Literature Review

Opposing views shared on assisted dying proposals BBC News, Isle of Man; by Rebecca Brahde; 7/1/24 Protesters both for and against proposed assisted dying laws on the Isle of Man have shared their views, ahead of an extra sitting of the House of Keys. Politicians will continue to debate legislation on Monday that would allow terminally-ill people the right to die. Millie Blenkinsop-French, from Douglas, said: "I think it is time now for us to have that choice." But Karen Owen said "one person's choice impinges on another's" and would lead to families having to have "terrifying" conversations as the end of life approaches. If the legislation is approved, there will be strict eligibility criteria: People who request an assisted death will have to be over 18, have lived on the island for at least five years and have been told by doctors they have less than 12 months to live. ... Public opinion was narrowly divided on the issue in a consultation held in April 2023 where more than 3,000 people shared their views.Editor's Note: The Isle of Man is a self-governing British Crown Dependency in the Irish Sea, between Great Britain and Ireland. We post this international article as a sample of the international scope of this extremely controversial issue, paired with similarities in different beliefs and opinions.

Delaware legislature passes Medical-Aid-in-Dying law CBS WBOC, DOver, DE; by Sean Curtis; 6/25/24 The Delaware State Senate is sending House Bill 140, or the End-of-Life Options Law, to Governor John Carney’s desk after passing it Tuesday [6/25/24]. ... Medical aid in dying would only be available to adult Delawareans diagnosed with an incurable disease or illness who have been given a prognosis of six months or less to live. The prognosis must come from at least two medical professionals, according to lawmakers. Advanced age, disability, mental illness, or chronic health conditions would not qualify a person, under the law. Those seeking medical aid in dying under HB 140 would need to demonstrate an ability to understand and grasp the consequences of their decision, as determined by a licensed psychiatrist or psychologist. ... It will now head to the Governor’s Office for Carney’s signature before becoming law, unless Carney chooses to veto the legislation. 

HPNA Position Statement: Medical Aid in Dying (MAiD)HPNA's position, policy, and value statements are reviewed every five years. Prior to approval from the Board of Directors, all new, revised, and updated position or value statements are posted for public comment to allow for opinions relevant to the position or value statement for a 30-day period. Statement open for comments through July 7, 2024.Position statement; feedback form

Death with dignity: 50th anniversary of America’s first hospiceYankee Institute; by Andrew Fowler; 6/7/24 ... In the late 19th century, terminally ill patients faced undignified treatment or were even “refused admission to the hospital entirely” due to “availability of space and resources” or race and socio-economic class, according to Doctors, Death, and Denial: The Origins of Hospice Care in 20th Century America by Sarah E. Pajka. ... All of this shaped the outlook of Florence Wald — a former dean of the Yale University School of Nursing, and a Branford native. Growing up in the early 20th century, she recognized the flaws and inhumane nature of medical care toward terminal patients, telling the Associated Press (AP), on Nov. 26, 1971, that death is “a period of life that can have a lot of meaning. It can be content, full of joy, with lots of reminiscing.” But death needed to be “more human and meaningful,” as she stated in the same AP article. Throughout her career, Wald’s passion for palliative care revolutionized the medical profession, with her co-founding “The Connecticut Hospice,” the first in the United States, on June 11, 1974.  Since then, more than 5,200 hospices have been established in the country and millions have sought both in-patient and home care services. This is the story of how the first hospice was founded in Connecticut 50 years ago.  ... Editor's Note: This fascinating history of hospice's beginnnings illuminate core purposes, outcomes (are we measuring the right factors?), and current 21st century challenges. This article is published by the Yankee Institute, not Connecticut Hospice. This author frames this history as a stand against "euthanasia." Whatever one's ethical, political, or religious stand on today's MAiD issues (Medical Aid in Dying)--also referred to as physician assisted suicide--we invite you to find common ground in learning from our history and celebrating Florence Wald's co-founding of The Connecticut Hospice. For readers, what do you know about your hospice organization's history? What might you research and learn? Whom can you honor? Fifty years from now, what will be said of how your organization chose to address 2024's core hospice purposes, outcomes, and challenges?

A moratorium on the euphemism MAIDJournal of the American Medical Directors Association; by Richard W. Sams II MD, MA (Ethics), CMD, Peter Jaggard MD, CMD; 6/24It is essential for high-quality health care for providers to adhere to the principle of truth telling, speaking with clarity and honesty. The euphemism medical aid in dying, MAID, is being mainstreamed in the medical literature by proponents of physician-assisted suicide and euthanasia. ... We recommend standardized language that accurately denotes the context and process. Provider Assisted Death by Prescription (PAD-P) and Provider Assisted Death by Administration (PAD-A) are terms that most accurately describe the process, taking into account who is prescribing or administering a lethal substance and the outcome of the actions. ... The standardized language needs to be used on death certificates so we can most accurately assess the impact that provider-assisted death is having on society. Emphasizing truth telling in morally controversial practices will foster trust among health care providers and with patients.

Spread of assisted dying shines spotlight on difficult decisions Financial Times; by Charlotte Middlehurst; 5/22/24 The right to control your death is a principle that societies have debated for centuries. But, as more countries prepare to legalise medically-assisted dying, the reality of allowing the practice is sparking fresh ethical arguments. Some form of assisted dying is now legal in 9 countries, as well as in 11 US states and parts of Australia. [Click on the title's link for data and discussion regarding international policies; concerns about increased "unassisted suicide"; rapid legislative/medical decisions; inducing death; devaluing the lives of disabled persons; ethical choices based on economic factors; doctors' choices; and more.] 

