Though it has brought advanced care planning to a remarkable number of people, Respecting Choices has encountered some resistance. Britt Welnetz, the organization’s business development consul­tant, said that she is often asked whether a nonphysician facilitator can effectively discuss medical decisions. She explains that the standardized, patient-centered conversation leads to an overall level of patient satisfaction.

Others ask if the Respecting Choices model can work in a community that’s more diverse than La Crosse. Research indicates that it can. The Respecting Choices program was implemented in a hospital in Mil­wau­kee, and the use of advance directives among racial and ethnic minorities in­creased substantially from 25.8 percent to 38.4 percent. Research suggests that it’s knowledge of advance directives, regardless of race and ethnicity, that leads to their use.

The advance care planning facilitator model has gained acceptance both nationally and internationally. Respect­ing Choices has trained more than 10,000 facilitators, as well as nearly 600 instructors and nearly 30 faculty members who can implement system-wide changes. There are facilitators in 47 states in the United States, and Respecting Choices is the national standard of care in Singapore and Australia; the program is also the model for an $8.5 million European Union study of advance-stage cancer patients and end-of-life care.

Read it all.

Brittany Maynard stuck by her decision.

The terminally ill woman who revived a national debate about physician-assisted suicide ended her life Saturday by swallowing lethal drugs made available under Oregon’s law that allows terminally ill people to end their lives. She would have been 30 on Nov. 19.

Maynard had been in the national spotlight for about a month since publicizing that she and her husband, Dan Diaz, moved to Portland from Northern California so that she could take advantage of the Oregon law. She told journalists she planned to die Nov. 1, shortly after her husband’s birthday, but reserved the right to move the date forward or push it back.

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In the five states where it’s legal, physician-assisted dying involves rigorous regulations, including how long a person has lived there, says Cathy Lynn Grossman, senior national correspondent for Religion News Service. “Brittany Maynard moved from California to Oregon, where it’s legal specifically to qualify for”¦a prescription for lethal drugs. The person takes the drugs themselves if and when they choose to, and not everyone who gets the prescription ever uses it.”

Read or watch it all.

China’s newly announced switch to a two-child population control policy does not resolve the coercive nature of the program, pro-life leaders say.

The disclosure of the change came even as the communist government imposes the most severe oppression in four decades, according to a leading advocate for the Chinese church.

Christians face the “worst persecution in China since the Cultural Revolution,” Bob Fu, president of ChinaAid, said in an article by Christian Today on Oct. 9.

That description is justified, Fu explained to BP in written comments in an email interview…[yesterday] (Oct. 22), due to “both the large scale and the severe degree of [the] violent crackdown” against not only the unregistered house churches but against the government-approved Three-Self Patriotic Movement congregations. About 300 churches have either been destroyed or had crosses forcibly removed recently in an ongoing campaign, and various believers have been arrested, Fu said.

Read it all.

This latest story from our brave new world may blow your mind, so I’ll read straight from the Chicago Tribune: “A white Ohio woman is suing a Downers Grove-based sperm bank, alleging that the company mistakenly gave her vials from an African-American donor, a fact that she said has made it difficult for her and her same-sex partner to raise their now 2-year-old daughter in an all-white community.”

Now, I don’t doubt the lesbian couple’s love for the child. But I find it troubling which challenges the couple was willing and isn’t willing to tolerate. They’re suing because of the difficulties of raising a black child in a white community, but they were perfectly willing to risk raising the child without a father””a situation that the best evidence suggests poses far greater consequences for the child. Make no mistake: this is one of those stories that’s a mirror of our culture’s view of sex and children.

There is no doubt that having a mom and a dad in the home is the best situation for healthy development of children. The evidence is overwhelming.

Read it all.

Consider also the reasons given by Francis and Anne which are partly personal fears and partly about a false altruism. Not wanting to ”˜watch the slow decline of a partner’; fear of going to a nursing home; ”˜too many people on this earth’- making more pension money available for others; not wanting to ”˜dig into our savings’ and not being able to do the things they could at an earlier age. Add this to John Paul’s clear point that he didn’t want to look after them, and it’s almost a ”˜perfect storm’ of lack of imagination, lack of a willingness to care and to look towards other alternatives.

