{"id":3324,"date":"2018-10-12T20:02:51","date_gmt":"2018-10-12T20:02:51","guid":{"rendered":"http:\/\/tvndy.ca\/?p=3324"},"modified":"2018-11-27T15:29:11","modified_gmt":"2018-11-27T15:29:11","slug":"webcast-archive-news-briefs-sick-kids-policy","status":"publish","type":"post","link":"https:\/\/tvndy.ca\/en\/2018\/10\/webcast-archive-news-briefs-sick-kids-policy\/","title":{"rendered":"Webcast archive: news briefs (Sick Kids policy!)"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"1180\" height=\"664\" src=\"https:\/\/www.youtube.com\/embed\/xEKW6DHlDiU?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<div class=\"otw-row\">\n<div class=\"otw-row\">\n<div class=\"otw-twentyfour otw-columns\">\n<p>In this episode of\u00a0<em>Euthanasia &amp; Disability<\/em>, Amy Hasbrouck and Christian Debray discuss:<\/p>\n<ul>\n<li>News briefs<\/li>\n<\/ul>\n<p>Please note that this text is only a script and that our webcast contains additional commentary.<\/p>\n<p><strong>PAEDIATRIC EUTHANASIA POLICY PROPOSED<\/strong><\/p>\n<ul>\n<li>This week we have three assisted suicide and euthanasia (AS\/E) policy issues to bring to your attention.<\/li>\n<li>On September 21, researchers at Sick Kids Hospital in Toronto published an essay in\u00a0<a href=\"https:\/\/jme.bmj.com\/content\/early\/2018\/09\/21\/medethics-2018-104896\">the British Journal of Medical Ethics<\/a>, describing how they came to adopt new policies on euthanasia for young people. Though the policy can apply to adults, the working group seems to be expecting that\u00a0<a href=\"http:\/\/www.scienceadvice.ca\/en\/assessments\/in-progress\/medical-assistance-dying.aspx\">the Council of Canadian Academies study<\/a>, due out in December, will recommend that eligibility for euthanasia be extended to \u201cmature minors\u201d (people under 18 years old). \u00a0It would then be up to Parliament to change the law if they wish to.<\/li>\n<li>The policy focuses on the question of whether \u201callowing someone to die\u201d and \u201ccausing someone to die\u201d are the same thing.\u00a0 The authors believe that, if you focus on the \u201cpatient\u201d rather than the doctor, the differences between allowing and causing death become irrelevant, because both satisfy the \u201cprimary goal of MAiD,\u201d which is to \u201calleviate unendurable suffering.\u201d (So much for \u201ckill the pain, not the person\u201d)<\/li>\n<li>The working group describes a 15-step process for assessment, approval and administration of euthanasia.\u00a0 The proposed policy, the working group:\n<ul>\n<li>Suggests that the conversation about AS\/E should be started by the person making the request, though they note that \u201cthis is diametrically opposed to the way virtually all other medical communication is structured.\u201d<\/li>\n<li>Does not mention suicide prevention. \u00a0(Though steps 6a and 7 mention \u201cmedically appropriate treatment options,\u201d, these are not listed.)\u00a0 This seems odd, until you remember that AS\/E are not considered suicide.<\/li>\n<li>Supports Ontario\u2019s presumption that a person is capable, regardless of their age.\u00a0 This follows the current policy of allowing people under 18 to make life-and-death decisions, but raises an important question: if\u00a0<a href=\"https:\/\/www.bostonglobe.com\/lifestyle\/health-wellness\/2014\/03\/09\/brain-development-makes-teens-more-vulnerable-suicide-and-mood-disorders\/tGBStHOnjqAyanfCe7rbsK\/story.html\">teenagers\u2019 brains are unstable<\/a>\u00a0due to rapid growth and hormone storms, and that instability can put them at risk for suicide, are adolescents really equipped to make thoughtful decisions about AS\/E?<\/li>\n<li>Presents conflicting information about whether people can appeal a finding of ineligibility due to incapacity to Ontario\u2019s \u00a0Consent and Capacity Board.<\/li>\n<li>Allows young people to be euthanized without their parents\u2019 knowledge or consent. \u00a0(Though adolescents are encouraged to inform their parents, they are not required to do so.\u00a0 This contradicts the hospital\u2019s own recommendations for\u00a0<a href=\"https:\/\/www.sickkidsfoundation.com\/aboutus\/newsandmedia\/stories2017sepsuicideriskchildrenteens\">suicide prevention among adolescents<\/a>).<\/li>\n<li>Fails to take into account the role of disability discrimination in creating a negative self-image.\u00a0 The policy also doesn\u2019t compensate for the impact of the age and power imbalance between adult medical personnel and minor children, or the role of learned compliance in institutional settings in discussing treatment options.<\/li>\n<li>Ignores the fact that\u00a0<a href=\"https:\/\/www.cps.ca\/en\/documents\/position\/medical-assistance-in-dying\">more parents request AS\/E for their children<\/a>\u00a0than children ask for it themselves.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>SASKATCHEWAN STOPS COUNTING AS\/E AS SUICIDE<\/strong><\/p>\n<ul>\n<li><strong>The province of Saskatchewan<\/strong>\u00a0has\u00a0<a href=\"https:\/\/www.cbc.ca\/news\/canada\/saskatchewan\/maid-medically-assisted-deaths-suicide-saskatchewan-1.4851451\">stopped counting assisted suicide and euthanasia deaths as suicides<\/a>, which require a coroner\u2019s investigation. They will now be recorded as \u201cunclassified\u201d on the Medical Certificate of Death.