Medical aid in dying bill didn’t cross finish line this MN Legislature session Twin Cities Pioneer Press; by Dene K. Dryden; 5/22/24 Despite advancing through several House committees, Minnesota’s End-of-Life Option Act did not receive a floor vote in the House or Senate during the 2024 legislative session, which ended earlier this week. The legislation, co-authored by Rep. Andy Smith, DFL-Rochester, and Sen. Liz Boldon, DFL-Rochester, would have permitted medical aid in dying, also known as physician-assisted suicide. The measure would have allowed terminally ill adults to request a prescription for life-ending medication, which they would have to self-administer. 

When doctors withhold futile treatments, that isn’t ‘assisted dying’ The Guardian; by Dr. James Haslam; 5/15/24 [Commentary / Letter] I write in response to Dr Jagat Aulakh’s letter (A form of assisted dying already happens in hospitals, 8 May). It must be made clear that withholding or withdrawing futile treatments is not and never has been assisted dying. Stopping – or not starting – treatments that are not wanted, are not working or are not worthwhile is good medicine and the law of the land. Whereas “assisted dying” is the modern euphemism for physician-assisted suicide and euthanasia, both forms of medicalised killing [the author's choice of words]. ... Intentions are important. ...Editor's Note: This thoughtful response puts forth ethical support against Medical Aid in Dying (MAiD), also known as "physican assisted suicide." Likely, different opinions can be inflammatory among your hospice and palliative employees, board, community, and more personally among your family and friends. As hospice and palliative leaders, we must address this issue with respectful dialogue, critical thinking, case studies, personal beliefs and values, empathy, and humanity.

‘Take Me Out Feet First’ docuseries about end of life options debuts on Amazon Prime Video Variety; by Addie Morfoot; 5/7/24 In “Take Me Out Feet First,” a new docuseries now streaming on Amazon Prime Video, director Serene Meshel-Dillman chronicles people’s right to choose medical aid in dying. The six-part docuseries, made in partnership with the nonprofit advocacy organization Compassion & Choices, profiles 25 terminally ill people, their families, and friends, as well as experts in the medical field who advocate for MAID. The series chronicles people who have taken control of how their final days will play out. While some live in states where medical aid in dying is legal, some do not.

More legislation in Illinois deals with ending a person’s life The Center Square - Illinois; by Kevin Bessler; 5/1/24 Another bill has been introduced in Springfield dealing with end of life options for the terminally ill. Illinois state Sen. Julie Morrison’s Senate Bill 2644 would establish a statewide electronic registry that would contain Physician Orders for Life Sustaining Treatment (POLST) forms, which detail what type of medical treatment a critically ill patient does and does not want. “How much or how little treatment a person receives at the end of their life should be up to each individual instead of the one-size-fits-all approach,” said Morrison, D-Lake Forest, during a news conference Wednesday. “This measure will enable physicians to access forms detailing patients wishes in a single, accessible location.” 

Death with dignity or slippery slope? Senate committee hears end-of-life bill testimonySeacoastline, Portsmouth (NH); by Margie Cullen; 4/25/24... The bill has sparked passions as it has made its way through the New Hampshire Legislature. It passed the House in March by just three votes. The hearing Wednesday was its first in the Senate and is likely to be its last public hearing before going to the Senate floor for a vote. The committee did not vote on whether to recommend the bill Wednesday. The bill has transcended typical party lines, with both Democrats and Republicans voting for and against the bill in the House. On Wednesday, Smith was joined by Rep. Bob Lynn, R-Windham, a cosponsor of the bill, in introducing it to the Senate committee. 

Debates begin in the Assembly on the “end of life” bill; Catherine Vautrin calls for a “spirit of humanity, listening and respect”Times.News - France; The Minister of Labor, Catherine Vautrin, and the president of the special commission, Agnès Firmin Le Bodo, on April 22 at the Assembly; 4/22/24At the opening of the work of the special committee of the National Assembly, ... on the “end of life” bill, the Minister of Health, Catherine Vautrin, called on the deputies to have a parliamentary debate which takes place in “a spirit of humanity, listening and respect.” ... At the heart of the questions is the fact of offering certain patients the means of committing suicide ... This “assisted dying” will be reserved for adult patients, born in France or residing in the country for a long time, and able to clearly express their wishes. ... “I have heard fears to which I hope we can respond point by point, a strong demand for clarity and precision, an expectation of vigilance with regard to the sensitivity of the subject”, assured Ms. Vautrin. ... Hoping for a debate full of “humility, seriousness and respect for all convictions” ... [From MP Carline Fiat,] “We can disagree but we have to be careful with the words we say,” she told the deputies present in this committee.

Hospice boss warns of funding challenges BBC News, Josh Sandiford; 4/28/24[United Kingdom] A West Midlands hospice boss has warned it faces a "huge challenge" under the current funding model. Acorns Children's Hospice, which is based in Birmingham, told the BBC the situation was not sustainable despite demand for its services growing. It came after Hospice UK said there was a £77m funding deficit at centres across the UK. Editor's Note: We highlighted this recurring theme from United Kingdom in posts on 4/16/24 and 4/17/24 in our "International" section. Pairing this critical, ongoing financial crisis with our article on 4/19/24, "Will Assisted Dying in Europe Impact Living With Dignity?", how might these potential losses of effective hospice care impact patients' desires for assisted dying? What similar trends are we seeing in the United States?