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Assisted Dying.

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medicineman said:
In Manitoba, we have a form called "Notice of Anticipated Death at Home" we send to the Chief Medical Examiner's office once someone is into their final days/weeks, so that all that needs to occur is someone to fill out the Certificate of Death with time and date and call the funeral home to remove the body. 

In Manitoba, what documentation is with the patient at home?


 
Interesting about the Confirmation Form.

At first I reacted to the additional "bureaucracy" but after reading Dr. Buchman's letter I think I get it.

The paramedics offer an emergency response.  A person dying at home and not desirous of resuscitation is not an emergency.  The problem here likely comes from the spouse or kids or grandkids, confronted by their loved one's demise,  and with or without knowledge of the DNR request, putting in a phone call.

The family needs to be at peace as much as the person passing.  And I guess that is true about all parts of this discussion.  It is not just a personal matter.
 
Chris Pook said:
The paramedics offer an emergency response.  A person dying at home and not desirous of resuscitation is not an emergency.  The problem here likely comes from the spouse or kids or grandkids, confronted by their loved one's demise,  and with or without knowledge of the DNR request, putting in a phone call.

"The ambulance siren alerts your neighbours. The Call Originator realizes they have made a mistake. But it’s too late. Someone dialed 9-1-1 and triggered the system. Soon paramedics are rushing through the front door and into the bedroom.

The paramedics attempt to coax life back into the body, a futile effort, and yet, despite your pleas for them to stop, they persist. Then you hear more sirens. Seconds later, you are standing in your driveway, a police officer peppering you with questions, and neighbours, curious about the commotion, peering at you through slits in living room curtains. Your grandfather didn’t want this. You didn’t want this. Nobody wanted this.

So much for a peaceful death at home."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291668/

“People panic and think that calling 911 means they are just calling for help, but what they are doing is triggering a cascade of events.”
 
mariomike said:
In Manitoba, what documentation is with the patient at home?

A copy of that, and a copy of the Advanced Care Directive...which actually annoys me when someone with an ACP "C" (comfort care only) gets sent to the ER by PCH staff when they're starting a downward spiral - they should be staying put.  For some reason, the staff get spooked by dying people actually dying in their "own" home as it were ::).

MM

 
On the supposed Dutch practice relating to PTSD and mental anguish, and combining that with walking off into the bush in the winter.  I really do believe that there is still not enough being done to treat mental health properly, and many of our social norms and practices actually make it worse. Many people conclude there is no point living any more because they will never feel "free" from whatever triggers them, or simply cannot allow themselves to be happy by setting borders and having a sense of self worth. This is a major, major problem in this country and it hardly discussed much less supported by governments and communities. Psychologists and therapists should not be a delisted service under our health care system. How many people who bear unspeakable memories are walking off into the bush that we don't know about. Death from drug overdose, mental anguish brought about on the persecutory actions of others (our family law system does a great job of that with men), etc.
Having a state appointed person to perform "the deed" is one thing, but performing "the deed" because a person is suffering from PTSD or another mental health problem is quite another.    In our society, suicide wrongly is considered "selfish", how do we change that moral position?

 
 
medicineman said:
A copy of that, and a copy of the Advanced Care Directive...which actually annoys me when someone with an ACP "C" (comfort care only) gets sent to the ER by PCH staff when they're starting a downward spiral - they should be staying put.  For some reason, the staff get spooked by dying people actually dying in their "own" home as it were ::).

MM

Perhaps that goes to what I was suggesting with respect to the "oaths" that the professionals take.

Is there an acceptance of the concept of "a good death"? 
 
mariomike said:
Or, sometimes they don't  want paramedics to resuscitate. The family hands you a DNR order signed by the doctor.

But, in Ontario, when called to respond to a scene where a person has lost vital signs, and in the absence of a Do Not Resuscitate Confirmation Form (DNRCF), even if a DNR Order is presented to attending paramedics, under regulations of the MOHTLC, paramedics must begin resuscitative measures.

What if a person had 'Do Not Resuscitate' tattooed on their chest where the paddle goes?

The problem I have with the form, is that it's only good if there is someone there to present it or you are at the place of it being held. If I'm at a restaurant, by myself, they'll attempt to revive against my wishes because I don't have a piece of paper. However, if it's tattooed on me, that was obviously my choice and it should be accepted as my wishes.
 
As to the suggestion of an "Executioner", would you prefer Terminator or End of Life Guide?

The main issues IMHO are:
- Past generations are dead,
- Will you or your generation live for ever,
- Should we have a voice in determining how and when we die?  Some people smoke, others participate in dangerous sports/endeavors, do we deem these actions illegal.

What if the granter of wishes for assisting you in dying was your spiritual guide (Priest, Minister, Imam, Rabbi etc.) and for those without one, then it is their immediate family that needs to concede.

I would prefer to have an informed discussion as was the case with my father in which the immediate family gathered at his bedside, he was kept "medication-induced" comfortable until he took his last breath, rather than being told to go get some rest and being called a few hours later that Mom had passed alone.

Is there a moral or ethical difference between assisted dying, suicide, and dying by refusing care in the case of terminal cancer patients?

A key point in the discussion is that under assisted dying laws in other countries such as The Netherlands (also referred to as Euthanasia and Assisted suicide), it is illegal; however, the medical practitioner is not punishable as long as specific guidelines are followed.
 
I am agnostic on what the Executioner is called so long as it is not some feel good euphemism like "Spiritual Guide".

