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Progress October 9, 2020

Posted by WorldbyStorm in Uncategorized.
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Got to admire Gino Kenny’s quiet but determined efforts on a range of fronts in the Oireachtas. His latest – the Dying with Dignity Bill – which cleared a hurdle to now move on to the Oireachtas Justice Committee.

Mr Kenny said it was a “significant” step forward that a majority of TDs backed the legislation by 81 to 71 after a free vote for all TDs.

And how telling is this:

The Cabinet split on the legislation when the vote took place on Wednesday. Just four Fianna Fáil TDs supported it and two thirds of Fine Gael TDs also voted against it. The Green party backed the Bill.

Which is not to minimise the fact that people take starkly different views on the issue for sincere reasons. That said, for myself, I think the proposals at the heart of it are sensible and sensitive:

The legislation provides for people with progressive terminal illness to decide the timing of their own death and avail of assistance to end their lives under controlled and monitored circumstances.

Anyone who has seen this situation first hand will know how truly difficult it is.

Kenny is rightly not overly optimistic, he notes that there’s no guarantee the legislation will pass, but he’s taking comfort in the fact that at least it is making some progress. Perhaps telling too that an amendment from the Government to put it to a special Oireachtas committee did not win through.

As to the breakdown of those voting for and against the Bill:

All 12 Green TDs backed Mr Kenny’s Bill as did Sinn Féin, Labour, the Social Democrats and Solidarity People Before Profit.

And:

Independents Joan Collins and Michael McNamara were the only Independents in attendance who supported the legislation A number of Independent TDs opposed both the Government amendment and the progression of the Bill to legislative scrutiny. Fifteen Independent TDs including all nine Regional and six Rural Independents also voted against the Bill’s progress.

An underconsidered aspect of the current dispensation is just how socially conservative many of the Independents are – and these are ones likely to hold seats in the future. It’s a mistake to think that only FF/FG are reservoirs of social conservatism. Granted there’s more of a patchwork on some social issues – but nonetheless, there’s a certain strand that is evident amongst them.

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1. Tomboktu - October 9, 2020

Gino has been a very effective legislator from the backbenches (a characteristic he shares with, of all people, Alan Shatter before he was elevated to the front bench).

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WorldbyStorm - October 9, 2020

He has. I’ve heard some being dismissive of him but in my experience he’s hard working and ( though this has nothing much to do with it or maybe it does) a genuinely sound guy as far as I can make out.

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2. alanmyler - October 9, 2020

It’s a difficult topic. Thankfully I’ve been spared any first hand experience of being close to this, and I have nothing but sympathy for anyone who has, I can only imagine the immensity of being in the situation either as the person at the centre of it or in the close circle around that person.

There was a very good Guardian podcast a while back that we were listening to the summer before last, on our holidays somewhere nice and warm as it happens, that was pretty thought provoking. It was about the situation in the Netherlands, which apparently leads the way in regard to assisted death, with something like 25% of deaths now being in that category. I think this is the link to it.

https://www.theguardian.com/news/audio/2019/feb/01/death-on-demand-has-euthanasia-gone-too-far-podcast

The one thought that struck me at the time, when listening to it, was that like everything else there are dynamics in play that are not restricted to compassion and humanity and all of those undeniable motivations to do right by the person in pain. There are others who benefit. Individually. Systemically.

If this ever came to a referendum vote I would be supportive of the change, but I do think there’s a debate to be had on the topic that goes a bit deeper than the usual divide between the secularising liberalism and the holier than thou conservatism which was so evident in the campaign over Repeal. Maybe it’s an easier debate, genuinely I don’t know, as I say I’ve thankfully never had to search my inner being to reconcile myself to this one way or the other.

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WorldbyStorm - October 9, 2020

I would completely agree and it’s something that has to be very carefully approached. It’s definitely not a simple issue and as you say there are many dynamics in play. I’ve had a little experience of it and I still can’t work it out fully for myself, but I think some degree of option for people in extremis is an inevitability.

