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Canada should legalize assisted death, report concludes November 15, 2011

Posted by rogerhollander in Canada, Civil Liberties, Criminal Justice, Health.
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http://www.thestar.com/news/article/1087017–canada-should-legalize-assisted-death-report-concludes?bn=1

Sue Rodrigues, then 43, is consoled by NDP MP Svend Robinson after leaving a press conference in Victoria on Sept. 30, 1993, after the Supreme Court of Canada turned down her plea for a doctor assisted suicide.Sue Rodrigues, then 43, is consoled by NDP MP Svend Robinson after leaving a press conference in Victoria on Sept. 30, 1993, after the Supreme Court of Canada turned down her plea for a doctor assisted suicide.

REUTERS FILE PHOTO

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By Megan OgilvieHealth Reporter

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Canada should legalize assisted suicide and voluntary euthanasia for competent adults who have decided their life is not worth living, according to a sweeping new report on end-of-life decision making in Canada.

The report, released Tuesday in Ottawa, recommends that Canada create a “permissive yet carefully regulated and monitored system with respect to assisted death.”

It also recommends governments increase access to palliative care and cover end-of-life planning discussions under health insurance plans. And it says the country needs legal clarity and clear guidelines about some end-of-life practices, including terminal sedation and the use of some pain treatments that may shorten a person’s life.

The report will likely spark renewed controversy and heated discussions about whether people should be allowed to choose when and how they want to die.

The findings of the Royal Society of Canada Expert Panel are out the same week a case is being heard in B.C. Supreme Court that is challenging the country’s laws against assisted suicide. Currently, it is illegal to counsel, aid or abet a person to commit suicide.

Eighteen years ago, the country’s highest court rejected the case of Sue Rodriguez, a B.C. woman in advanced stages of ALS, or Lou Gehrig’s disease, who argued the criminalization of assisted suicide violated her constitutional rights.

Since then, other countries and jurisdictions have legalized assisted death, including Switzerland, Belgium and the Netherlands, and the U.S. states of Washington, Oregon and Montana.

The expert panel report, commissioned by the Royal Society of Canada, the senior national body of distinguished artists, scientists and scholars, is the first in-depth look at end-of-life issues in this country in 15 years.

The international panel, whose six members have expertise in clinical medicine, philosophy, bioethics and health law and policy, looked at all aspects of end-of-life decisions and care.

Panel chair Udo Schuklenk, professor of philosophy and Ontario Research Chair in Bioethics at Queen’s University, said the lengthy report and its conclusions should serve as a trigger for a new national conversation about end-of-life laws and practices.

He noted that although the topic is emotionally charged, it is important to have such discussions in spite of profound disagreements over whether the country should decriminalize assisted death.

“In Canada, we find people simply do not talk and do not plan enough about the end-of-life,” Schuklenk said at an embargoed online press conference Monday. “As a nation we have failed to develop coherent policies and set sufficient standards of end-of-life care.”

Dr. Ross Upshur, panel member and director of the University of Toronto’s Joint Centre for Bioethics, said thinking and talking about end-of-life issues is important for every single Canadian because “whether we like to think of it or not we are all mortal.”

In a literature review, Upshur found that Canadians are willing to engage in a discussion on end-of-life issues and that most would support a more permissive legislative framework for voluntary euthanasia and assisted suicide.

He also stressed that too few Canadians are having meaningful conversations about their final days with their family or their physicians.

“With the advances of modern technology there is more that physicians can do to extend and maintain life,” Upshur said, noting these advances make it even more important for Canadians to make end-of-life plans.

The panel drafted 24 recommendations for the reform of end-of-life care in Canada.

They include, among others:

  Government and health care institutions should educate Canadians about how to complete advanced-care directives, and should work to ensure these directives can be accessed no matter where a patient receives care.

  Government should cover end-of-life planning discussions under health insurance plans.

  Government should increase access to palliative care and expand its scope beyond that for cancer patients.

  Health care providers, regulators and prosecutors should develop clinical practice and prosecutorial charging guidelines on potentially life-shortening symptom relief and terminal sedation.

  The federal government should modify the criminal code so that in “carefully circumscribed and monitored circumstances” assisted suicide and voluntary euthanasia are legally permissible.

  Health care providers should be allowed — but not obliged — to provide voluntary euthanasia and assisted suicide.

  Granting a request for assisted death should only be done when that person’s request is voluntary and informed and that individual has been deemed competent.

  There should be a national oversight commission to monitor and to provide annual, public reports on voluntary assisted deaths.

  The provinces and territories should consider implementing a restorative justice program for voluntary assisted deaths until the practice is decriminalized.