There is also an insidious cultural side to this affair evident in the reporting at Moustique. There is no alternate voice here; no suggestion that promoting this story might have a deleterious effect upon others. No help lines promoted, no questioning in any constructive way. The social question, as always, is about the cart and the horse ”“ is the media effectively pushing the issue or is it, as it may claim, simply reflecting the vox populi?

This is not a ”˜celebration of choice’; far from it. It is a rationalization devoid of humanity and created, in the first instance by the legal possibility of euthanasia. It is then abetted by whatever it is in that family and that society that confirmed and supported the kind of dysfunction that allowed the children to confirm and assist instead of saying a clear, No, and offering every alternate support, no matter what the cost.

Read it all.

Doubtless, death is a loss. It deprives us of experiences and milestones, of time spent with our spouse and children. In short, it deprives us of all the things we value.

But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.

Americans seem to be obsessed with…a valiant effort to cheat death and prolong life as long as possible. This has become so pervasive that it now defines a cultural type: what I call the American immortal.

I reject this aspiration. I think this manic desperation to endlessly extend life is misguided and potentially destructive. For many reasons, 75 is a pretty good age to aim to stop….

Read it all.

The panel, which included doctors, nurses, insurers, religious leaders, lawyers and experts on aging, said Medicare and other insurers should create financial incentives for health care providers to have continuing conversations with patients on advance care planning, possibly starting as early as major teenage milestones like getting a driver’s license or going to college.

It called for a “major reorientation and restructuring of Medicare, Medicaid and other health care delivery programs” and the elimination of “perverse financial incentives” that encourage expensive hospital procedures when growing numbers of very sick and very old patients want low-tech services like home health care and pain management.

And it said that medical schools and groups that accredit and regulate health providers should greatly increase training in palliative care and set standards so that more clinicians know how to compassionately and effectively treat patients who want to be made comfortable but avoid extensive medical procedures.

Read it all.

“Sadly, Belgium has been at the forefront of making euthanasia available on demand. The door was first opened in 2003, and every year since then the demand for euthanasia and its practice has increased,” Paul Moynan, director of CARE for Europe, told Christian Today.

“Last year these deaths were up by 27 per cent on the previous year, with five people a day being euthanised,” he added.

Moynan blamed the Belgian health system for failing to address Van Den Bleeken’s needs sufficiently.

“With euthanasia being packaged as palliative care, our care homes are not safe. With its extension this year to all ages, our children are not safe. And now the mentally ill in prison are not safe,” he explained.

Read it all.

After I published a story about my grandmother’s dilemma on July 24 last year, I received hundreds of emails and letters from readers worldwide. Some wrote about struggles they’d experienced with their relatives. Others were anxious about their parent-care challenges ahead.

“I have never cried when reading a Bloomberg story,” wrote one reader. “I am going to make sure to talk with my grandmother about what she wants when she reaches that point.”

The story was also read by medical professionals. Kojiro Tokutake, a Japanese gastroenterologist, shared his story about his own internal conflict about the value of tube feeding. His experiences formed the basis of another story that I published.

Read it all.

Douglas Schreiber, vice-president of DUSA, told the Dundee Courier: “We have students on campus who have had abortions in the past and there was clearly some distress felt by a number of the students that attended the fair surrounding this issue.

“The students largely do not want anything to do with a group that promotes the removal of rights over bodily autonomy for over half the student population that attend this university.”

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New York state, Minnesota and Washington, D.C., all have pending legislation that would legalize the practice of commercial surrogacy””paying someone to have a baby on your behalf. Reproductive technology has made surrogacy possible since the 1980s, but it remained relatively rare until recent years as the technology improved and the legalization of same-sex marriage increased the number of childless couples eager to have children.

The Catholic Church has long opposed surrogacy, whether paid or unpaid. Nowadays, with increasing pressure for the legalization of paid surrogacy, the church has found itself with an unfamiliar ally: feminists.

The Catholic Church and women’s rights groups are accustomed to clashing over policy matters involving contraception and abortion. But now the two camps can often be found working hand in hand when it comes to protecting both women and children from being exploited in the growing and largely unregulated fertility industry.

