarian to withstand rigorous medical treatment. Very old age is no longer an automatic barrier for aggressive therapies, from cancer care like the former president has received, to major heart procedures, joint replacements and even some organ transplants.
In many cases, the nation’s most senior citizens are getting the same treatments given to people their grandchildren’s age ”” but with different goals.
“Many elderly patients don’t necessarily want a lot of years, what they want is quality of life,” said Dr. Clifford Kavinsky, a heart specialist at Rush University Medical Center in Chicago. “They want whatever time is left for them to be high quality. They don’t want to be dependent on their family. They don’t want to end up in a nursing home.”
Q:Your article on homesickness was very thought-provoking. Many of my peers and I relocated in our sixties. Although we volunteer, attend houses of worship, have friends and travel, many of us are still lonely for home and sometimes depressed because of it. Has anyone studied this?
”” E.M.
A:People of all ages can feel homesick, and longing for the security and comfort of a past home can increase with age, according to a few studies that have included healthy elderly participants.
People often look for new sources of identity as their relationship with career and past colleagues fade. A 2004 study by Norwegian researchers found that elderly Danes and Pakistanis who had settled in Norway decades earlier identified more strongly with their native countries as they grew older, bringing a feeling of homesickness. Connecting to their cultural heritage by decorating their homes with related artwork or talking about their memories supported self-esteem and helped make up for age-related losses in other areas, researchers found.
A French doctor convicted last week of having given an elderly patient a lethal injection was hospitalized in critical condition on Saturday after apparently trying to commit suicide, according to media reports said….
The drama came seven days after the doctor, described in court as a “militant supporter of euthanasia,” was convicted of deliberately causing the death of an 86-year-old woman who was in a coma after suffering a severe stroke. Bonnemaison gave her a fatal dose of sedative, the court was told.
He was given a two-year suspended sentence in the woman’s death, while cleared of six other charges of euthanasia involving elderly patients with fatal diseases at the hospital in Bayonne where he worked in 2010 and 2011.
[The] Reverend David West said it was the first lecture the church had banned and admitted the timing was “unfortunate”, saying he only became aware of the content of the talk on Monday….
“We use church property for all sorts of groups, but the content of any group can’t be offensive to the Anglican Church and assisted dying is something the Anglican and mainstream Christian churches object to.”
The grim reaper is feeling bullish.
Following success in California ”” the fifth state where doctors are now free to prescribe lethal doses of medication to terminally-ill or dying patients ”” so-called “right-to-die” activists have turned their eyes to Maryland, New York and beyond.
“I think that this is a national wave,” Maryland Del. Shane E. Pendergrass, D-Howard, told The Washington Post. Pendergrass plans to sponsor “right-to-die” legislation in January.
It’s a wave with the potential to sweep some of society’s most vulnerable ”” the elderly, the terminally ill and disabled ”” prematurely into the hereafter.
Perhaps it’s not surprising that the best arguments against assisted suicide ”” especially advanced by such liberal icons as E.J. Dionne and Victoria Kennedy ”” are progressive. Liberals are generally happy for government to restrict individual freedoms to prevent violence and killing. They are also generally skeptical of the idea that choice leads to genuine freedom, especially for those without power on the margins of our culture.
Indeed, liberal states such as Massachusetts, Connecticut, New Jersey and, until this week, California had all recently rejected such legislation. Britain’s attempt to pass an assisted-suicide bill also went down to overwhelming defeat.
To get a victory in California, its supporters were forced to bypass the regular legislative process (which defeated the bill) and instead consider the bill in a healthcare special session, and under unusual rules. This context is as telling as it is disturbing.
Read it all from the LA Times.
Q: What do critics say?
Many doctors continue to object to it, as do many religious leaders and activists for the disabled who fear that the disabled could be put under duress to end their lives prematurely.
The California Catholic Conference, the Medical Oncology Assn. of Southern California and the California Disability Alliance note that similar bills have failed recently in Connecticut, Delaware and Colorado.
“This bill is simply about protecting doctors and HMOs from liability,” Marilyn Golden, a senior policy analyst for the Berkeley-based Disability Rights Education and Defense Fund told The Times earlier this year, “and tells people with disabilities who face a terminal diagnosis that may well prove inaccurate that there is no dignity in our lives.”
The denial of God — or the blithe bracketing of the question of God — is not a harmless parlor game. Rather, it carries with it the gravest implications. If there is no God, then our lives do indeed belong to us, and we can do with them what we want. If there is no God, our lives have no ultimate meaning or transcendent purpose, and they become simply artifacts of our own designing. Accordingly, when they become too painful or too shallow or just too boring, we ought to have the prerogative to end them. We can argue the legalities and even the morality of assisted suicide until the cows come home, but the real issue that has to be engaged is that of God’s existence.