\u00a0 (Not to be confused with a Death Certificate, which is a separate document, used for legal proof that person is dead.)\n<ul>\n<li>Clive Weighill, the chief coroner for the province, has said his office will investigate any death \u201cif somebody thinks it is\u00a0<a href=\"https:\/\/www.cbc.ca\/news\/canada\/saskatoon\/coroners-service-medically-assisted-death-saskatcehwan-1.4853595\">sudden, unexpected, unnatural or unexplained<\/a>,\u201d implying that an autopsy must be requested. In the case of AS\/E, that would include claims of coercion or an improper procedure. Weighill said that to his knowledge \u201cthat has never happened in Saskatchewan.\u201d<\/li>\n<li>As we noted last month, local law enforcement\u00a0<a href=\"https:\/\/tvndy.ca\/en\/2018\/09\/webcast-archive-18-09-14\/\">does not have the resources, the motivation or the expertise<\/a>\u00a0necessary to look into these cases.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>NEW GUIDELINES FOR DISORDERS OF CONSCIOUSNESS<\/strong><\/p>\n<ul>\n<li>The\u00a0<strong>American Academy of Neurology\u00a0<\/strong><a href=\"https:\/\/www.aan.com\/Guidelines\/home\/GetGuidelineContent\/929\">released new guidelines<\/a>\u00a0for doctors treating disorders of consciousness (DoC) caused by traumatic brain injuries or oxygen deprivation. The document emphasized:\n<ul>\n<li>the importance of periodic re-testing by qualified neurologists using tools recommended by the Academy of Neurology and the American Congress of Rehabilitation Medicine (ACRM).\u00a0 They also recommend using functional Magnetic Resonance Imaging, and making sure the person is as awake as possible when doing the testing;<\/li>\n<li>the need for rehabilitation services and stimulation, either at a rehabilitation facility or at home;<\/li>\n<li>avoiding statements that suggest a \u201cuniversally poor prognosis\u201d when talking to the family;<\/li>\n<li>the fact that, since many people with nontraumatic DoC recover consciousness after three months, and others with traumatic DoC wake up after 12 months, the authors suggest:\n<ul>\n<li>Applying the term \u201cchronic Unresponsive Wakefulness State (UWS)\u201d rather than \u201cpersistent vegetative state\u201d; and<\/li>\n<li>These benchmarks (adopted in 1994) should not be used as a signal to withdraw life support;<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Doctors often rush to judgment about people\u2019s ability to recover from brain injuries, or what that \u201crecovery\u201d will look like.\n<ul>\n<li>When Not Dead Yet US wrote about the new AAN standards in its blog, NDY referenced the story of a little boy\u00a0<a href=\"https:\/\/abc13.com\/health\/hospital-plans-to-cut-off-life-support-to-infant-in-coma-\/4261278\/\">whose life support was nearly removed<\/a>\u00a0just six weeks after a non-traumatic brain injury, as an example of the \u201crush to judgment\u201d.<\/li>\n<li>Sometimes the decision to withdraw life support is rooted in fear of the disability caused by brain injury; the family devalues their loved one\u2019s disabled life rather than taking the time and support they need to adjust.<\/li>\n<li>As well, the continued use of the term \u201cvegetative state\u201d is dehumanizing. No person can ever lose their humanity \u2013 or become broccoli!<\/li>\n<\/ul>\n<\/li>\n<li>We hope that medical professionals will follow these new standards, rather than cutting lives short because people weren\u2019t given the time they needed to heal.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"share\"><\/div>\n   ","protected":false},"excerpt":{"rendered":"<div class=\"entry-summary\">\n<div class=\"entry-summary\">\nA webcast on: some news briefs. We look at pediatric euthanasia at Sick Kids Hospital, Saskatchewan assisted suicide statistics, and new guidelines for treating people with consciousness disorders.\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2018\/10\/webcast-archive-news-briefs-sick-kids-policy\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: news briefs (Sick Kids policy!)&rdquo;<\/span>&hellip;<\/a><\/div>\n<\/div>\n<div class=\"link-more\"><a href=\"https:\/\/tvndy.ca\/en\/2018\/10\/webcast-archive-news-briefs-sick-kids-policy\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &ldquo;Webcast archive: news briefs (Sick Kids policy!)&rdquo;<\/span>&hellip;<\/a><\/div>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[92],"tags":[166,167,121,165,168,101,118],"class_list":["post-3324","post","type-post","status-publish","format-standard","hentry","category-webcast-archive","tag-american-academy-of-neurology","tag-consciousness-disorders","tag-euthanasia-disability","tag-saskatchewan","tag-sick-kids-hospital","tag-suicide","tag-webcast","entry"],"_links":{"self":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/3324","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/comments?post=3324"}],"version-history":[{"count":4,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/3324\/revisions"}],"predecessor-version":[{"id":3348,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/posts\/3324\/revisions\/3348"}],"wp:attachment":[{"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/media?parent=3324"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/categories?post=3324"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tvndy.ca\/en\/wp-json\/wp\/v2\/tags?post=3324"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}