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Parker, the article says, preached in Baptist churches as a young man, before going into medicine. He had, he says, a “come to Jesus” moment where he became convinced that he ought to do abortions. “The protesters say they’re opposed to abortion because they’re Christian,” he says. “It’s hard for them to accept that I do abortions because I’m a Christian.”

The profile portrays Dr. Parker as he prepares women for the abortions he is selling them. He tells them to ignore everything but their own consciences, and then, of course, he informs their consciences that abortion is morally acceptable. “If you are comfortable with your decision, ignore everything from everybody else.”

Apparently, he knows how to ignore everything else, including the conscience. The article quotes him talking a woman through an abortion by telling her that her unborn child is “very small.”

Read it all.

Research shows that children are best brought up in families where a mum and dad are present. The role of fathers in the nurture of their children is unique and cannot be replaced by other so-called ”˜male role-models’ or, indeed, an extra ”˜mother’.

Research tells us that children relate to their fathers differently than to their mothers, and this is important in developing a sense of their own identity….

None of this should detract from the heroism of single parents. They should be provided with every support by the State and by local communities.

There is, however, a big difference between children growing up without fathers because of death or family breakdown, and actively planning to bring children into the world who will not know one of their biological parents and where such a parent will never be part of the nurture of these children.

Read it all.

The Most Revd Clarke said: “One of the most perplexing aspects of the intervention of a former Archbishop of Canterbury, George Carey, into the debate in England on the side of assisted dying was that a fundamental Christian tenet ”“ that our life on earth is not our property to do with as we choose ”“ appeared to have eluded him entirely.

“Much therefore depends on how we understand the significance of earthly life.

“If life is simply a personal commodity…then life is disposable, entirely at the will of the individual ”˜possessor’. This is clearly not the Christian perspective and, even for the non-believer, it is not an automatic understanding of the significance of life.”

Read it all.

Before birth, it is accepted practice to inject the heart of the unborn child with potassium chloride to cause death before inducing a stillbirth, or late term there may be a partial birth abortion in which during delivery an instrument is inserted into the child’s brain through the back of the neck so it also is born dead. After birth, even the birth of a baby of the same or even less maturity or gestational age, to end the life would be regarded as a criminal offence in most jurisdictions.

Anecdotally, mothers who opt not to have their child given the fatal injection before birth are placed under great pressure to use the technique to prevent the birth of a child with a disability. It is a cognitive dissonance that seems irresolvable that birth, not maturity or gestational age, is what makes the difference in status of the infant.

Cultural attitudes to disability are obviously conflictual. Public reaction appears to condemn the commissioning couple for reportedly deserting a child on the basis of disability and the inherently discriminatory attitude involved, but would presumably have accepted the killing of baby Gammy before birth at the request of the commissioning couple or the agency, if the birth mother had acquiesced.

There are many other conflicts underlying this case.

Read it all.

“We should not be surprised if parents who have ordered a baby and rented a woman’s womb refuse it at birth if it is not healthy and perfect,” said an article published in the Vatican’s semiofficial newspaper, L’Osservatore Romano.

“In fact if a child becomes a product to buy, it is obvious that as with any acquisition it must meet with the buyer’s approval.”

The strongly worded commentary was written by prominent Catholic feminist and regular contributor Lucetta Scaraffia, who argued the child’s rejection was to be expected in the “explosive mix” of consumerism combined with a “throwaway culture.”

Read it all.

Should a fertility treatment clinic implement a policy requiring patients to use only ethnically or racially matched gamete donors? If the idea of such a policy already triggers some element of moral revulsion, you need not read further. But for argument’s sake, here’s why a controversial policy that was in effect until last year at Calgary’s only fertility clinic, and which requires patients to use racially matched sperm donors, is morally, ethically, and legally objectionable.

The policy suggests that a child is disadvantaged by not having an ethnically matched parent. This is a dangerous idea that stigmatizes children who are part of ethnically mixed families. Besides, there is not a shred of evidence that suggests the welfare of a child born (with or without donor gametes) to a person of different ethnicity or race is diminished by the mere fact of that difference.

