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REITH LECTURE: AGING AND DYING
I’ve known of (and heard some) of the prestigious BBC Reith Lectures since they began in l948. Therefore it was a surprise and pleasure on Tuesday night, on BBC world radio, to hear ASSISTED DYING freely discussed by Atul Gawande, American surgeon and author, who said he was in favor provided it was carefully controlled. The right-to-die movement has come a long way from its years in the wilderness by now getting to Reith Lecture status. – D.H.
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Atul Gawande: The Problem of Hubris

Broadcast on BBC World Service, Tue, 9 Dec 14, Duration: 42 mins

In this episode Atul Gawande calls for a new approach to the two great unfixable problems in life and healthcare - ageing and death. He tells the story of how his daughter’s piano teacher faced up to terminal cancer and the crucial choices she made about how to spend her final days.

Dr. Gawande argues that the common reluctance of society and medical institutions to recognise the limits of what professionals can do can end up increasing the suffering of patients towards the end of life. He proposes that both doctors and individuals ask a series of simple but penetrating questions to decide what kind of treatment is appropriate – or whether treatment is appropriate at all. The programme was recorded at The Royal Society in Edinburgh in front of an audience.

By going to http://www.bbc.co.uk/podcasts/series/reith
you can hear this talk.

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Public support for choice in dying legislation has grown even stronger in the days since the planned death of 29-year-old brain cancer patient Brittany Maynard, a new HealthDay/Harris Poll has found.

An overwhelming 74 percent of American adults now believe that terminally ill patients who are in great pain should have the right to end their lives, the poll found. Only 14 percent were opposed.

Broad majorities also favor physician-assisted suicide and physician-administered euthanasia.

Only three states — Oregon, Washington and Vermont — currently have right-to-die laws that allow physician-assisted suicide.

“Public opinion on these issues seems to be far ahead of political leadership and legislative actions,” said Humphrey Taylor, chairman of The Harris Poll. “Only a few states have legalized physician-assisted suicide and none have legalized physician-administered euthanasia.”

People responded to the poll in the weeks after Maynard took medication to end her life in early November.

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A state senator wants to make New York the fifth state to allow assisted suicide for the terminally ill. Democrat Brad Hoylman said his proposed law would permit doctors to prescribe lethal medication to terminally ill adults who want to take their own lives.

In a memo seeking co-sponsors, Hoylman cited the case of Brittany Maynard, the terminally ill California woman who became the public face of the right-to-die movement when she moved to Oregon to end her life under that state’s “Death With Dignity Act.”

Maynard, who had an aggressive form of brain cancer, took her life on Nov. 1.

“This bill will give capable adults who have been given a terminal medical prognosis a measure of control over their end-of-life care options,” Hoylman said.

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A bill legalizing physician-assisted death for terminally ill patients in Colorado is being drafted and would probably be introduced later this year.

Roland Halpern, the regional director of Compassion and Choices in Denver, said surveys show that 90 percent of people ages 65 and older want to die at home but only 24 percent have been able to achieve it, and 55 percent of them will succumb to a terminal illness.

Halpern said even in Oregon only about 60 percent to 65 percent of patients who get the prescription to end their lives use it, but they want to have that option.

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Oregon’s first-in-the-nation Death with Dignity law turned 20 this month, establishing a substantial record of who dies and why.

As of last year, 1,173 Oregonians have qualified for lethal prescriptions, and 752 patients have used them to end their lives. The typical participant was white, well-educated, over 65 years old and suffering from terminal cancer.

The vast majority had health insurance and died at home.

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Brittany Maynard took her life on the day she had predicted, Saturday, November 1, 2014.
A brave person who faced up realistically to the tragedy in her life. Her story has had an impact.

About 70 terminal residents every year in Oregon use this law to hasten their ends.

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THE TERMS AND THEIR EUPHEMISMS
(Take your pick!)

Euthanasia:
Help with a good death – in whichever way is desired, justifiable and appropriate. A broad, generic term for the right to die.

