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VAEH Newsletter #31March 11, 2005 Hi Folks, (1) Several of us from VAEH have been very involved with testimony on H-115, the bill introduced by the Attorney General’s Task Force on End-of-Life care. It should help to improve end-of-life care by updating VT’s advance directives, allow do-not-resuscitate orders to remain in effect outside the hospital, etc. (2) The March 10 issue of the New England Journal of Medicine includes an essay about the Gronigen Protocol which establishes criteria for euthanasia of severely ill newborns in the Netherlands. The Dutch have been quite open about expansion of their original (1984) criteria for allowable euthanasia or PAS: from terminally ill to chronically ill; from physical suffering, to mental suffering; from adults to adolescents; from voluntary, to involuntary; from competent, to incompetent. There have been rumors about lethal injections for newborns since 1992, and finally neonatologists have decided to go public with the practice of killing newborn infants. This reports says there are 3 classes of infants who can benefit from euthanasia: (a) those who are going to die within a few days no matter what is done; (b) those with severe congenital abnormalities who might survive with intensive care, but in whom the intensive care would cause suffering; and (c) those who have a “hopeless prognosis” and who the parents and physicians believe would have unbearable suffering (they give the example of severe spina bifida). They don’t even discuss (a) and (b), but only (c) where the decision is based on poor quality of life rather than on terminal illness. In truth, if babies (a) and (b) are going to die anyway, there is no need for lethal injection, they just need to be given comfort care, and consideration about stopping measures that will only postpone an inevitable death. They report that 22 cases of type (c) neonatal euthanasia have been reported in the past 7 years, buth their surveys indicate that actually 15-20 cases happen each year, but most go unreported. They are now making a plea for openness and honesty. [beside the NEJM article, this was reported in the New York Times 3/10/05] (3) The case of David Prueitt’s failed suicide last month is making quite a stir in Oregon. He was 47, had terminal lung cancer, had lost a lot of weight, and complained of pain. After threatening to shoot himself, he was put in contact with Compassion in Dying in February, and one of their doctors provided a “lethal” prescription for 100 Seconal capsules. He took them, promptly went to sleep, and woke up 65 hours later saying “What the hell happened? Why am I not dead?” He remained alert and conversant and died naturally about 2 weeks later. Part of the “stir” is that Barbara Coombs Lee, president of Compassion & Choices (latest name for what used to be Compassion in Dying, previously End-of-Life Choices, formerly Hemlock Society) said this is the first reported serious complication [recall that ~20% of patients who take the same dose of the same drug in the Netherlands don’t die and are subsequently given a lethal injection]. She expressed great concern about how this could happened and said the case would be investigated by the Oregon Department of Human Services. However, in a press release, the DHS said they have no authority or resources to investigate deaths; their sole job is to collect and report annually the data that is given to them by the doctors. (4) The 2004 Oregon data was released by ODHS yesterday. Slight drop in number of death to 37 (v 42 in 2003; 208 total since 1998); 60 prescriptions written. Little change in the demographics; still only 5% receive a mental health evaluation; “no serious complications.” One of the disturbing things about this year’s report is that C&C (formerly CID, etc.) publically revealed the numbers 2 months ago. It is more than a little curious that the suicide advocacy group, who admit to assisting 75% of those who take their own lives, but should have no knowledge of those who do so without their help, is aware of the “private” data of the ODHS. This suggests at least cooperation, if not collusion. Sort of like the fox watching the chicken coop. (5) In Vermont, bill H-168 is “on the wall” of the House Human Services Committee. No word about whether it will be brought up for committee discussion this session. I expect they have many more pressing things that will generate less controversy, so I hope they will use their time prudently. We appreciate the many of you who have contacted Committee members to express your opinion and your request that this not be discussed or passed out of committee. If any of you haven’t done so yet, now would be a great time to contact any or all of the 11 Human Serivces Committee members: COMMITTEE ON HUMAN SERVICES (Room 46) Representative Pugh of S. Burlington, Chair
Bob Orr, President, Vermont Alliance for Ethical Healthcare |
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