JOIN THE CONVERSATION
Using advance directives to control what happens to us after mental incapacity -PART 4
By Lamar Hankins | Dementia
Suicide is not the same as PAD
American Assn of Suicidology
The American Association of Suicidology (AAS) recognizes that the practice of physician aid in dying (PAD) is distinct from the behavior that has been traditionally and ordinarily described as “suicide.” Although there may be overlap between the two categories, legal physician assisted deaths should not be considered to be cases of suicide.
By JoNel Aleccia
Kaiser Health News
November 3, 2017
New ‘Instructions’ Could Let Dementia Patients Refuse Spoon-Feeding
Patients with advancing dementia now have a document they can add to their advanced directives.
End of Life Washington State
INSTRUCTIONS FOR REFUSING ORAL FEEDING AND DRINKING - Directives for patients with advancing dementia to add to your Living Will.
April 19, 2017
Changing the Paradigm of Advance Directives to Avoid Prolonged Dementia
By Norman L. Cantor
With the increasing prevalence of Alzheimer’s disease and similar degenerative dementias, the focus of advance directives has changed for some people. The primary specter is neither an unavoidable looming demise nor the insensate limbo of permanent unconsciousness.
April 29, 2017
A Better Way to Care
for the Dying
How the medical profession is starting to move beyond fighting death to easing it.
THE NEW YORK TIMES
We're Bad at Death,
Can We Talk?
A new wave of research sheds light on what patients want at the end of life, and who is or isn’t getting it.
HOW TO HAVE A BETTER DEATH
A treatment that is unbearable in the imagination can seem like the lesser of two evils when the alternative is death. Some patients will want to fight until all hope is lost.
START THE CONVERSATION
Make ZdoggMD's video go viral! Send this brilliant video on to everyone you know! Share with your friends & family, children and grandchildren, and take time to 'start the conversation.'
THE NEW YORK TIMES
FEBRUARY 18, 2017
First, Sex Ed. Then Death Ed
By Dr. Nutik Zitter, Oakland, CA
Five years ago, I taught sex education to my daughter Tessa’s class. Last week, I taught death education to my daughter Sasha’s class. In both cases, I didn’t really want to delegate the task. I wanted my daughters and the other children in the class to know about all of the tricky situations that might await them. I didn’t want anyone mincing words or using euphemisms. Also, there was no one else to do it. And in the case of death ed, no curriculum to do it with.
FEBRUARY 1, 2017
Trump supreme court nominee Neil Gorsuch cited Oregon law in his book on assisted suicide
By Eder Campuzano
Donald Trump on Tuesday announced his pick to replace Supreme Court Justice Antonin Scalia, who died suddenly last February. The president's nominee, Neil Gorsuch, has been likened to the late justice by several media outlets.
If confirmed, one thing Gorsuch would have with Scalia is their view on assisted suicide. In fact, Gorsuch published a book on the subject in 2006. "The Future of Assisted Suicide and Euthanasia" cites Oregon law extensively, from the first chapter to the epilogue.
The book was published the same year the U.S. Supreme Court rendered a verdict in the case of Gonzalez v Oregon, where it ruled George W. Bush's attorney general couldn't use the Controlled Substance Act against state doctors who assisted their patients in dying.
Scalia was one of the dissenting votes in the 6-3 case. Throughout his book, Gorsuch argues against assisted suicide.
The seventh chapter, in particular, cites Oregon law extensively. If readers had any doubt about the Supreme Court nominee's thoughts on the matter, the title would be illuminating: "Legalization and the Law of Unintended Consequences: Utilitarian Arguments for Legalization."
The second paragraph of the chapter even refers to the practice as "consensual homicide." Much of the chapter is free to preview on Google Books. The epilogue, which deals exclusively with the Gonzalez v Oregon decision, is not.
Gorsuch's views on assisted suicide have been taken by many to assume he'd side with anti-abortion arguments in cases concerning the practice. He's never ruled on an abortion case in his time on the Tenth Court of Appeals, although he has issued rulings against the Affordable Care Act's requirements on contraceptives.
For much of the campaign, Trump vowed he'd choose a "pro-life" justice to fill Scalia's seat on the court. The president even claimed he was open to appointing someone who would overturn Roe v. Wade, leaving states to make their own rules on abortion.
