Monday, December 12, 2016

Julie Ali shared a link. Dec 12, 2016 11:09pm Demand for medically assisted death continues to rise in Alberta edmontonsun.com These are the numbers of legal deaths. What about the premature deaths? Who counts these? Doctors can and do impose death on patients in Alberta with the use of DNR orders. These do not resuscitate orders are put on patient files despite the presence of personal directives indicating full resuscitation. Doctors can do this even when the patient and the family oppose the orders. Doctors are supported by the system and patients--especially handicapped patients have no rights in Alberta. It's clear to me that patients in hospitals and residents in continuing care need rights that ensure that the most vulnerable are not subject to unilateral DNR orders that do not respect the special vulnerabilities of disabled and elderly citizens.


Demand for medically assisted death continues to rise in Alberta

Sixty Albertans have received medical aid to end their lives this year, as demand for the service continues to grow across much the province.
EDMONTONSUN.COM

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Julie Ali I wonder what the numbers of DNRs are (premature terminations).
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Julie Ali

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So I am curious. The requirements for medically assisted death are higher than the requirements for doctor determined do not resuscitate orders. 

http://m.edmontonsun.com/2016/12/13/demand-for-medically-assisted-death-continues-to-rise-in-alberta
Common reasons why people are deemed ineligible include a having a mental health diagnosis, a loss of capacity or competency, or failing to have a condition where death is “reasonably foreseeable,” AHS said.

Who can tell me what the requirements are for DNRs?
We need clarity here. I mean you can't get a doctor assisted or a nurse practitioner assisted death if you have a mental condition. So why were the doctors at the Grey Nuns Hospital able to throw around DNRs with impunity for my sister?
It's also curious no one seems to care that there is no decision tree present for these orders.
I am pretty sure that if you do not have an advocate you are pretty well toast if a doctor decides on his lonesome to do the deed.
All the other pretty doctors simply support the first one as in the case of my sister and voila! The deed is done.

You gotta admire the mess in the GOA.
No one does anything about problems but passes the buck.
The buck ends with the family and the DNR order.
And in an emergency who do you think wins this fight?

I decide to go ask government more questions:

Hi,
I have written previously about the DNR orders that were issued for my handicapped sister.
I am not satisfied by the current state of affairs.

I believe that there needs to be legislation made by the government of Alberta.
1) There needs to be laws present to ensure patients in medical settings and residents in continuing care have rights.
2) One of these rights is the ability to go outside of Alberta health, AHS, Covenant Health and the continuing care industry to an independent appeal body to ensure there is no bias in the consideration of complaints or appeals to decisions made by these public bodies / government department.
3) There needs to be an automatic independent appeal when DNRs are issued with reference to people without capacity or handicapped citizens.
4) Why are DNRs allowed for mentally handicapped citizens and those without capacity when the death by doctor legislation prohibits termination in this way with this special population?
5) What rights do handicapped people have and those without insight when a doctor imposes a DNR order?
6) What can handicapped patients do if a DNR order is issued and they have no advocates?
7) How will poor handicapped citizens find the cash for a lawyer to go to court to challenge such orders?
8) How will a handicapped citizen challenge this order when he or she is in an emergency situation and doesn't even know about the DNR?
9) What are the legal obligations set out by the government of Alberta for DNR orders?
Surely if there are obligations set out by the federal government for legal termination there must be obligations set out by government for premature termination of this sort?
10) What are the legal obligations of the government of Alberta with reference to the rights of disabled citizens in this area of conflict?
11) What are the purposes of these DNR orders and why were they kept on my sister's file for 5 years?
12) It is the obligation of our government to protect the most vulnerable among us. A government that fails this especially at the most critical time--at medical emergency time-is not doing the job required to protect the rights of the disabled in our society.

Please provide answers.
Sincerely,
Julie Ali


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Date: Mon, Dec 12, 2016 at 11:42 PM
Subject: RE: Do Not Resuscitate Orders (DNR)s (AC425769)
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Do Not Resuscitate Orders (DNR)s
Hi, I have written previously about the DNR orders that were issued for my handicapped sister. I am not satisfied by the current state of affairs. I believe that there needs to be legislation made by the government of Alberta. 1) There needs to be laws present to ensure patients in medical settings and residents in continuing care have rights. 2) One of these rights is the ability to go outside of Alberta health, AHS, Covenant Health and the continuing care industry to an independent appeal body to ensure there is no bias in the consideration of complaints or appeals to decisions made by these public bodies / government department. 3) There needs to be an automatic independent appeal when DNRs are issued with reference to people without capacity or handicapped citizens. 4) Why are DNRs allowed for mentally handicapped citizens and those without capacity when the death by doctor legislation prohibits termination in this way with this special population? 5) What rights do handicapped people have and those without insight when a doctor imposes a DNR order? 6) What can handicapped patients do if a DNR order is issued and they have no advocates? 7) How will poor handicapped citizens find the cash for a lawyer to go to court to challenge such orders? 8) How will a handicapped citizen challenge this order when he or she is in an emergency situation and doesn't even know about the DNR? 9) What are the legal obligations set out by the government of Alberta for DNR orders? Surely if there are obligations set out by the federal government for legal termination there must be obligations set out by government for premature termination of this sort? 10) What are the legal obligations of the government of Alberta with reference to the rights of disabled citizens in this area of conflict? 11) What are the purposes of these DNR orders and why were they kept on my sister's file for 5 years? 12) It is the obligation of our government to protect the most vulnerable among us. A government that fails this especially at the most critical time--at medical emergency time-is not doing the job required to protect the rights of the disabled in our society. Please provide answers. Sincerely, Julie Ali
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end of message.