The incoming freshman class at Harvard is a disturbing omen indeed, for the more our society drifts into atheism, the more human life is under threat. The less we are willing even to wrestle with God, the more de-humanized we become.
The Rector of Faughanvale Parish has condemned those responsible for a break-in at the home of an elderly parishioner, which took place while she was attending a religious service in her local church.
The incident happened on Friday evening, while the victim was in St Canice’s Church in Eglinton, attending the institution of the parish’s new Rector, Rev Paul Hoey. Thieves broke into the woman’s home in the village and ransacked every room.
The break-in was discovered when the woman returned home after the service. She was extremely shaken by the incident and was comforted by parishioners.
On Feb. 6, 2016 ”“ one year after the historic Supreme Court ruling in the case of Kathleen Carter and Gloria Taylor ”“ physician-assisted death will be legal in Canada. The Canadian Medical Association last week debated what life would be like for physicians and patients in this brave new world. One thing was clear: We are woefully unprepared for Feb. 7.
The Court said the Criminal Code’s prohibitions on assisted suicide will no longer apply “to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.” It also stated that physicians cannot be compelled to hasten a person’s death.
In the yawning gap between this straightforward theory and the complexities of everyday practice lie many questions:
Ӣ When a patient asks for a hastened death, who will they ask?
”¢ What do the terms “grievous and irremediable” and “enduring suffering that is intolerable” mean?
”¢ Who will determine a patient’s capacity to consent?
”¢ If a physician can’t be compelled to perform the act, does he or she have an obligation to refer to a doctor who will?
”¢ How long will the “cooling off” period be between a request and administration of a lethal drug?
If you are wondering what the next social debate in the United States will be, NPR host Diane Rehm spelled it out recently in a public campaign: assisted suicide.
Those like Rehm who believe terminally ill patients should be to able to end their lives with help from physicians typically avoid the words suicide and mercy killing. The bald truth of those words would not win support for the movement. Still, Rehm declared that Jack Kevorkian, who went to jail for killing terminally ill patients, “was before his time” and that “the country wasn’t ready.”
But it’s apparently ready now. The agenda is set. Death will not be defeated.
Assisted suicide””defined as a physician providing a patient the means to take his or her own life, usually through medicine””is now legal in five states, with several more currently considering end-of-life legislation.
The compelling religious opposition to Dignity in Dying’s aims has been a constant thorn in their side and, as their own polling has shown, opposition to assisted suicide is strongest among those who most frequently attend worship: support is highest amongst infrequent attendees; those who might be described as culturally or more loosely affiliated to a religion.
What is surprising is not that Dignity in Dying has sought to apply PR solutions to their problematic lack of support among churches and other religious bodies, but that they have taken a more combative position against those with a religious faith more generally; those who tend to believe that assisted suicide is mistaken, regardless of whether the primary objection is on religious or non-religious grounds. This has, as we saw last weekend, extended so far as to question the sincerity of those advancing pragmatic arguments about concern for the vulnerable, because they might also happen to have a faith, or because they may be associated with others that do.
In June, Catherine Bennett wrote in the Guardian ”˜When politicians do God, no wonder we have doubts”˜. She focused negatively on Liberal Democrat leadership contender Tim Farron’s Christian beliefs. Wootton tweeted that she “couldn’t agree more” with Bennett, who had concluded that “everyone agrees that, when it might affect their objectivity, MPs must declare an interest. It seems only fair to ask that, when ethics are debated, they disclose which supernatural affiliation has dictated their response, along with any penalties for disobedience”.
The controversial Liverpool Care Pathway for dying patients was phased out after an independent review by Baroness Neuberger, which concluded that it had been “misused and misunderstood” by hospital staff.
But although the LCP has gone (in name, at least), it represented “the best quality of care possible” for the dying as defined by palliative medicine physicians. It is therefore not surprising that new guidelines replacing the LCP, recently issued by the National Institute for Health and Care Excellence (Nice), are very similar. Indeed, they perpetuate the features that made the LCP so dangerous.
The Nice guidelines are, if anything, even worse than the LCP as a result of certain additions. The writers had the Neuberger report to draw on, but they have not taken on board some of its main recommendations. Although the guidelines say they respond “to a need for an evidence-based guideline for the clinical care of the dying”, references to a solid base of scientific evidence are almost totally lacking.
In a landmark victory for supporters of assisted suicide, the California State Legislature on Friday gave its final approval to a bill that would allow doctors to help terminally ill people end their lives.
Four states ”” Oregon, Washington, Montana and Vermont ”” already allow physicians to prescribe life-ending medication to some patients. The California bill, which passed Friday in the State Senate by a vote of 23 to 14, will now go to Gov. Jerry Brown, who will roughly triple access to doctor-assisted suicide across the country if he signs it. Mr. Brown has given little indication of his intentions.