Although Gorsuch characterized the 1973 decision as "a new right in the face of substantially contrary history," the 1992 Planned Parenthood v. Casey decision seemed to placate his concerns with the older ruling.
DC Mayor Signs Assisted Suicide Bill
The Washington Times
December 20, 2016
By Robert King
Washington, DC Mayor Muriel Bowser signed into law Tuesday a bill that would make assisted suicide legal in the district, if it gets through Congress.
If approved by Congress, the district would join six states that allow assisted suicide for the terminally ill.
The bill, which the D.C. Council approved last month, would enable someone 18 years or older who is mentally capable and terminally ill to end their life. It sets up reporting requirements for physicians and the district's Department of Health.
It is not clear if Congress will approve the legislation. It has blocked D.C. legislation before, most recently the city's recreational marijuana law. Under the Constitution, Congress has to sign off on all D.C. laws.
California, Colorado, Oregon, Montana, Washington and Vermont are the other states that have assisted suicide bills on the books. [It is an error to state that Montana has an assisted suicide law. Montana's is a Supreme Court ruling that only says that doctors will not be prosecuted.]
Waiting for The Die Medicine
By Myriam Coppens, Special to the Sentinel
The Santa Cruz Sentinel, California, November 22, 2016:
The Washington Post
November 1, 2016:
By Fenit Nirappil
The D.C. Council on Tuesday gave initial approval to legislation that would allow physicians to prescribe fatal drugs to terminally ill residents in the city, making the District the sixth jurisdiction nationwide to allow the practice.
It is the first predominantly black community to legalize so-called "death with dignity," overcoming objections from some African American residents.
A spokesman for Mayor Muriel E. Bowser (D) declined to say whether the mayor would approve or veto the legislation, although he said Bowser expects the bill to become law.
The council still must hold a final vote on the bill, possibly as early as Nov. 15.
Octtober 27, 2016
The Courthouse News Service
Doctors Ask Court to Approve Assisted Suicide
By Zack Huffman
BOSTON (CN) - A Massachusetts physician and his terminally ill patient are seeking a court order that would decriminalize doctor-assisted suicide.
Dr. Roger Kligler and Dr. Alan Steinbach filed a lawsuit in Suffolk Superior Court seeking a declaratory judgment that would allow physicians to provide "Medical Aid in Dying" -- in other words, using medication to induce a peaceful death for patients with less than six months to live.
Kligler, who is a retired physician, is seeking a lethal dose of medication from his doctor, Steinbach, without his doctor having to face the danger of prosecution.
The lawsuit names state Attorney General Maura Healey and Cape & Islands District Attorney Michael O'Keefe as defendants, calling for a preliminary injunction that would prevent them from prosecuting Steinbach for providing a lethal dose of medication to Kligler.
Kligler was diagnosed with Stage 4, metastatic castrate-resistant prostate cancer, and given only a few more years to live. With treatment, people with similar diagnoses to Kligler survive on average, for about two years.
State law allows terminally ill patients on life support -- such as a feeding tube, dialysis machine or ventilator -- to opt to remove it and accept painkillers until they succumb to death. Terminal patients in extreme pain can also opt to placed into a medically-induced coma in which they often starve to death.
In lieu of a slow death, Kligler would prefer to have the option of a medically assisted suicide, but fears the possible repercussions to any doctor or even a family member that would supply him with the medication.
The plaintiffs argue that denying Kligler the means to end his own life infringes on his rights of privacy and liberty.
"Dr. Kligler does not wish to linger in a state of palliative sedation until he dies of dehydration or starvation," the complaint says. "Dr. Kligler and others like him would be barred from a fundamental medical option for a peaceful and painless death if Medical Aid in Dying is found to be prohibited."
Cape & Island District Attorney Michael O'Keefe questioned if the courts were the best route for legalizing assisted suicide.
"I am sympathetic to this ordeal the doctors are facing but they are petitioning the wrong branch of government," he said. "This is a question raising serious ethical and moral issues and must be addressed by legislators who make laws and not to judges who only apply them."
