Always Care, Never Kill: How Physician-Assisted Suicide Endangers the Weak, Corrupts Medicine, Compromises the Family, and Violates Human Dignity and Equality

Always Care, Never Kill: How Physician-

Assisted Suicide Endangers the Weak, 

Corrupts Medicine, Compromises the Family,

 and Violates Human Dignity and Equality

Allowing physician-assisted suicide would be a grave mistake for four reasons. First, it would endanger the weak and vulnerable. Second, it would corrupt the practice of medicine and the doctor–patient relationship. Third, it would compromise the family and intergenerational commitments. And fourth, it would betray human dignity and equality before the law.

Doctors Induce Twenty-Five Percent of Dutch Deaths-(How may Murdered in the U.S. ILLEGALLY???)

Doctors Induce Twenty-Five Percent of Dutch Deaths

(How may Murdered in the U.S. ILLEGALLY???)

An exposé on Dutch euthanasia published in The Guardian discloses that around twenty-five percent of Dutch deaths are induced/caused by doctors.

These are not all lethal-injection euthanasia deaths. As I have written here before, many more people are killed in the Netherlands by “terminal sedation”–a slow motion euthanasia wherein patients not in the active stage of dying are put into artificial comas and denied all sustenance until they dehydrate to death–than die by lethal jabs. (Terminal sedation should never be confused with the proper practice of “palliative sedation,” which eases a dying patient’s symptoms while not intentionally causing death.)

2013 New Hampshire Revised StatutesTitle X - PUBLIC HEALTHChapter 137-J - WRITTEN DIRECTIVES FOR MEDICAL DECISION MAKING FOR ADULTS WITHOUT CAPACITY TO MAKE HEALTH CARE DECISIONSSection 137-J:23 - Penalty.

Universal Citation: NH Rev Stat § 137-J:23 (2013)

    137-J:23 Penalty. – A person who knowingly and falsely makes, alters, forges, or counterfeits, or knowingly and falsely causes to be made, altered, forged, or counterfeited, or procures, aids or counsels the making, altering, forging, or counterfeiting, of an advance directive or revocation of same with the intent to injure or defraud a person shall be guilty of a class B felony, notwithstanding any provisions in title LXII.

Source. 2006, 302:2, eff. Jan. 1, 2007.

Penalty? In NH? Next Joke!

2013 New Hampshire Revised StatutesTitle X - PUBLIC HEALTHChapter 137-J - WRITTEN DIRECTIVES FOR MEDICAL DECISION MAKING FOR ADULTS WITHOUT CAPACITY TO MAKE HEALTH CARE DECISIONSSection 137-J:33 - Do Not Resuscitate Identification.

Universal Citation: NH Rev Stat § 137-J:33 (2013)

    137-J:33 Do Not Resuscitate Identification. – Do not resuscitate identification as set forth in this chapter may consist of either a medical condition bracelet or necklace with the inscription of the person's name, date of birth in numerical form and "NH Do Not Resuscitate'' or "NH DNR'' on it. Such identification shall be issued only upon presentation of a properly executed do not resuscitate order form as set forth in RSA 137-J:26, a medical orders form in which a physician or advanced practice registered nurse has documented a do not resuscitate order, or a do not resuscitate order properly executed in accordance with a health care facility' s written policy and procedure.

Source. 2006, 302:2, eff. Jan. 1, 2007. 2009, 54:5, eff. July 21, 2009.

2013 New Hampshire Revised StatutesTitle X - PUBLIC HEALTHChapter 137-J - WRITTEN DIRECTIVES FOR MEDICAL DECISION MAKING FOR ADULTS WITHOUT CAPACITY TO MAKE HEALTH CARE DECISIONSSection 137-J:26 - Issuance of a Do Not Resuscitate Order; Order to be Written by the Attending Physician or APRN.

Universal Citation: NH Rev Stat § 137-J:26 (2013)

    137-J:26 Issuance of a Do Not Resuscitate Order; Order to be Written by the Attending Physician or APRN. – 
    I. An attending physician or APRN may issue a do not resuscitate order for a person if the person, or the person's agent, has consented to the order. A do not resuscitate order shall be issued in writing in the form as described in this section for a person not present or residing in a health care facility. For persons present in health care facilities, a do not resuscitate order shall be issued in accordance with the policies and procedures of the health care facility and in accordance with the provisions of this chapter. 
    II. A person may request that his or her attending physician or APRN issue a do not resuscitate order for the person. 
    III. An agent may consent to a do not resuscitate order for a person who lacks the capacity to make health care decisions if the advance directive signed by the principal grants such authority. A do not resuscitate order written by the attending physician or APRN for such a person with the consent of the agent is valid and shall be respected by health care providers and residential care providers. 
    IV. If an agent is not reasonably available and the facility has made diligent efforts to contact the agent without success, or the agent is not legally capable of making a decision regarding a do not resuscitate order, an attending physician or APRN may issue a do not resuscitate order for a person who lacks capacity to make health care decisions, who is near death, and who is admitted to a health care facility if a second physician who has personally examined the person concurs in the opinion of the attending physician or APRN that the provision of cardiopulmonary resuscitation would be contrary to accepted medical standards and would cause unnecessary harm to the person. 
    V. For persons not present or residing in a health care facility, the do not resuscitate order shall be noted on a medical orders form or in substantially the following form on a card suitable for carrying on the person:

As attending physician or APRN of __________ and as a licensed physician or advanced practice registered nurse, I order that this person SHALL NOT BE RESUSCITATED in the event of cardiac or respiratory arrest.

