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description= 3 posts published by Tara Nipe during August 2017;
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the (155), and (106), that (53), her (46), with (38), for (33), have (31), she (29), this (28), assisted (28), are (27), not (26), dying (23), care (19), life (18), will (17), they (16), people (16), end (16), doctors (16), who (14), more (14), their (14), from (13), 2012 (12), 2017 (12), about (12), can (12), when (12), there (11), even (11), than (11), has (11), legislation (11), death (10), would (10), was (10), which (10), palliative (10), patients (10), all (10), voluntary (9), 2013 (9), one (9), but (9), health (9), deaths (8), only (8), any (8), were (8), like (7), still (7), other (7), august (7), these (7), cases (7), right (7), very (7), our (7), suffering (7), patient (7), september (6), 2014 (6), 2016 (6), what (6), been (6), them (6), suicide (6), oregon (6), had (6), find (6), you (6), also (6), over (6), illness (6), because (6), fought (5), february (5), march (5), may (5), october (5), november (5), before (5), then (5), years (5), out (5), while (5), said (5), did 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Text of the page (random words):
g death even to willing eligible pleading people they study and work to make peoples lives better it s what ensures that applicants in oregon are more often directed to other measures including better palliative care interventions than are prescribed medication to help them die justine martin the multiply unfortunate woman with ms cll and sll articulates the desires of many people who have seen loved ones die badly i don t want to end my life at the moment but i want to know that if and when the time comes that i will definitely have a choice i agree with michelle when she says that assisted dying can only be a real choice if excellent expert palliative care is available in addition to the andrews government s palliative care plan announced in 2016 palliative care services from funding and resources to education and access improve when assisted dying legislation is introduced for that very reason patients are better and more comprehensively assessed and alternatives to assisted dying explored including additional refersals to specialists and services and she s right that coercion presents a genuine risk of influencing decision making which is why as dr carr points out this legislation provides more safeguards for the vulnerable that they currently have assessing applicants ensuring their requests are genuine consistent and uncoerced will be a major part of the coordinator and consultant roles for doctors under the legislation and of the legislation doctors will be mandated to undertake before playing any part in the process i fear that dr kaminsky has not reviewed the advisory panel s final report because the concerns she raises are comprehensively addressed from up skilling doctors a contributing factor in the 18 month period between the bill passing both houses and the act going into effect to how the medication is to be stored and who is responsible for returning it to the dispensing pharmacist if unused there is more danger of unused narcotics falling into the hands of a child than a bitter liquid in a locked metal box particularly as ms contin and oxycontin are small and brightly coloured fentanyl patches can look like stickers or bandaids and morphine mixture is sweet this is not an easy or straightforward issue it shouldn t be it s too nuanced too important and too open to misuse and error if not rigorously and robustly constructed the bill proposed in victoria is tighter than any anywhere else in the world incorporating the safeguards used in north america and europe in addition to measures unique to this legislation 23 8 17 09 40 edited to add in a brief exchange on twitter leah kaminsky reported that she d been quoted out of context and has written a book about the realities of facing death i have a copy on my teetering to be read pile it looks particularly light hearted and reassuring given the subject matter so i was a little surprised the abc has a second item about the positions of the same three victorian doctors for those who are interested in a little more on this http www abc net au news 2017 08 21 doctors divided over voluntary assisted dying legislation 8827204 caring at the end of life 07 monday aug 2017 posted by tara nipe in clinical nursing 1 comment a guest post by victorian nurse elisabeth hall who has changed identifying features about this patient whose dying she says is not atypical of her nursing experience i walk quickly efficiently down the corridor checking the six patients in my care this evening my lady in 24 s still with us drifting in and out of consciousness her mouth hanging wide open revealing naked pale gums her dentures have been soaking in a plastic container on the bedside table for the last few weeks it s been a while since she could chew and anything thinner than honey will slide into her lungs all she can tolerate now are teaspoons of water mixed with thickened and on good days finely crushed tablets mixed with strawberry jam i wipe the corners of her dry lips clean of the white crusts remnants from the last time she tried to swallow some medication reminders of how little dignity she has left so little autonomy she can no longer dab her mouth with the monogrammed