Legal Euthanasia: a discussion

I use the term "discussion" lightly when referring to this topic, but in 2002, the Netherlands became the first country to legalize euthanasia as an option for patients who were terminal.  The practice had been taking place since the 1970s, but finally it was signed into law.  There were strict laws and licenses that must be in place for it to take place, and Dutch doctors had a long list to check. Patients must be adults.  There must be suffering.  There must also be no other alternative for the patient.  A second doctor must be consulted to concur with the desires of the patient and the conclusion of suffering and terminal disease.

Christians immediately have thoughts of suicide and how this is a sin.  We classify life as human and it is wonderful that someone took their beloved pet to the vet to end their life humanely.  I did this for my dog, and I can say, it was the most amazing experience to know that he was in my arms and that I did not allow him to suffer as he would have in the last maybe two days of his life.  But wait.  He was a DOG.  We are different, or are we?

I know that personally there was a young lady that I met through one of my jobs years ago.  She was in her twenties, had never been married and had no children.  She had an older boyfriend.  She had been diagnosed with breast cancer and had waited a little too long on having a double mastectomy.  She did not have clean borders of the tumor.  The cancer had spread, and she had gone through many rounds of chemotherapy and radiation.

By the time she became my patient as a home infusion pharmacist, I was intrigued by her case.  Her age (she was four years older than me), her name (we had the same initials), and the thought of how she would probably never marry and definitely never have her own biological children.  I knew she was terminal based on the pain pump I was in charge of filling and keeping running for her so she would be in no pain during the months of her life.

We spoke on the phone weekly, sometimes two to three times a week.  She was always upbeat and positive, and after ten years, I can still hear her voice.  She was going on a trip to Florida with her boyfriend and wanted to jet ski in the ocean. She wanted to take her pain pump with her and jet ski.  We made it happen.

And now years later, The Lancet releases an article basically saying legalizing has not added more cases of euthanasia in  Netherlands.

The introduction of legalised euthanasia in the Netherlands has not led to an increase in the number of cases according to a team of Dutch university researchers, writing in The Lancet magazine.

While there was a slight decrease in the years after euthanasia was made legal in 2002, assisted suicide has now returned to pre-legalisation levels of around 2.8% of all deaths, the researchers from four Dutch teaching hospitals and the national statistics office CBS found.

And while opponents of euthanasia had warned the legislation would lead to a sharp rise in involuntary euthanasia among terminally-ill patients, there has actually been a reduction in this sort of deaths, professor Bregje Onwuteaka-Philipsen from Amsterdam's VU university told the Volkskrant.

Based on interviews with 6,000 doctors and research into 7,000 deaths, the team found just 300 cases of euthanasia where the patient had not given explicit consent in 2010, compared with around 1,000 in the years prior to legalisation.

Openness

'This is probably because there is more openness and doctors talk to their patients at an earlier stage,' Onwuteaka-Philipsen told the paper.

The researchers also found some 600 people forced an end to their own lives in 2010 by stopping eating and drinking. In around half of these cases, euthanasia had been refused.

Euthanasia is legal in the Netherlands under strict conditions. For example, the patient must be 'suffering unbearably' and the doctor must be convinced the patient is making an informed choice. The opinion of a second doctor is also required.

Although it's not legal in the US, believe me, it sort of goes on.  It is an unspoken way to die or at least comfort in the very very end.  I know that my patient "BB" went peacefully.  I know that there were many times she kept urging me to come meet her.  I was leery because I knew that I was already attached. Her pump would beep for whatever reason, she would call me.  I had specific orders from the oncologist that I could basically freely increase her dilaudid based on her pain level.  There was a trust thing between the three of us.

I finally did go meet her.  She was laying in bed at 33 years old with just a little bit of time yet.  Her sweet family brought out pictures of her before the cancer changed her so much.  She was beautiful.  I just hope to see her again, shake her hand (or hug her) and tell her how much of an impact she had on my life.  She missed out on so much yet she impacted others in ways she probably never knew.

What does this have to do with euthanasia?  I believe that it should be legal.  It's humane.  No one should have to suffer today.

Integrity is Lost in Wakefield

Hypothesis testing and the outcome, all part of the scientific process, shows integrity whether positive OR negative. In the Wakefield study, he focused his attention on 12 children who had been referred to for GI problems. Dr. Wakefield had already been toying with the idea of a connection between bowel problems and the MMR vaccine. At the same time Dr. Wakefield was paid to find out if children who had already had the MMR vaccine and a corresponding decline had a case. Some of these children were in both studies. That in itself is called "conflict of interest." Dr. Wakefield did admit that more research was needed but that he insisted on the MMR being administered individually rather than the 3-in-1 jab. Today, this study has been retracted as an elaborate fraud with Dr. Wakefield vehemently denying such an accusation. The British medical journal BMJ, which published the results of its investigation, concluded Dr. Andrew Wakefield misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study - and that there was "no doubt" Wakefield was responsible. The journalist who wrote the BMJ articles said Thursday he believes Wakefield should face criminal charges.

Is this an example of a doctor who wanted recognition and to be the pariah in the medical community for autism OR is this an example of Big Pharma winning out and going on a witch hunt?

Because of this article, I have personally witnessed the attitude toward vaccinations shift from lifesaving to poison even so far as one parent telling me that she would not vaccinate her three children because it was wrong and if I did the same I was a bad parent. Tell that to the parents of the infants, babies, and children who have died since 1998 when Dr. Wakefield's study appeared.

In the prevaccination era, pertussis (ie, whooping cough) was a leading cause of infant death. The number of cases reported had decreased by more than 99% from the 1930s to the 1980s. However, because of many local outbreaks, the number cases reported in the United States increased by more than 2300% between 1976 and 2005, when the recent peak of 25,616 cases were reported.¹ The disease is still a significant cause of morbidity and mortality in infants younger than 2 years. Pertussis should be included in the differential diagnosis of protracted cough with cyanosis or vomiting, persistent rhinorrhea, and marked lymphocytosis. (link)

In the prevaccination era, pertussis caused more than 270,000 cases and nearly 10,000 deaths annually. This rate reached a low of 4 reported deaths in the United States in 1982 and has recently risen to an average of about 25 deaths annually, with 39 being reported in 2005.

It's not so much that if you don't vaccinate your child that your child will die. It's that you are now taking advantage of herd immunity. You are taking advantage of a scenerio where most follow the rules and thus pertussis was on the decline. You are saying, "I don't have to vaccinate my child because pertussis isn't here." It is here. You are helping to carry it along. I am grateful for the recent push to booster dTaP in the adult community.

MMR was the focus of the study, though. I did cringe as both my children received the MMR and watched them like a hawk for the next six months wondering if "the light bulb would turn off suddenly." It did not. I do feel relieved that I don't have to worry about mumps. Mumps is back, folks. Ask those who are deaf now how THEY feel about those parents that will not vaccinate their children.

Read this post from back in May. Exactly. I couldn't have written it any better.

Please, for the love of God, stop putting our children at risk. Vaccinate your children. I truly believe that those that don't are negligent.