This order has been discussed with __________ (or, if applicable, with his/ her agent,) __________, who has given consent as evidenced by his/her signature below.

Attending physician or APRN Name

Attending physician or APRN Signature

Address

Person Signature

Address

Agent Signature (if applicable)

_________________________

Address ____________________

    VI. For persons residing in a health care facility, the do not resuscitate order shall be reflected in at least one of the following forms: 
       (a) Forms required by the policies and procedures of the health care facility in compliance with this chapter; 
       (b) The do not resuscitate card as set forth in paragraph V; or 
       (c) The medical orders form in compliance with this chapter.

Source. 2006, 302:2, eff. Jan. 1, 2007. 2009, 54:4, 5, eff. July 21, 2009.

2013 New Hampshire Revised StatutesTitle X - PUBLIC HEALTHChapter 137-J - WRITTEN DIRECTIVES FOR MEDICAL DECISION MAKING FOR ADULTS WITHOUT CAPACITY TO MAKE HEALTH CARE DECISIONSSection 137-J:10 - Withholding or Withdrawal of Life-Sustaining Treatment.

Universal Citation: NH Rev Stat § 137-J:10 (2013)

    137-J:10 Withholding or Withdrawal of Life-Sustaining Treatment. – 
    I. In the event a health care decision to withhold or withdraw life-sustaining treatment, including medically administered nutrition and hydration, is to be made by an agent, and the principal has not executed the "living will'' of the advance directive, the following additional conditions shall apply: 
       (a) The principal's attending physician or APRN shall certify in writing that the principal lacks the capacity to make health care decisions. 
       (b) Two physicians or a physician and an APRN shall certify in writing that the principal is near death or is permanently unconscious. 
       (c) Notwithstanding the capacity of an agent to act, the agent shall make a good faith effort to explore all avenues reasonably available to discern the desires of the principal including, but not limited to, the principal's advance directive, the principal's written or spoken expressions of wishes, and the principal's known religious or moral beliefs. 
    II. Notwithstanding paragraph I, medically administered nutrition and hydration and life-sustaining treatment shall not be withdrawn or withheld under an advance directive unless: 
       (a) There is a clear expression of such intent in the directive; 
       (b) The principal objects pursuant to RSA 137-J:5, IV; or 
       (c) Such treatment would have the unintended consequence of hastening death or causing irreparable harm as certified by an attending physician and a physician knowledgeable about the patient's condition. 
    III. The withholding or withdrawal of life-sustaining treatment pursuant to the provisions of this chapter shall at no time be construed as a suicide or murder for any legal purpose. Nothing in this chapter shall be construed to constitute, condone, authorize, or approve suicide, assisted suicide, mercy killing, or euthanasia, or permit any affirmative or deliberate act or omission to end one's own life or to end the life of another other than either to permit the natural process of dying of a patient near death or the removal of life-sustaining treatment from a patient in a permanently unconscious condition as provided in this chapter. The withholding or withdrawal of life-sustaining treatment in accordance with the provisions of this chapter, however, shall not relieve any individual of responsibility for any criminal acts that may have caused the principal's condition. 
    IV. Nothing in this chapter shall be construed to condone, authorize, or approve: 
       (a) The consent to withhold or withdraw life-sustaining treatment from a pregnant principal, unless, to a reasonable degree of medical certainty, as certified on the principal's medical record by the attending physician or APRN and an obstetrician who has examined the principal, such treatment or procedures will not maintain the principal in such a way as to permit the continuing development and live birth of the fetus or will be physically harmful to the principal or prolong severe pain which cannot be alleviated by medication. 
       (b) The withholding or withdrawing of medically administered nutrition and hydration or life-sustaining treatment from a mentally incompetent or developmentally disabled person, unless such person has a validly executed advance directive or such action is authorized by an existing guardianship or other court order, or, in the absence of such directive, authorization, or order, such action is taken in accordance with the standard protocol of a health care facility licensed under RSA 151 as applicable to its general patient population. 
    V. Nothing in this chapter shall impair or supersede any other legal right or responsibility which any person may have to effect life-sustaining treatment in any lawful manner; provided, that this paragraph shall not be construed to authorize any violation of RSA 137-J:7, II or III. 
    VI. Nothing in this chapter shall be construed to revoke or adversely affect the privileges or immunities of health care providers or residential care providers and others to provide treatment to persons in need thereof in an emergency, as provided for under New Hampshire law. 
    VII. Nothing in this chapter shall be construed to create a presumption that in the absence of an advance directive, a person wants life-sustaining treatment to be either taken or withdrawn. This chapter shall also not be construed to supplant any existing rights and responsibilities under the law of this state governing the conduct of physicians or APRNs in consultation with patients or their families or legal guardians in the absence of an advance directive.

Source. 2006, 302:2, eff. Jan. 1, 2007. 2009, 54:4, eff. July 21, 2009. 2012, 251:1, eff. Jan. 1, 2013.

Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio

Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio 

Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity
What OIG Found Hospice care can provide great comfort to beneficiaries, families, and caregivers at the end of a beneficiary’s life. Use of hospice care has grown steadily over the past decade, with Medicare paying $16.7 billion for this care in 2016. 
However, OIG has identified vulnerabilities in the program. OIG found that hospices do not always provide needed services to beneficiaries and sometimes provide poor quality care. In some cases, hospices were not able to manage effectively symptoms or medications, leaving beneficiaries in unnecessary pain for many days.