linen hanky she used to tuck up her sleeve long since relegated to a bedside drawer by the clothes she wore when she could still choose and the large print mysteries she once used to escape the hospital at least she looks peaceful for the moment last night i gave her all of her prescribed as needed morphine and midazolam and still she cried out for her mum long gone from this 90 year old woman s life to help relieve her pain her bed has been lowered to the ground with a mat on the floor beside it just in case she falls while she s trying desperately to find a position that is if not comfortable at least bearable i check on her often gently changing her position moistening her dry mouth with damp cotton swabs and minty lip balm cleaning her frail body in stages so it doesn t exhaust her jutting bones lie beneath parchment soft skin that i assess for signs of pressure injury as i talk to her about what i m doing and the setting sun only i see through the curtained window i don t know if she can hear me any more before she was so far along when she asked me to please help her die she told me she would have no visitors had outlived most of her relatives and friends had no children of her own her wasted muscles are rigid and she moans when i move her her face shows the pain the discomfort and the utter aloneness that has dragged on for so long when my shift finally slows down i go in and sit in the dark on the mat next to her i hold her cold gnarled hands and talk to her quietly trying to soothe her this intimate moment feels like a single drop of comfort in an ocean of unrelenting suffering i pump hospital stock moisturiser and massage her hands comb her shock of white hair her breathing is uncomfortable to watch but i m certain it s much more uncomfortable to experience this woman with her brow furrowed in mostly quiet suffering is a palliative care patient she has been cared for by nurses visited by doctors ministered to by a chaplain they have all done what they can to ease her pain her breathlessness and her distress we do our best to care for her but cannot release her and end her terminal suffering all we can do is wait watch her deteriorate and hope we never have to see a loved one in the same situation swear to ourselves that we ll find a way to end it if it ever happens to us we go home make our family or friends promise them that they ll help if we ever end up in such a way we go to bed at night and replay our shift cry quietly to ourselves feeling both silly and useless this isn t even one of the awful ones many of us will think of assisted dying and hope that one day the laws will have changed so that we can help other patients end their journey on their own terms without pain and with their dignity with someone holding their hands in the place of their choosing and with relief in their heart right to life s latest tactic 04 friday aug 2017 posted by tara nipe in voluntary assisted dying leave a comment tags ethics health politics voluntary assisted dying three days ago nick staikos the mp for bentleigh tweeted about a leaflet his constituents had received at first glance it could be construed as coming from his office rather than from right to life and mr staikos did not appreciate the confusion this will be a conscience vote which means each parliamentarian will decide for themselves ideally based on review of the facts and reflection on the best interests of the people of victoria the seat of bentleigh is one of a small handful of very marginal seats over a month ago the australian christian lobby announced that it would be targeting these seats and vowed to derail the legislation and electorally punish mps who end up supporting it i have no problem with lobbying those of us who want this legislation passed will also be calling on like minded people to contact their mps will as i have write to papers and post things on social media the key difference as i see it is that while the people i m talking with are very careful to remain accurate calm and support our positions with facts those who think differently appear to be a little less cavalier with the truth i was given a pamphlet that as far as i can tell differs from the one distributed in mr staikos s electorate only by the mp details let s take a look at it i ll set aside the fact that right to life have created a false binary in which suicide prevention is antithetical to assisted dying and note that not only is this intentionally inflammatory it falsely conflates suicide the intentional ending of one s viable life with the inevitable death of a person in the end stages of a fatal disease illness or condition in the case of the former intervention can result in a healthy happy life in the latter the only question is whether the end will be comfortable and on their terms or tormented first of all the government sanctioned suicide will not be by doctors except in rare cases where patients are unable to do so because of physical or digestive reasons the role of doctors is to assess advise refer as appropriate educate and if indicated by the screening process and the patient s unwavering intent prescribe the use of the phrase sick and inform is hard to read as anything but intentionally misleading anyone accessing this legislation must be nearing or at the end of life from a disease illness or condition and have suffering that not able to be adequately managed a and be