In 2012 Massachusetts voters narrowly rejected a ballot question that would have legalized doctors prescribing life-ending medication for terminally ill patients, 52 percent to 48 percent. More recently, state Rep. Louis Kafka filed a bill that would legalize assisted suicide, but the bill never made it out of committee before the 2015-16 legislative session expired.
October 10, 2016
Aid in Dying Movement Advances
By The New York Times Editorial Board
"Victories in the three jurisdictions would galvanize a movement that seeks to give terminally ill Americans a dignified alternative to the dismal choices they face in most of the country. In states where assisted dying is banned, some terminal patients manage to get a lethal dose of drugs...under the table, which exposes the health care workers to prosecution. Others are advised to starve themselves to death."
September 30, 2016
In spite of California's new law, few doctors are aiding the terminally ill with their EOL requests.
The Mercury News
By Tracy Seipel
By the time she located one, it was too late, and when Dale drew her final breath Tuesday morning, it was not the kind of death she — or her family — had envisioned.
“She did not want to die that way, too confused to say goodbye,’’ said daughter Catherine Dale, crying over the memory of her bedridden mother begging daily to know how much longer she would have to wait for “the die medicine.’’
September 23, 2016
Adult class canceled over discussion of critically ill people ending their lives
By Bill Roberts
The Boise School District’s Community Education program canceled a class this week for adults on ways critically ill people can end their lives because it would have discussed physician-assisted suicide.
Agusut 23, 2016
Columbia Journalism Review
By Corey Hutchins, CJR
[UPDATE: This initiative passed.]
Voters in Colorado will have a big decision to make: whether to approve an initiative that would allow terminally ill patients to obtain a prescription for drugs to end their lives.
But before then, news outlets in the state have a decision of their own to make: what language to use when describing the proposal.
September 9, 2016
Politics & Prejudices, The Right to Die Revisited
Detroit Metro Times
By Jack Lessenberry
Twenty years ago, Detroit was almost as famous for assisted suicide as it was for cars, thanks to Dr. Jack Kevorkian and his flamboyant attorney, Geoffrey Fieger.
Kevorkian wasn't the only doctor who thought hopelessly suffering patients who wanted out of their misery should have the right to ask a physician to help them die.
September 5, 2016
Canadians excluded from assisted dying law eager to join legal challenge. British Columbia Civil Liberties Association raised its goal of $75,000 for legal costs in just 10 days.
The Toronto Star
By Joan Bryden, The Canadian Press
OTTAWA Scores of suffering Canadians who have been excluded from the federal government restrictive eligibility criteria for medical assistance in dying are lining up to join a constitutional challenge to the new law.
The British Columbia Civil Liberties Association, which is spearheading the challenge, has been overwhelmed by scores of responses to its call for help in the case, says Grace Pastine, the association's director of litigation.
The BCCLA has also been stunned by the response to its crowdfunding campaign to pay for the looming legal battle, which so far features one plaintiff, Julia Lamb, a wheelchair-bound 25-year-old who suffers from spinal muscular atrophy, a degenerative disease that she fears will eventually consign her to years of intolerable suffering.
Just 10 days after announcing the constitutional challenge in late June, the BCCLA met its goal of raising $75,000.
"It is a testament to how important and deeply personal this issue is to so many Canadians," said Pastine.
But the BCCLA which spearheaded the four-year legal challenge that led to last year's landmark Supreme Court ruling striking down the ban on medically assisted dying will need a lot more donations to compete with the kind of money the federal government is evidently prepared to throw at the issue.
August 29, 2016
What would make you want to die?
A paper by Emily Rubin and her colleagues, just published in JAMA Internal Medicine, attempts to give statistical rigour to scientific hunches about end-of-life care. Over an eight-month period, beginning in July 2015, her team surveyed 180 patients who had been admitted to a hospital in Philadelphia suffering from serious illnesses, including lung and heart disease. All participants were over 60, and were asked by medical staff to hypothesise whether they would prefer to die than be in progressively worse vegetative states.
As the chart shows, half or more said that they would consider being incontinent, being unable to get out of bed or relying on a breathing machine to stay alive as fates worse than death.
August 26, 2016
Report from Death With Dignity National Center
By George Eighmey, President, Death with Dignity National Center
It wasn't even close. Moments ago, Riverside County Superior Court Judge Daniel A. Ottolia denied the request for an injunction filed by a group of anti-choice physicians against the California End of Life Option Act.