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Liberius - October 9, 2020

It was about the situation in the Netherlands, which apparently leads the way in regard to assisted death, with something like 25% of deaths now being in that category. I think this is the link to it.

Just on that, the 2019 annual report from the Netherland’s euthanasia commission gives a figure of 4.2% on page 10 of the PDF linked below.

In 2019 the RTEs received 6,361 notifications of euthanasia. This is 4.2% of the total number of people who died in the Netherlands in that year (151,793). This represents a 3.8% rise in the number of notifications compared with 2018 (6,126 notifications) but a decline of 4. 4% compared with 2017 (6,585 notifications).

Earlier on page 8 during the preamble is the following, which seems to imply that there aren’t that many cases where there are issues.

Even more important is that, as in previous years, the review of notifications in 2019 delivers the incontrovertible message that due care is exercised in the practice of euthanasia in the Netherlands: in only four of a total of 6,361 notified terminations of life on request in the past year did the RTE find a failure to satisfy one or more of the due care criteria laid down in the Act.

The report is 98 pages long so I haven’t gone in depth, a breakdown of the type of patients is outlined on pages 13 & 15 with 91.1% having the following illnesses;

91.1% of the notifications (5,792) involved patients with:- incurable cancer (4,100)- neurological disorders such as Parkinson’s disease, multiple sclerosis and motor neurone disease (408);- cardiovascular disease (251);- pulmonary disorders (187); or a combination of conditions (846).

The rest are as below.

Two notifications in 2019 involved patients in an advanced or very advanced stage of dementia who were no longer able to communicate regarding their request and in whose cases the advance directive was decisive in establishing whether the request was voluntary and well considered. These cases are described in Chapter II and have been published (numbered 2019-79 and 2019-119)…

…In 160 cases the patient’s suffering was caused by early-stage dementia. These patients still had insight into their condition and its symptoms, such as loss of bearings and personality changes. They were deemed decisionally competent with regard to their request for euthanasia because they could still grasp its implications. Case 2019-90, described in Chapter II, is an example.

In 68 notified cases of euthanasia the patient’s suffering was caused by one or more psychiatric disorders. In 42 of these cases the notifying physician was a psychiatrist, in 11 cases a general practitioner, in two cases an elderly-care specialist and in 13 cases another physician. In 52 cases of euthanasia involving patients with psychiatric disorders, the physician performing euthanasia was affiliated with the Euthanasia Expertise Centre (EE), formerly the End-of-Life Clinic (SLK). In these cases, the physician must exercise particular caution, as was done in case 2019-121 (described in Chapter II).

Multiple geriatric syndromes – such as sight impairment, hearing impairment, osteoporosis, osteoarthritis, balance problems or cogni-tive deterioration – may cause unbearable suffering without prospect of improvement. These syndromes, which are often degenerative in nature, generally occur in elderly patients, and are the sum of one of more disorders and related symptoms. In conjunction with the patient’s medical history, life history, personality, values and stamina, they may give rise to suffering that the patient experiences as unbearable and without prospect of improvement. In 2019 the RTEs received 172 notifications of euthanasia that fell into this category. Two notifications reviewed by the RTEs relating to multiple geriatric syndromes are included in Chapter II (2019-67 and 2019-127).

Lastly, the RTEs register cases involving conditions that do not fall into any of the above categories, such as chronic pain syndrome, as ‘other conditions’. There were 167 such cases in 2019.

I know for some it’s a difficult “moral” issue, for me though this isn’t an abstract as I’ve cared for somebody with Alzheimer’s, knowing that it runs in the family I’m very much of the opinion that if I was allowed to I’d sign a declaration of my wish to die under those circumstance if it came about and I would expect it to be carried out.

Click to access Annual+report+2019.pdf

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WorldbyStorm - October 9, 2020

Nor for me either with a very elderly immediate relative who at the end really had had enough and I think that’s definitely shaped my feeling that it is necessary as a step forward, but I do get how people in the same boat as us themselves might have deep hesitations. All that said I think there’s a tide in this which is going just one way towards a greater degree of individual autonomy for people.