competent unwavering and uncoerced the question is he trying to save healthcare dollars is an egregious allegation while it s true that people on average consume for lack of a better word more health resources in the last twelve months of life than at any other time that is rarely because of palliative care far more often it s because death is fought with icu investigations expensive imaging and surgery i have spoken with doctors victoria s health minister other mp s palliative care and hospital administrators and not once have any of these people mentioned money more than that i have cared for patients for over a quarter of a century in victoria s public system despite the pressure for beds and kpi s and review meetings regarding length of stay nobody has ever suggested cost as a reason for transferring a patient or changing their care if the premier were motivated by that a surely he would have brought this up as an option earlier either pre election or when he was health minister and b his position wouldn t have changed following his witnessing the dying of his father right to life end the facing page with equal distortion we already have world class patient care improving palliative care resources and nobody is killing other people the line the life you save may be your own is ridiculous even in belgium where some of the most liberal laws are in place people are not at risk of being killed against their will oregon s laws are unchanged in two decades and victoria s bill is even firmer this is nothing but fearmongery onwards apparently right to life are unaware that britain comprises england scotland and wales it is true that over time utilization of these laws increases as is the case with anything novel from smart phones to laparoscopic surgery if you legalize on the broad basis that the dutch have then this increase is what you would expect said penney lewis co director of the centre of medical law and ethics at king s college london doctors become more confident in practicing euthanasia and more patients will start asking for it she said without a more restrictive system like what you have in oregon you will naturally see an increase source in the netherlands that increase is from 1 7 of all deaths in 1990 before the introduction of legislation to 4 5 in 2015 in belgium it is also true that both the netherlands and belgium have widened the parameters under which assisted dying may be provided and that a person who has unbearable suffering without realistic likelihood of improvement meets the criteria even if that suffering is psychological rather than physical in the table below underlying illnesses of dutch assisted dying cases proportion of all deaths source those patients are represented in bright blue and account for some 3 of all assisted deaths in 2015 cancer which is the cause of almost a third of all deaths in the netherlands also accounts for the overwhelming majority of assisted deaths it is utterly untrue that the oregonian law allows people accessed to assisted dying because they have a mental illness a person must be 1 18 years of age or older 2 a resident of oregon 3 capable of making and communicating health care decisions for him herself and 4 diagnosed with a terminal illness that will lead to death within six 6 months emphasis added source absolutely nothing there about mental illness being a reason to access the act though as here having or having had a mental illness does not prevent someone applying provided they are clinically competent ms tighe s pamphlet also refers to 431 people in the netherlands whose lives were ended without specific request and that appears to be accurate on cbs s statistical summary dated may 24 of this year the breakdown of 7 254 assisted deaths of a total of 147 134 for the year includes 431 titled levensbeëindigend hand zonder verzoek or assisted end of life without request that s 0 059 of the 4 9 of dutch deaths that are assisted and that figure doesn t tell us anything about the cases or prior directives and as 350 of those cases were patients aged 65 and over 201 of which were over 80 it is fair to assume many involved end stage dementia this is certainly not ideal but it s also not applicable to the victorian situation where competency is an integral component of the process it s a pleasant to change to find a verifiable accurate fact in this pamphlet albeit one i suspect is also the worst ms tighe s organisation was able to find speaking of verifiable facts when we turn the page we find three cautionary cases from oregon of women who were either forced into this option or avoided it and lived happy lives as there are no citations i have had to search for these stories myself ms wagner s case was publicised in 2008 when after several years of treatment with first and second line chemotherapy her insurance company refused to pay for an experimental drug that would potentially extend her life from four to six months as tarceva did not meet their requirement of 5 survival at 5 years indeed at the time the drug made no significant improvement for 92 of patients though it did induce rashes diarrhea and other unpleasant side effects in 19 of people taking it instead they were only prepared to cover palliative and comfort care which included but was not restricted to assisted dying after the media storm the drug manufacturer a...
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