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Quebec nurses back euthanasia for the demented to the hilt: survey

Michael Cook

An overwhelming majority of registered nurses working in Quebec nursing homes support euthanasia for dementia patients who have left a living will, researchers from Canada and the Netherlands. In an article in the journal Geriatric Nursing.

Euthanasia is legal in Canada, but only for patients who are competent, even if they had expressed a request for “medical aid in dying” in their lucid moments. However, this restriction is under pressure. After a man killed his demented wife, the Quebec Minister of Health and Social Services asked experts to study whether MAiD could be provided for patients with advance directives.

Although only doctors are able to euthanize patients, the researchers point out that “Given their unique experience and expertise, nurses’ voice must be taken into account in deciding whether or not to modify the current legislation to give incompetent patients access to MAiD.”

Five hundred and fourteen nurses were surveyed; 219 responded. Of these, “83.5% agreed with the current legislation that allows physicians to administer aid in dying to competent patients who are at the end of life and suffer unbearably. A similar proportion (83%) were in favor of extending medical aid in dying to incompetent patients who are at the terminal stage of Alzheimer disease, show signs of distress, and have made a written request before losing capacity.”

Just as interesting as the nurses’ attitudes towards incompetent patients was their feelings about how they would like to be treated themselves should they become demented. If diagnosed with Alzheimer’s, 79% said that they would make a formal request to die. If a love-ones were diagnosed, 65% would call a doctor to euthanise them (provided they had left a request).

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Dutch doctors oppose plans for ‘completed life’ euthanasia

BioEdge

Michael Cook

Although Dutch government proposals for euthanasia for “completed life” – that is, for elderly people who want to step off the treadmill gracefully – have received a lot of publicity, they have not been legislated.

Now the Royal Dutch Medical Association (KNMG), the peak body for doctors in the Netherlands, has announced its opposition.” Such a radical proposal is not desirable for practical reasons and for reasons of principle,” says the KNMG.

Adding another law to govern the practice of euthanasia will lead to great complications, it contends. “The current Act is meticulous, transparent, verifiable, safe for patients and physicians, and has broad support.”

The government’s proposal could harm the elderly. “Vulnerability due to age, when people experience many medical and non-medical problems, can cause unbearable and hopeless suffering within the meaning of the legislation.” It could end up stigmatising the elderly.

The KNMG points out that the term “completed life” has an attractive ring to it for the public. “In practice, however, it will mainly be vulnerable people who experience loneliness and loss of meaning. These are complex and tragic problems for which no simple solutions.”

If sex reassignment surgery is the answer, what is the question?

BioEdge

Michael Cook*

Sex reassignment surgery requires the intervention of doctors. But what kind of treatment is it? Is it a therapy for a disease which should be offered only after psychiatric authorization? Or is it a biomedical enhancement which anyone can freely choose?

The answer to this theoretical question has practical consequences. If it is a therapy, then transgenderism is a disease. If it is an enhancement, then it hardly deserves to be funded by the government.

In a very interesting article in the Journal of Medicine and Philosophy, Tomislav Bracanović, of the University of Zagreb, in Croatia, analyses the competing conceptions. . . [Full text]

Give them sterile razors: controversial self-harm strategy

BioEdge

Michael Cook*

Some people who self-harm should be provided with sterile razors, says a mental health expert in the Journal of Medical Ethics. Patrick Sullivan, of the University of Manchester, argues that this approach may be more respectful of patients’ autononomy. He suggests that a harm-minimisation strategy for self-harming individuals could include provision of sterile cutting implements, education on how to self-injure more safely to avoid blood poisoning and infection, as well as therapy and alternative coping strategies. . . .
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Australian women complain of ‘gender disappointment’

BioEdge

Michael Cook*

“Gender disappointment” is not a recognised medical condition. But many women in Australia – where gender selection is illegal — attribute their depression to it. Speaking to Australia’s ABC network, a woman using the pseudonym Kate described it as “a guilt-ridden, debilitating depression”. She has two boys and she desperately wants a daughter.. . .
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