This means the newest Death with Dignity law remains in place and eligible terminally ill Californians can continue to assert control over how they die.
In denying the case, the judge decided that the law poses no threat to anyone, especially the doctors who filed the suit knowing full well they can opt out of the law at any time and for any reason.
While we count today?s ruling as a significant victory for all Californians and our movement overall, our work is not done. First, the plaintiffs will be filing an appeal. And, a similar lawsuit is pending
in Vermont, where the same shadowy anti-choice group that represented the California doctors is pushing their views with local physicians. We must -- and we will -- continue protecting the laws you fought so hard to pass.
August 14, 2016
ALS Patient Uses California's New Law with Great Difficulty
Op-Ed by Linda Van Zandt
Los Angeles Times
We would come to learn the law establishes a strict protocol to obtain the life-ending drugs. It takes a minimum of 15 days, and the countdown would start once a primary care doctor attested to my aunt’s mental fitness, her terminal condition, her desire and ability — on her own — to take the medication that would allow her to die. She had to sign a form stating her intentions, with two witnesses, one not related to her. A second doctor had to affirm the diagnosis and her mental fitness.
August 11, 2016
Terminally Ill Woman Holds Farewell Party before Using CA New Law
By Julie Watson, AP Reporter
In early July, Betsy Davis emailed her closest friends and relatives to invite them to a two-day party, telling them: "These circumstances are unlike any party you have attended before, requiring emotional stamina, centeredness and openness.
August 4, 2016
Medical Aid in Dying Bill Will Now be on Colorado Ballot
The Denver Post
A campaign to put a “medical aid in dying” measure on the November ballot in Colorado has turned in 160,000 voter signatures to the Secretary of State’s Office, well over the 98,000 required to get the measure on the ballot.
The “End of Life Options” measure would allow terminally ill Coloradans with six months or less to live to obtain a prescription to end their life. The drugs must be self-administered and be approved by two doctors who found the patient “mentally capable.”
The measure faces opposition from religious groups, including Catholic leaders, as well as a disability advocacy group that says an “assisted suicide” law could target people with disabilities because of their life-long medical costs.
Murder-Suicide for couple with no other options
An elderly, loving couple in Venice, California, described by a neighbor as "lifelong best friends" committed suicide together when the husband found he could no longer deal with his wife's advancing dementia. With no other choice, as the California EOL Act would not help his wife, they made a suicide pact to end their lives together.
Christian groups sue Vermont over physician-assisted suicide law
By Erin Mansfield of VT Digger
Two Christian groups are suing the state of Vermont over the physician-assisted suicide law the Legislature passed in 2013. Christian Medical and Dental Associations, Inc., based in Tennessee, is suing along with the Vermont Alliance for Ethical Healthcare, Inc. The two filed a civil suit in U.S. District Court in Rutland this week.
The defendants are the director of the Vermont Medical Practice Board, the members of the Vermont Medical Practice Board, the Secretary of State, and the Secretary of State's Office of Professional Regulation.
The lawsuit argues that Act 39 violates the First Amendment, which protects freedom of speech and religion, and the Fourteenth Amendment, which provides equal protection under the law.
The lawsuit also asks the court to say Act 39 violates the Vermont Constitution and Vermont?s Administrative Procedures Act; to pay all legal fees of the two organizations; and to permanently block Vermont's physician-assisted suicide law. A federal court ruling for the plaintiffs would nullify Vermonts physician-assisted suicide law.
Faith Leaves Minnesota
Revised video of a Final Exit Network member, Faith, who was forced to leave Minnesota to learn more about her end-of-life options. Minnesota courts have said that end-of-life counseling that includes peaceful self-deliverance is against Minnesota law. Final Exit Network is Appealing that decision.
July 5, 2016
New Final Exit, the book, addendum available
If you already have 'Final Exit' 3rd edn. in paperback, there is now a 2016 Addendum. Send $5 for print copy: ERGO, 24829 Norris Lane, Junction City, OR 97448
Or get the paperback plus Addendum for $23 incls of s/h
This Addendum is already included in the Ebook 2016 download version at
June 17, 2016
Doctors Have a Duty to Help, Great Britain
By Sophie Borland for the Daily Mail
Doctors have a "duty" to help their patients die and it should be a part of their jobs, according to the Queen?s former physician. Sir Richard Thompson is one of a growing number of eminent doctors who want assisted dying to be made legal.