Individuals who do not have fertility issues are free to seek out partners of any race, colour, ethnicity or creed for procreation purposes. Why then should those seeking fertility treatment be limited to ethnically matched donors? Such limitation stifles patient choice and makes a mess of the ethical and legal concept of autonomy, which is fundamental to medical decision-making in our society. Indeed, it violates professional practice guidelines issued by the International Federation of Gynecology and Obstetrics, which stipulate that patients should “be provided with the opportunity to consider and evaluate treatment options in the context of their own life circumstances and culture.” Simply put, decisions regarding a future child’s ethnicity should be made by parents, not by doctors.

Read it all.

The Rt. Rev. James Newcome, who speaks for the Church of England on health, has called for Lord Falconer to withdraw the Bill in favour of a Royal Commission on the subject.

The Bishop of Carlisle said: “It has brought the issues to the forefront of public discussion and highlighted what an important issue this is. Certainly, our hope as the Church of England is that the Falconer Bill will be withdrawn and that, because this is such an important issue, it could be discussed at length by a Royal Commission.”

A Royal Commission would allow the arguments to be “carefully assessed” and for expert opinion to be taken.

He added that the Church of England is in favour of the law on assisted suicide to remain unaltered as it provides a “good balance” between compassion and protection of the vulnerable.

Read it all.

Read it all.

It’s been a busy season for news from the Church of England. Below are just a few of the recent important stories about the CoE General Synod, the Women’s Bishop vote, the Assisted Dying debate, the new Baptismal liturgy, and more..

You can find all CoE posts using the Church of England category link.
For more on Assisted Dying, check out the life ethics category or the ethics/moral theology category..
For more on women bishops, use the CoE bishops category

Links below are from the period July 7 – July 21. Some earlier stories of note may be found in our July 8: Other recent featured entries post.

Featured Entries:
July 18: Russian Orthodox Church Statement on Unilateral CofE Women Bishops Decision
July 14: May I Vote or Should I Go? Transcript CofE Synod Friday Afternoon Women Bishops
July 11: CofE General Synod 11th to 15th July 2014 Links
July 10: Papers for Business at Church of England General Synod which Begins Tomorrow

Assisted Dying:
([A Terrifying] Economist Leader) Most Western people favour assisted suicide, change the law
The assisted dying debate has been dominated by Christian voices ”“ sadly in disagreement
Latest: House of Lords allows Assisted Dying Bill to proceed
Archbishop John Sentamu Speaks Against Assisted Dying bill today
(Guardian) Legalising assisted suicide is a mistake I learned from my wife’s death says Bishop Inge
(Telegraph) Follow the Assisted dying debate in the House of Lords””live
“Assisted Dying”: Archbp Welby signs faith leaders’ statement against Lord Falconer’s Bill
(Telegraph) Michael Nazir-Ali””Lord Carey’s judgment on assisted dying is un-Christian
Jeffrey Bishop””The Hard Work of Dying: Refusing the False Logic of Physician-Assisted Death
(Observer) Desmond Tutu: a dignified death is our right ”“ I am in favour of assisted dying
(BBC) Assisted dying: The Church of England seeks inquiry
Peter Saunders””Why Lord Carey is so desperately wrong about legalising assisted suicide
(Bishop of Leeds) Nick Baines””Dying matters
(Church Times) Archbishop Welby and Lord Carey part ways on assisted dying
George Carey-Why I’ve changed my mind on assisted dying says a former Archbishop of Canterbury
Archbishop Justin Welby writes for The (London) Times arguing against the Assisted Dying Bill
A Pastoral Letter on the Assisted Dying Bill from the Bishop of Shrewsbury (Mark Davies)
(C of E) Malcolm Brown on Assisted Suicide””Is the choice to be killed the same as choosing a car ?
(Telegraph) Charles Moore””If ”˜dying with dignity’ is legalised, soon it will be expected

Women Bishops
(The Tablet) Ruth Gledhill on the Women Bishops Vote in General Synod
Rod Thomas writes Reform members in response to the York General Synod
Statement by Forward in Faith North America
Interfax: Russian Church chagrined by Church of England vote allowing women to be bishops
(Church Times) General Synod delivers a confident vote for women bishops
Albert Mohler: ”˜Get with the Program’ ”” The Church of England Votes to Ordain Women Bishops
[WATCH] We will behave like our hero the TEC Presiding Bishop – CofE women bishop hopefuls
(Ephraim Radner) What Women Bishops Mean For Christian Unity
A Pastoral Letter from the Council of Bishops of The Society on the Women Bishops Vote
(TLC) Key Moments in C of E Synod’s Debate on Women Bishops
(RC Church in Eng. and Wales) A Statement on Women Bishops and the C. of England
(Lambeth Palace PR) C of E approves women bishops
(BBC) Church of England General Synod backs women bishops
NCR: Church of England’s Impending Ordination of Women Bishops Poses Ecumenical Challenge
[John Bingham] Women Bishops: What are the issues?