I was unaware that the Dutch law still consider the act illegal but allowed it to be justifiable.  In my view that goes a long way to resolving some of my internal debates.

WRT the mode of egress - that is a matter for the individual to decide.  Whether they choose to involve their family or their god is up to them. 

I don't think that anybody should be forced to kill somebody against their wishes.  (and before anybody chirps up with Soldiers! - they volunteer for the job knowing what the job requirements are).
 
Chris Pook said:
WRT the mode of egress - that is a matter for the individual to decide. 

I prefer not  to go the DIY route for certain jobs, because I might botch it. Would rather hire a pro to handle it instead.
 

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mariomike said:
I prefer not  to go the DIY for certain jobs, because I might botch it. Would rather hire a pro to handle it instead.

Me too.  But I don't want somebody doing the job because they have been coerced either.
 
I suppose one could become a Suicide Tourist and fly to Switzerland on a one-way ticket,

Zurich voters keep 'suicide tourism' alive
http://www.foxnews.com/world/2011/05/15/zurich-voters-suicide-tourism-alive.html
Voters in Zurich have overwhelmingly rejected calls to ban assisted suicide or to outlaw the practice for nonresidents

Or do it on the cheap at a pet shop in Mexico,

Euthanasia tourists snap up pet shop drug in Mexico
http://www.reuters.com/article/us-mexico-euthanasia-idUSN0329945820080603?sp=true
Elderly foreign tourists are tapping Mexican pet shops for a drug used by veterinarians to put cats and dogs to sleep that has become the sedative of choice for euthanasia campaigners.

Clutching photos of the bottled drug to overcome a lack of Spanish, they have maps sketched by euthanasia activists to locate back-street pet shops and veterinary supply stores near the U.S. border. There they can buy a bottle for $35 to $50, enough for one suicide, no questions asked.

Nine myths about euthanasia in the Netherlands

Euthanasia is really easy is in the Netherlands

Elderly Dutch people prefer to go to hospitals abroad for fear of being murdered by doctors in hospitals in the Netherlands

Children can use euthanasia to get rid of their elderly parents in order to get their hands on the inheritance

A Dutch clinic is to open where you can end your life

One telephone call and a mobile team turns up to end your life

Dutch people go around with wristbands saying they don’t want to be euthanized

Ten percent of Dutch deaths are down to euthanasia and many people are forced into it

Everyone can come to the Netherlands in order to have their life terminated

Parents can get rid of their handicapped child
https://www.rnw.org/archive/nine-myths-about-euthanasia-netherlands
 

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Sep 17, 2016

Belgian minor granted euthanasia for first time ever
http://www.680news.com/2016/09/17/belgian-minor-granted-euthanasia-for-first-time-ever/
Belgium is the only country that allows minors of any age assistance in dying, De Gucht said. In Holland, the lower age limit for euthanasia is 12 years.
 
recceguy said:
What if a person had 'Do Not Resuscitate' tattooed on their chest where the paddle goes?

Canadians vacationing in Florida may find this of interest,

1 Nov., 2017

Man has 'Do Not Resuscitate' tattooed on his chest. Doctors at the University of Miami Hospital Emergency Room honored it.
http://www.nejm.org/doi/full/10.1056/NEJMc1713344#.Wh84KQwAH0s.twitter
 
When my dad died a couple years ago
He had strokes at " the end " .he was not doing well. And likely was done for.
But he was a tough guy a I -suspect- the nurses did everybody a favour and kinda tipped the scales
 
We used to joke about what we would do if we ever saw a DNR tattoo, but I never saw one.

Dec. 4, 2017
Tattooed wish for withholding treatment not good enough, doctors say
https://ca.news.yahoo.com/tattooed-wish-withholding-treatment-not-good-enough-doctors-191018739.html

See also,

DNR Order 
https://army.ca/forums/threads/67123.0
 
Just a couple quick thoughts from the civie side of the street.  Recently I had a Stroke, well mini Stroke, well more accurately a TIA (transient ischemic attack) for which thank God I made a full recovery.  Anyhow one of the first things I did was get a Medic Alert.  Couldn't for someone in the Canadian Forces who wants a DNR get a Medic Alert. There is a section on the on line form for "Special Needs" and the person could enter DNR. And the person could attach the Medic Alert medallion to the chain holding their identity disk. On top of that there would be a wallet card issued by Medic Alert for medical personal to look at
And second thing about what to call someone who ends a patient's life who has a DNR order.  Instead of executioner, how about executor or DNR Executor
Anyhow posted for whatever it's worth

Tom
 
The Do Not Resuscitate Confirmation Form ( attached ) is the only order ( Ontario ) paramedics can accept.
 

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Aid-In-Dying Process Not as Graceful as Imagined ...By The Phrase 'Not As Graceful' They Mean It Is A Prolonged Gruesome Death.
https://www.usnews.com/news/best-states/colorado/articles/2017-12-23/aid-in-dying-process-not-as-graceful-as-couple-imagined

At some point someone will take the dose, it will not go as expected or panic will set in and EMS will be called. One Heck of a job to go to.
 
WRT the post above that there are people in NL that are being euthanized against their will  - what is the hard, verifiable and reliable proof of this? It seems to me if this is the case, the Ministry of Justice is not enforcing the law.
That being said, the practice  of assisted suicide (different and distinct from euthanasia) is a reality whose time has come in Canada, and the courts have confirmed this, there is no going back.

Re: DNR, why not a secure NFC medallion that authenticates the identity of a person who  can choose to wear it (or not). In Ontario, the e Healthcare records system should be able to handle this.
 
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