Next Tuesday, the British Medical Association will vote for the first time in more than a decade on whether to stop opposing the controversial practice.
At their annual meeting in Belfast, more than 500 doctors will decide on whether to take the significant step of adopting a neutral stance as their official position on assisted dying. This would be a significant step because at present doctors' official position is that they oppose assisted dying.
Recent polls show that more and more doctors want to legalize the practice and would be prepared to help their patients end their lives.
Faye Girsh's Movie List
Hemlock of San Diego (with some additions!)
Movies that explore the many facets of the topic of death and dying.
Me Before You
Me Before You is a 2016 British-American romantic drama film starring Emilia Clarke, Sam Claflin, and Steve Peacocke. Set in the UK, the film is shot in various historic locations around the country, including Pembroke Castle in Wales, and Chenies Manor House in Buckinghamshire, England.
A sensitive award-winning Japanese film about a young man who stumbled across a job working as a Japanese ritual mortician. Shunned by his wife and friends for working with death, they changed their minds when they realize the beauty and dignity he brings to the dead and the comfort he provides their loved ones.
Harold and Maude
1971 dark comedy film classic: Harold, obsessed with death, meets the 79-year-old carefree Maude.
An Italian film about a young woman who helps people die.
What happens when her guidelines are violated? How does this occupation affect her life? Are there other “Honeys” around? Should there be?
How to Die in Oregon
How terminally ill persons, their family, and friends consider whether and when to take a lethal medication overdose as allowed in Oregon since 1997 and soon to be available in California through the End of Life Option Act. Winner of Sundance Film Festival Grand Jury Prize. Presented by the Hemlock Society of San Diego.
Based on the best-selling book by Dr. Atul Gawande, this documentary shows him meeting with colleagues and patients to discuss treatment choices at the end of life. Up-close and even better than the book!
The Farewell Party (Israel)
Residents of a retirement community figure out how to help their fellow retirees who are suffering a bad death.
La Grande Bouffe (The Big Feast)
In this 1973 award-winning French-Italian film with Marcello Mastroianni, four gourmet friends rent a chateau. If you ever thought about how it would be to eat yourself to death, this will amuse and entertain you.
A Final Promise
A boy helps his brother die and makes a vow to himself to end his own life at 37— until he falls in love with a woman with ALS who needs his help. Based on the novel, How Angel's Die, by British musician, Guy Blews.
A beautiful woman, a handsome charming magician who is also a quadriplegic—in a beautiful house with wonderful music. But he wants to die —and the court denies him. A love story with a bittersweet ending.
The Sea Inside - Xavier Barden
A Spanish film about a quadriplegic man who gets help to die from a Spanish RTD group.
One True Thing - Meryl Streep and Renee Zelwegger
Cancer patient dies from an overdose. Who did it?
Documentary of a doctor dying by stopping eating and drinking
A Short Stay in Switzerland
Fictional account of a true story of a doctor going to Dignitas to die
The Suicide Plan
Frontline account about Final Exit Network and other RTD activities
The Barbarian Invasions
Canadian fictional account of a disagreeable man who dies peacefully
Whose Life Is It Anyway? - Richard Dreyfuss
(Classic movie of a quadriplegic who wants treatment removed)
Grace Quigley - Katherine Hepburn and Nick Nolte
(Old lady finds a reluctant hit man to help her older friends die)
Amour (shown at a movie theater)
An older man caring for his wife who has repeated strokes
Right of Way - Bette Davis and Jimmy Stewart
An older couple want to die together despite daughter's protestations
Shaking Hands with Death
Speech given by British author, Terry Pratchett, about his dementia
You Don't Know Jack - Al Pacino and John Goodman
TV movie about Jack Kevorkian and his crusade to provide a peaceful death
Mademoiselle and the Doctor
80 year old healthy woman wants to die
The Suicide Tourist
Documentary about an ALS patient who goes to Dignitas