Other Stories:
(CEN) Yes to new Baptismal service
Church Times’ Paul Handley talks to TEC’s Katharine Jefferts Schori, the only woman Primate
Bishop of Sheffield orders Welby Facilitated Conversations on Sexual Immorality in Communion/CofE
Lee Gatiss: What does ”˜flourishing’ actually mean?
(RNS) Church of England kicks the devil out of baptism rite
Archbishop Justin Welby at Synod, speaking on the common good
Church of England Church Commissioners confirm Wonga exit
(Church Times) A Chaplain is blocked from new post after same-sex marriage

The arguments against assisted suicide are strongly held. Many people object on moral or religious grounds, while some doctors say that it conflicts with their oath to “do no harm”. Opponents add that vulnerable people may feel pressure to spare their carers the burden””or, worse, may be bullied into choosing suicide. And there is a broader argument that allowing assisted suicide in some cases will create a slippery slope, with ever more people being allowed (or forced) to take their own lives, even for trivial reasons.

But the arguments in favour are more compelling. In a pluralistic society, the views of one religion should not be imposed on everybody. Those with a genuine moral objection to assisted suicide need not participate. What a doctor sees as harm a patient may see as relief; and anyway it is no longer standard for medical students to take the Hippocratic oath. The hardest argument concerns vulnerable people: they may indeed feel pressure, but that is simply a reason to set up a robust system of counselling and psychiatric assessment, requiring the agreement of several doctors that a patient is in their right mind and proceeding voluntarily.

It is also true that as some countries relax their restrictions on assisted suicide, the practice will become more common and there will probably be pressure for other restrictions to be removed. But there is nothing unusual in this. Moral absolutes are rare. When faced with dilemmas societies draw boundaries and carve out exceptions.

Read it all.

Up until yesterday for someone who has little love for what I consider to be a deeply flawed bill, it’s been pretty depressing following the coverage. The pro-assisted dying lobby are a slick and well oiled machine and it’s most vociferous cheerleaders have been out in force to bang the battered right-to-die drum. In contrast the voices of opposition, at least in the secular mainstream media, have been few and far between. Having spent some time attempting to record as many articles as possible from the papers and the BBC over he last week that have either had an opinion piece or an item on an individual or group with a partisan view, the results have been stark. There have been 34 pieces with strongly held views in favour of assisted dying and only 8 against. In the last day and a bit at least there has been a noticeable increase in the voices opposing the bill. This is partly because the BBC has produced various interviews, being very careful to finally balance their coverage and also because the Guardian somewhat surprisingly came out strongly against the bill and also published a powerful piece by the Bishop of Worcester whose wife died of cancer in April. Andrew Lloyd Webber has also revealed that he contacted Dignitas whilst struggling with depression last year seeking to end his life, but now believes that taking such action would have been “stupid and ridiculous”.

It’s not that those in favour have more to talk about, it’s more that the same things have been said more frequently. Predictably, so much of this talk has been emotive and far less has been focused on the mechanics of what assisted dying would look like in practice. ComRes have published a poll today that finds that although 73 per cent of the public back assisted dying in principle, this dwindles to 43% when they are presented with (mostly empirical) arguments against it. Doctors who need to be listened to and considered more than any other group still overwhelmingly oppose assisted dying, but you probably wouldn’t know it from the coverage in the last few weeks.

Having trawled the internet it has become apparent that much of what has been driving the media coverage has been the religious aspect.

Read it all.

19:46h After a debate of nine hours and 43 minutes of debate the bill was granted its second reading and now goes forward to a committee of the whole House for scrutiny. Lord Falconer described it as a “historic day”.