Voluntary Euthanasia:
When a physician administers a lethal dose to a dying person at their request.

For when a doctor prescribes a lethal overdose which the dying patient chooses to drink:
Physician-assisted suicide; Physician-assisted death; Physician-assisted dying; Physician-hastened death; Death With Dignity; Aid in Dying; Medically-assisted dying; Medicide (Kevorkian book); Physician-managed death; Mercy killing; Terminal sedation.

For when a terminal patient chooses to end his or her own life without medical help:
Self-deliverance; Patient-directed dying (Preston book); Humane self-chosen death; Auto-euthanasia; Rational suicide; Hastened death; Right to choose to die; Choice in dying; Self-determination; Suicide; Assisted suicide; Final Exit (Humphry book); Managed death; Self-destruction; self-murder; self-directed death; Peaceful Pill (Nitschke book); Drion Pill; stopping eating and drinking.

Common euphemisms to avoid saying dead :
Passed away; Passed on; Gone to a better place; Departed; Gone to meet the Maker; Gone to meet the majority; Gone to the world of light; Gone to Davy Jones’s locker; Crossed to the other side; Gone to sleep with the fishes; Quietly slipped from our embrace; Succumbed; Called home; Got her/his final reward; Expired; Dearly departed; Gone to Jesus.

The criminal world has its own set of avoidances of the reality of death:
Whacked, smoked, wasted, rubbed out, deep sixed; given cement overshoes.

Finally, there are the humorous and sardonic terms for death: Croaked, gave up the ghost, put on the wooden overcoat, total goner, kicked the bucket, dead as a doornail, snuffed it, bit the dust, bought the farm, flat-lined, pushing up daisies, celestial discharge, negative patient-care outcome.

Note: It would be useful if we still had Shakespeare around to invent modern new terms, because nobody currently can agree on the foregoing ones.

10.30.14 — Derek Humphry (ergo@finalexit.org) Oregon

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Last month Derek Humphry was given the World Federation of Right To Die Societies “Lifetime Achievement Award” for ‘contributing so much, so long and so courageously to our right to a peaceful death.’

The award was presented by world president Faye Girsh at the 20th international conference in Chicago on 9/19/2014. It is the first time this award has been made.

Derek began working in the right-to-die movement in l978. He founded the original Hemlock Society USA in 1980. (It ceased in 2003) Since l993 he has been president of the Euthanasia Research and Guidance Organization (ERGO).

He is the author of the best-selling books ‘Jean’s Way’ and ‘Final Exit’.

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Doctors in the Netherlands assisted 4,829 people to die in 2013, representing a 15% percent increase over 2012. The vast majority of cases involved patients suffering with cancer or unbearable pain, according to a report published by the five regional review committees.

The report outlined how doctors working in 2013 performed the euthanasia procedure in almost all cases. The committee flagged doctors in five cases because they did not perform the procedure according to the guidelines. In two cases, doctors made mistakes in their methodology, prescribing a non-standard drug to make the patient comatose. In none of the five cases were the errors so severe that the Public Prosecutor had to be called in.

Of the 4,829 people who were assisted, almost 3,600 were suffering from cancer related illnesses, 42 people reported having the procedure due to severe psychiatric problems, and 97 due to dementia cases where the patents were able to communicate their wish to die.

Euthanasia has been legal in the Netherlands under strict conditions since 2002.

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The ADVANCE DIRECTIVE (also known as a Living Will)

You can download an Advance Directive for $5 at this site:

http://www.finalexit.org/ergo-store/documents-c-72/advance-directives-form-living-will-pdf-p-187.html

Drawn up by Faye Girsh, EdD, former chief executive of the Hemlock Society USA, the Advance Directive available through ERGO does not claim to be an enforceable legal document. It is an honest expression of a person’s wishes while they still have all their marbles. Intelligent, caring people would likely respect it as a human right.

Dr. Girsh calls her document “My Last Wishes (in the event of irreversible cognitive decline)” and outlines how you would wish to be treated if a brain affliction ever affected you.
www.finalexit.org

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