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Sue Rodrigues, then 43, is consoled by NDP MP Svend Robinson after leaving a press conference in Victoria on Sept. 30, 1993, after the Supreme Court of Canada turned down her plea for a doctor assisted suicide.

 

Guatemala Experiments: Syphilis Infections, Other Shocking Details Revealed About U.S. Medical Experiments August 30, 2011

Posted by rogerhollander in Foreign Policy, Guatemala, Health, Latin America.
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Roger’s note: I was recently telling friends about my first consciousness of Latin America when students in Lima, Peru attacked then Vice President Nixon’s motorcade back in the mid 1950s.  It might then have prompted the question that we hear today: why do they hate us?  United States foreign policy towards Latin America has not changed in substance since the declaration of the Monroe Doctrine.  Until the modern era of mostly “democratically” elected governments, the US openly supported dictators in Argentina, Chile, Brazil, Venezuela, Bolivia, Panama, Nicaragua, Cuba, Dominican Republic, Haiti (stop me when you get bored) — some of the dictators were virtually put into power by US subterfuge or intervention.  In the modern era the US supports the most repressive and dictatorial “democracies” (Colombia, Mexico, Honduras) and is at odds with the most progressive (Ecuador, Bolivia, Venezuela); and as recently as two years ago the US clandestinely organized the overthrow of th democratically elected president of Honduras.  So when I say to you, read the following article and know why they hate us, please don’t tell me that was then, this is now.

By MIKE STOBBE, www.huffingtonpost.com, 29 August 2011
ATLANTA — A presidential panel on Monday disclosed shocking new details of U.S. medical experiments done in Guatemala in the 1940s, including a decision to re-infect a dying woman in a syphilis study.

The Guatemala experiments are already considered one of the darker episodes of medical research in U.S. history, but panel members say the new information indicates that the researchers were unusually unethical, even when placed into the historical context of a different era.

“The researchers put their own medical advancement first and human decency a far second,” said Anita Allen, a member of the Presidential Commission for the Study of Bioethical Issues.

From 1946-48, the U.S. Public Health Service and the Pan American Sanitary Bureau worked with several Guatemalan government agencies to do medical research – paid for by the U.S. government – that involved deliberately exposing people to sexually transmitted diseases.

The researchers apparently were trying to see if penicillin, then relatively new, could prevent infections in the 1,300 people exposed to syphilis, gonorrhea or chancroid. Those infected included soldiers, prostitutes, prisoners and mental patients with syphilis.

The commission revealed Monday that only about 700 of those infected received some sort of treatment. Also, 83 people died, although it’s not clear if the deaths were directly due to the experiments.

The research came up with no useful medical information, according to some experts. It was hidden for decades but came to light last year, after a Wellesley College medical historian discovered records among the papers of Dr. John Cutler, who led the experiments.

President Barack Obama called Guatemala’s president, Alvaro Colom, to apologize. He also ordered his bioethics commission to review the Guatemala experiments. That work is nearly done. Though the final report is not due until next month, commission members discussed some of the findings at a meeting Monday in Washington.

They revealed that some of the experiments were more shocking than was previously known.

For example, seven women with epilepsy, who were housed at Guatemala’s Asilo de Alienados (Home for the Insane), were injected with syphilis below the back of the skull, a risky procedure. The researchers thought the new infection might somehow help cure epilepsy. The women each got bacterial meningitis, probably as a result of the unsterile injections, but were treated.

Perhaps the most disturbing details involved a female syphilis patient with an undisclosed terminal illness. The researchers, curious to see the impact of an additional infection, infected her with gonorrhea in her eyes and elsewhere. Six months later she died.

Dr. Amy Gutmann, head of the commission, described the case as “chillingly egregious.”

During that time, other researchers were also using people as human guinea pigs, in some cases infecting them with illnesses. Studies weren’t as regulated then, and the planning-on-the-fly feel of Cutler’s work was not unique, some experts have noted.

But panel members concluded that the Guatemala research was bad even by the standards of the time. They compared the work to a 1943 experiment by Cutler and others in which prison inmates were infected with gonorrhea in Terre Haute, Ind. The inmates were volunteers who were told what was involved in the study and gave their consent. The Guatemalan participants – or many of them – received no such explanations and did not give informed consent, the commission said.

The commission is working on a second report examining federally funded international studies to make sure current research is being done ethically. That report is expected at the end of the year.

Meanwhile, the Guatemalan government has vowed to do its own investigation into the Cutler study. A spokesman for Vice President Rafael Espada said the report should be done by November.

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Associated Press writer Sonia Perez in Guatemala City contributed to this report.

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