Friday, September 27, 2013

A Chilling Prospect for Disabled People

As posted by Not Dead Yet

        Stephen Hawking has expressed the view, in the course of a BBC interview, that people “who have a terminal illness and are in great pain should have the right to choose to end their own life”. They do, of course, have that right now:       ending your own life isn’t a criminal offence. What Professor Hawking means, presumably, is that the law should be changed to legalise what is being euphemistically called ‘assisted dying’ – or, to put it another way, that doctors should   be licensed to supply lethal drugs to terminally ill people to help them commit suicide.
There is, in fact, a Private Member’s bill, in the name of Lord Falconer, before the House of Lords at this moment proposing just that. Professor Hawking believes that “there must be safeguards that the person concerned genuinely wants to end their life and they are not being pressurised into it”. This is a fair enough caution to sound. What is remarkable, however, is that Lord Falconer’s ‘assisted dying’ bill does not contain any specific safeguards to ensure that these and other conditions are met.

Professor Hawking states that “human beings should not be allowed to suffer any more than animals”. This is a well-worn argument of the euthanasia lobby – that we put down suffering animals out of kindness, so why don’t we do the same for humans? But what those who use this argument seem to overlook is that people don’t always take their pets to be put down out of compassion: they sometimes do so because they are a nuisance or because they are proving expensive to treat or to feed. Is that the sort of society we want to see?

Those of us with disabilities are all too familiar with the view that many in society take of us – that they wouldn’t want to live with our limitations and that our lives are less worth living than the lives of others. I myself have encountered such attitudes: I have been told that ‘people like me’ do ‘a good job’, I have had it put to me by a medic that I should not have children and I have even been patted on the head by a colleague. The Paralympics, in which I have had the opportunity to participate, is sadly an all too rare occasion in which people with disabilities are valued.

Legalising ‘assisted dying’ for terminally ill people illness reinforces prejudices about people with disabilities. Terminal illness and physical disability aren’t, of course, the same thing – many people with disabilities aren’t terminally ill. But terminal illness can often bring with it disability of one kind or another and it’s not a big step in popular perceptions to see the two as in some way linked.

That’s why the majority of people with disabilities, including me, are afraid of a law that would offer a lesser standard of protection to seriously ill people than to others. Anyone who is inclined to discount such fears should read the report of Lord Falconer’s self-styled ‘commission on assisted dying’: it is on the recommendations of this unofficial and self-appointed group that his Private Member’s bill rests. Their report recommends that physician-assisted suicide should not be offered to people with disabilities who are not terminally ill “at this point in time“. It is those italicised words that send a chill down the spine of many people with physical disabilities. Lord Falconer’s ‘assisted dying’ bill may be well-intended. But it risks becoming a law to cater for the strong rather than to protect the weak.

Monday, September 2, 2013

POLST: What is it and why should you oppose it?

By Julie Grimstad

The POLST (Physician Orders for Life-Sustaining Treatment) form is a standard document that, when signed by a designated healthcare professional, dictates whether to withhold or administer certain forms of medical treatment and/or care. POLST is known by different acronyms in various states (MOST, MOLST, POST, etc.). 

A brightly colored form that is very visible in a patient's medical chart, POLST has boxes to check off indicating that a patient does or does not want cardiopulmonary resuscitation (CPR), antibiotics, nutrition and hydration, etc. Trained "facilitators"—usually not physicians—discuss treatment options with patients. After filling out the form with a patient, the facilitator presents it to be signed by a designated healthcare professional—someone who may never have seen or talked to the patient. The completed POLST form is not simply an expression of a patient’s treatment preferences; it is a set of physician's orders which must be followed.

POLST medical orders travel with the patient from one healthcare setting to the next and even home to be followed by EMT's in the event of a medical emergency. The first order in many POLST-type forms is "FIRST follow these orders, THEN contact Physician, Advanced Practice Nurse, or Physician Assistant for further orders if indicated."[i]

POLST is tilted toward non-treatment and can encourage premature withdrawal of treatment from patients who, but for the denial of treatment, would not die. Facilitators present options for treatment as if they are morally neutral, even though certain decisions may lead to euthanasia by omission. Groups that promote euthanasia and assisted suicide, such as Compassion & Choices (formed by the merger of Compassion in Dying—a Hemlock Society spin-off—and End of Life Choices), strongly endorse POLST. This is a big RED FLAG.