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WorldbyStorm - October 9, 2020

Btw that’s a terrible weight Alzheimer’s and I’m very sorry to hear you had to go through that.

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Liberius - October 10, 2020

Thanks & you’re right the tide on this only going in one way, I think that is largely driven by people’s lived experiences of degenerative illnesses and terminal illnesses so it undercuts the fairly abstract ethical philosophy that composes much of the anti argument. And on that that’s why as much factual information as possible is important, the figures I’ve quoted above prove a system, much less conservative than the dying with dignity bill, to be well overseen and with a minimum of issues.

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WorldbyStorm - October 10, 2020

Very useful information and much appreciated. I think that along with people’s experiences is important in terms of changing attitudes – again I get those attitudes even if like yourself I don’t share them, but for the individuals caught at the heart of it it is essential to give them the space. In a way it’s like marriage equality and the 8th. The more we hear from those directly at the heart of this and their testimony the more chance there is of moving things forward.

Anyway, again, fair dues to GK.

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alanmyler - October 10, 2020

Thanks for that correction about the percentage of deaths being assisted. Either I completely misunderstood whatever I thought I’d heard originally, or the guardian got it wrong, but whichever the correct figure is good to know.

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WorldbyStorm - October 10, 2020

I’d bet it’s the latter re the Guardian getting it wrong.

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Liberius - October 10, 2020

I’ve not listened to the Guardian podcast but I did read the written version of it back last year, that contains the following which I think is conflating euthanasia with end-of-life palliative care in an unhelpful and disingenuous way.

Also in 2017, some 1,900 Dutch people killed themselves, while the number of people who died under palliative sedation – in theory, succumbing to their illness while cocooned from physical discomfort, but in practice often dying of dehydration while unconscious – hit an astonishing 32,000. Altogether, well over a quarter of all deaths in 2017 in the Netherlands were induced.

The correction at the bottom is also instructive of the level of quality that was applied to the article.

This article was amended on 23 and 24 January 2019. A previous version referred to “muscle-wasting diseases such as multiple sclerosis”, where muscular dystrophy was meant. It was further amended because an earlier version said the decision to allow euthanasia was “contingent on a single, mercurial human conscience”. Dutch law states that at least two doctors must be involved in any request for assisted dying.

https://www.theguardian.com/news/2019/jan/18/death-on-demand-has-euthanasia-gone-too-far-netherlands-assisted-dying

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3. gregtimo - October 13, 2020

The bill sounds good on the surface, but I suspect there are holes in it that could allow abuse . I hope I am wrong, I do not share the faith of some in Kenny’s wisdom, given he is a long time SWNer, and am not much diverted by his McCann like charisma. A bit amazed the bill got so far without apparent input from Sinn Fein or the Left independents. Such input would make the bill more palatable/credible for me. Will a comprehensive Crime/Policing policy follow from PBP/Sol+ , seeing as the bill apparently makes provision to send people to prison in Section 5 (penalties) ?. There is still none in PBP’s policy section and I doubt one is coming, given SWN/SWP’s historic hostility to police . I presume this is part of the Transitional programme to a yet to be defined post-capitalist future without police . Who will man the prisons ? Will there be police like functionaries to enforce the above ? Call me an old conservative, though I see myself as a middle left dem socialist (both former Left social democrat and unwise dabbler in extreme leftism ). Has the bill been legal proofed to avoid abuse, or is such even possible ?

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4. Liberius - October 30, 2020

New Zealanders have voted overwhelmingly to legalise euthanasia in what supporters said was a victory for “choice” and “dignity”, preliminary referendum results showed.

A referendum on the controversial issue was held on 17 October, alongside the general election that returned Prime Minister Jacinda Ardern to power with a landslide majority.

Early figures showed a decisive 65.2% of voters supported euthanasia, with 33.8% against, meaning New Zealand will join a handful of countries around the world that allow doctor-assisted deaths.

http://www.rte.ie/news/world/2020/1030/1174854-new-zealand-euthanasia/

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