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There is an interesting (and lengthy) book review by Marcia Angell in the New York Review of Books, January 8, 2015, issue and it is well worth reading.

Here is a small extract:

“There is no doubt in my mind that hospice is the best option for helping dying patients during their last months, but I am not at all sure it is adequate for the death itself. I have long supported physician-assisted dying (and was a lead petitioner in getting a Death with Dignity Act put on the Massachusetts ballot). More than ever, I believe dying patients should have that choice.

“But after my husband’s death, I have come to favor euthanasia as well, for home hospice patients in the final, agonal stage of dying, who can no longer ingest medication orally. These patients are usually no longer mentally clear enough to give contemporaneous consent, but if they have earlier made it known that this is what they would wish, I believe that a duly appointed proxy should be able to have that wish carried out.”

Read the whole article at this site (copy & paste URL):


The review is of this book:
Being Mortal: Medicine and What Matters in the End
by Atul Gawande, Metropolitan, 282 pp., $26.00

The Hemlock Society USA (1980-2003) advocated — and proposed a model law — that voluntary euthanasia and medical assisted suicide both be approved, surrounded with rules and guidelines. For political expediency, later law campaigns removed the euthanasia clauses. Ms. Angell is one of the rare advocates who thinks similarly to Hemlock.

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For persons interested in the helium hood method of self-deliverance from a terminal or hopeless illness, this site (it’s graphic) on TUMBLR may be educational:


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Dr Lawrence D. Egbert, 87, has lost the Maryland medical license he had held for more than 60 years after a disciplinary panel for the Maryland Board of Physicians found that he had engaged in “unprofessional conduct” while working as the medical director for the Final Exit Network, which offers aid to people “who are suffering from intolerable medical circumstances.”

State regulators said that Dr. Egbert had acted as what the network calls an exit guide for six people in Maryland from May 2004 to November 2008.

“Dr. Egbert reviewed their applications and medical records and recommended accepting them as members,” said the order, which was signed by Christine A. Farrelly, the executive director of the Board of Physicians. “Dr. Egbert attended their suicide rehearsals. He held each member’s hand and talked to him or her.”

Each of the patients died, the state said, of asphyxiation caused by helium inhalation, and Dr. Egbert “removed the hoods and helium tanks” from the places where the five women and one man died. Those patients had been diagnosed with conditions that included Parkinson’s disease, multiple sclerosis and chronic obstructive pulmonary disease.

Dr. Egbert said he planned to appeal the board’s decision. “What we’re doing should be available to any patient with an incurable, horrible disease that they’ve tried everything on, and it doesn’t seem to work,” he said.

The state, he said, “misportrayed me” and was undermining what he defends as a constitutional right to “advise” people how to die.

In its order on Dec. 12, the Board of Physicians outlined four reasons it had deemed Dr. Egbert’s conduct unprofessional. The board said he had violated the American Medical Association’s Code of Medical Ethics and that his activities were “illegal under Maryland law.” It is unclear whether Dr. Egbert will be prosecuted in Maryland.

Maryland regulators first charged Dr. Egbert with misconduct in late 2012, and an administrative law judge recommended more than a year later that he lose his medical license. Maryland records show that Dr. Egbert has not been disciplined within the last decade by other state medical boards.

The decision in Maryland is the latest effort by government agencies to sanction Dr. Egbert for his activities. Before he could stand trial in Georgia, the state’s Supreme Court voted to strike down the law under which he was being prosecuted. He was acquitted of criminal charges in Arizona. He is also facing prosecution in Minnesota.

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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.
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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