The California bill is modeled on the law in Oregon, with several notable changes. The California law would expire after 10 years and have to be reapproved, and doctors would have to consult in private with the patient desiring to die, as part of an effort to ensure that no one would be coerced to end his or her life ”” a primary concern for opponents of the law.
Leaders of the “death with dignity” movement said they hoped the passage of the California law could be a turning point.
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…I can understand the argument for assisted dying, especially when I see people with dementia. I can (or I think I can) cope with physical frailty but it is the thought of losing one’s mind that troubles me most. Perhaps I, too, would want the independence to end my life at a time and circumstances of my choosing. But is dementia or another intractable condition even part of this assisted dying bill, which talks of capacity and death within fixed timeframes?
The proposed bill does not offer sufficient safeguarding for patients and doctors. Mental capacity can change depending on mood, physical distress or social hardship. There is always the risk that doctors will get it wrong. This risk of causing harm far outweighs any potential benefits.
Patients must have the trust and assurance that we are on their side. More thought needs to go into amending the bill further and looking at the practicalities of how assisted dying could be implemented, as there is no scope for this in routine medical practice. Assisted dying should not be the cheap alternative to high-quality palliative care.
Wesley Smith is right: north of the border there is a concerted attempt to erase the conscience rights of doctors, by demanding referrals for the killing of the unborn (who do not need to put in a request) and of the terminally ill (who thus far do) and, for that matter, of any other procedure deemed “medical.”
The Montreal Gazette today published a letter of mine objecting to this “ethical cleansing” of conscientious objectors from the medical community. The editor chose to leave off my final remark, that “the time has come to press for the full legal rights and recognition for those, both patients and professionals, of Hippocratic conviction. Bill 52 notwithstanding, and Carter v. Canada notwithstanding, the Canadian Charter of Rights and Freedoms still guarantees freedom of conscience and religion.”
While Carter (a truly atrocious judgment) left open the question of how patients’ rights and doctors’ rights are to be balanced under the Charter, it is noteworthy that the former set of rights is always considered only in terms of the rights of those who desire “medical assistance in dying” and never in terms of the rights of those who want physicians and health care professionals committed to the Hippocratic principles. It is imperative, at least as a holding action, that the latter be asserted and defended. Otherwise it will soon be impossible even to be trained in medicine without grave violations of conscience.
Assisted dying would create new dilemmas at the end of life. Doctors would be concerned about the certainty of the diagnosis. For example, I recall an elderly man who was confidently diagnosed by a specialist team as having inoperable pancreatic cancer and given weeks to live. He would have met the Assisted Dying Bill criteria, but years later he is still playing golf; the diagnosis was wrong. Doctors would be concerned about assessing people’s mental capacity to take such an irrevocable decision. The standard tests assess a person’s ability to take a decision, not whether the decision itself is reasonable or based on realistic assumptions. Doctors would be concerned that a person might be pressurised in subtle or concealed ways.
In the Netherlands the law requires that the doctor believes that the person faces unbearable and hopeless suffering and that there are no reasonable alternatives. There is no such requirement in the Assisted Dying Bill. A doctor might be asked to end the life of a person who, although believed to be terminally ill, was not suffering and where palliative care would be expected to alleviate future suffering. Even doctors who find assisted suicide morally acceptable would find ending the life of such a person difficult.
The Bill would legalise physician-assisted suicide but not euthanasia. The deliberate killing of a person with the intention of avoiding suffering would remain illegal. A health professional could assist someone to self-administer the medicine but the final act must be taken by the person herself. Consider the position of a nurse attending a home to carry out an assisted suicide. The patient cannot swallow the medication so she sets up a syringe driver. The patient is too weak to press the button and requests that the nurse does it. But if the nurse presses the syringe driver button, that would be euthanasia, therefore illegal, and would expose her to the risk of an accusation of murder. The line between assisted suicide and euthanasia can be a fine one.
It appears, then, that it is a question of when, not if, there will be a change in the law. And yet we must heed John Stuart Mill’s call to be wary about the tyranny of the majority. For, as the archbishop of Canterbury, Justin Welby, argues in today’s Observer, such a change would mark the crossing of a legal and ethical Rubicon. “We are asked to sanction doctors participating in individuals taking steps to end their lives,” Welby writes. “This is a change of monumental proportions both in the law and in the role of doctors.”
Welby observes that any “change in the law would place very many thousands of vulnerable people at risk”. Fearing that they were a burden, some would choose to end their lives, he says. The risk, ultimately, he warns is that we end up in a society “where each life is no longer seen as worth protecting, worth honouring, worth fighting for”. For Welby, “the current law is not ”˜broken’. There is no need to fix it.”
Society seems to disagree, as does one of his predecessors, Lord Carey. So, too, do the majority of Christians, according to at least one poll. But this is not to say that polls should determine policy nor that the church’s entrenched opposition to reform be ignored.