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http://m.edmontonsun.com/2016/12/13/demand-for-medically-assisted-death-continues-to-rise-in-alberta


Demand for medically assisted death continues to rise in Alberta


Keith Gerein

Today at 12:24 AM

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article
Sixty Albertans have received medical aid to end their lives this year, as demand for the service continues to grow across much the province.
New statistics released Monday by Alberta Health Services show the number of assisted deaths has essentially doubled in the past two months, a trend that has confounded health leaders.
Instead of tapering off following an initial surge of interest, demand appears to have grown stronger through the fall and into the start of the holiday season — months after new federal legislation came into effect.
“It’s still quite out there and people are aware of it and are therefore thinking about it as an option,” said Dr. James Silvius, AHS's lead for medical assistance in dying preparedness. “Whereas a year from now when it’s not so prominent, people may not be thinking about it the same away. At least, that’s my guess.”
The statistics show 90 per cent of the deaths have taken place since June 17, when the new federal law removed the need to obtain a court order to receive the service.
Silvius said the province had been averaging two to four deaths per week from June to September, but that rate has since gone up to about three to five per week.
In addition to the procedures that have been performed, 28 other requests for medical aid in dying have been rejected because the patients did not meet one or more legal criteria. Common reasons why people are deemed ineligible include a having a mental health diagnosis, a loss of capacity or competency, or failing to have a condition where death is “reasonably foreseeable,” AHS said.
The higher-than-expected demand has put pressure on a small team of nurses hired by the health authority to respond to the requests and navigate patients through the process.
Silvius said one more position has recently been added to better handle the workload, and extra nurses could be hired if the trend continues to escalate.
“Obviously, it would be nice to have more but I don’t think we are delaying anybody because of the number of navigators we have,” he said.
AHS has also been struggling to find additional doctors willing to assist a patient’s death.
An initial survey of physicians earlier this year found 150 or more who said they would be willing to provide the service, but far fewer have come forward.
Silvius said AHS plans to send a new survey to doctors early in the new year, in part to gauge the reasons for physicians’ reluctance.
“It also gets into what role would they be prepared to play. We will ask, ‘Would you be willing to be a consultant, or an assessor? Or would you be willing to actually be a provider?’”
Silvius said AHS will also reach out to Alberta’s 450 nurse practitioners, after they received cabinet approval last week to provide medical aid in dying.
Associate health minister Brandy Payne said the approval should provide additional options for people wanting the service, particularly patients in rural and remote areas of Alberta who may not have regular access to a doctor.
Alberta’s demand appears to be roughly comparable with other provinces, Silvius said. He said Alberta has been one of the best prepared jurisdictions and the process has been working quite smoothly overall, despite the higher-than-expected requests.
Close to half of Alberta’s assisted deaths (28) have occurred in the Edmonton zone.
Cancer, amyotrophic lateral sclerosis and multiple sclerosis are the three most commonly cited conditions among the patients who have received the service.
As of the end of November, six patients requesting medical aid in dying have been transferred to AHS care from another health agency, such as Covenant Health, Silvius said.
Covenant, the Catholic-based health organization, has said it will not allow medical aid in dying to take place in any of its hospitals, continuing care facilities or palliative care units.
By the Numbers: Medical Aid in Dying in Alberta
60: Total deaths that have taken place in 2016.
28: Deaths in the Edmonton zone.
19: Deaths in the Calgary and central zones.
8: Deaths in the south zone.
5: Deaths in the north zone.
6: Deaths that occurred between Feb. 6 and June 17, when a court order had to be obtained.
41: Deaths that have taken place in a facility.
19: Deaths that have taken place in the community, including at home.
70: Average age of people who received the service in Edmonton.
kgerein@postmedia.com
twitter.com/keithgerein






Julie Ali shared a link.
Dec 12, 2016 11:09pm
These are the numbers of legal deaths.
What about the premature deaths? Who counts these? Doctors can and do impose death on patients in Alberta with the use of DNR orders. These do not resuscitate orders are put on patient files despite the presence of personal directives indicating full resuscitation. Doctors can do this even when the patient and the family oppose the orders. Doctors are supported by the system and patients--especially handicapped patients have no rights in Alberta.
It's clear to me that patients in hospitals and residents in continuing care need rights that ensure that the most vulnerable are not subject to unilateral DNR orders that do not respect the special vulnerabilities of disabled and elderly citizens.





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