Read it all and it may be possible [depending on locality] to watch the debate here

Update: Frank Cranmer has a summary of key speeches here and the full transcript of the debate is available from Hansard online here or in pdf form here or indexed by speaker here

My Lords, this present Bill is not about relieving pain or suffering. It makes that quite clear in its definition of a terminally ill patient to include those whose progressive illness can be relieved but not reversed. This bill is about asserting a philosophy, which not only Christians, but also other thoughtful people of goodwill who have had experience in care for the dying must find incredible: that is, the ancient Stoic philosophy that ending one’s life in circumstances of distress is an assertion of human freedom. That it cannot be. Human freedom is won only by becoming reconciled with the need to die, and by affirming the human relations we have with other people. Accepting the approach of death is not the attitude of passivity that we may think it to be. Dying well is the positive achievement of a task that belongs with our humanity. It is unlike all other tasks given to us in life, but it expresses the value we set on life as no other approach to death can do.

We need time, human presence and sympathy in coming to terms with a terminal prognosis. To put the opportunity to end one’s life before a patient facing that task would be to invite him or her to act under their influence rather than dealing with them.

It is possible to think abstractly that one’s early death would be welcome to one’s nearest family and would spare them trouble. But in fact the best service one could do for them would be to accept their care, and to show appreciation of them at the end of one’s life.

Read it all.

Many, including former Archbishop of Canterbury, Lord Carey, argue that it would have been the “compassionate” and “caring” thing to do. How difficult it would have been for Denise to argue with me if she was made to feel that she was a “burden” to myself and others. Had assisted dying been legal, I daresay the medics might have agreed with me, and the pressure on her, though subtle, would have been unbearable.

That is one of the many reasons I believe Lord Carey’s arguments to be so profoundly misguided and dangerous. He quotes a dying woman parishioner of his who whispered in his ear before she died that, “It is quality of life that counts, not length of days”. Well, maybe ”“ but who is to decide, when, and on what grounds?

Denise’s quality of life at the time of her prognosis and following it was poor by any standards. However, against the odds the chemo did have an effect and the tumour shrank for a while. Had assisted dying been legal, we might never have had the opportunity to enjoy the precious months together that we were given as the more debilitating effects of the treatment wore off. The despair of the moment would have determined our actions. What a tragedy that would have been.

Read it all.

11.20 Lord Tebbit, whose wife was left disabled by the IRA’s bombing of the Brighton hotel, speaks against the Bill.

“No-one could dispute the good intentions of this bill, but the road to hell is paved with good intentions.

“I notice Baroness Greengrass talked of the right we have to take our own lives. We do not have that right. We have only the capacity to do it.”

It creates financial inventives to end the lives of the “ill, disabled, frail and elderly”.

Read it all.

Care Minister Norman Lamb has said he has “changed his mind” and would now support a new law on assisted dying.

The Liberal Democrat told BBC Newsnight an individual should be able to “make their own decision about their life”.

But a cancer specialist told the programme it could create “death squads” by putting the decision in the hands of doctors.

Read it all.

Archbishop of Canterbury Justin Welby today joins over 20 British faith leaders calling for Lord Falconer’s Assisted Dying Bill not to be enacted.

In a joint statement ahead of the House of Lords debate on Friday, the faith leaders said that if passed the bill would have “a serious detrimental effect on the wellbeing of individuals and on the nature and shape of our society.”

Read it all.

I yield to no one in my respect for Lord Carey and for the good things he has said and done, but I am simply amazed at his arguments (or lack of them) in support of Lord Falconer’s Assisted Dying Bill for the terminally ill. Lord Carey says that he has changed his mind after encountering the cases of Tony Nicklinson and Paul Lamb, who had severe paralysis but were not terminally ill. In what way do these cases support a Bill specifically for those with a life expectancy of six months or less?

The majority of those who are terminally ill want what Dr Peter Saunders, of the Christian Medical Fellowship, calls “assisted living” rather than “assisted dying”. This is what the Christian-inspired hospice movement seeks to do, enabling those nearing the end of their lives to prepare for a peaceful and good death. The fact that good hospice care is based on a postcode lottery is what should shame us, rather than not having our own answer to Dignitas in Switzerland.

Instead of concocting expensive ways of getting rid of those at their most vulnerable, I strongly believe we should be making sure that good hospice care is evenly available across the length and breadth of the country.

Read it all.