health care to a state near you

**Dark Geared God** · 02-25-2010, 05:15 PM

LONDON (Associated Press) --
New guidelines published Thursday offer people in England and Wales broad hints about how to help a gravely ill loved one end their life with minimal fear of prosecution.

Assisted suicide remains illegal, but Director of Public Prosecutions Keir Starmer said six factors would make it less likely that prosecutors would bring criminal charges in individual cases.

Starmer said prosecutors will still evaluate each case for possible prosecution. One key indicator: Whether the suspect was acting wholly out of compassion, or had a darker motive.

"The policy is now more focused on the motivation of the suspect rather than the characteristics of the victim," he said. "The policy does not change the law on assisted suicide. It does not open the door for euthanasia."

He said prosecutors will examine each case on its merits.

"In cases where there is enough evidence to justify a prosecution, we have to decide whether it is in the public interest to prosecute," he said. "That involves an exercise of discretion."

Starmer was forced to clarify the assisted suicide guidelines by the House of Lords, acting on behalf of multiple sclerosis sufferer Debbie Purdy, who wants her husband to be able to help her end her life at a time of her choosing without facing potential prosecution.

She said the new guidelines, which take effect immediately, would help her end her life when that time comes. Still, Purdy said an entirely new law governing assisted suicide is needed to replace the existing law written nearly 50 years ago.

"He has been able to differentiate clearly between malicious intent and compassionate support," she said of the chief prosecutor. "But I think we need a new law because interpretation and tweaking of the 1961 suicide act will never be enough."

She said tribunals should be established to study individual cases before a person commits suicide so family members and close friends can know where they stand legally before they take any action to assist in the suicide.

This is the view of Terry Pratchett, a well-loved British author suffering from early onset Alzheimer's disease.

"I would like to see death as a medical procedure _ in very carefully chosen cases," said Pratchett, 61, who believes he should be able to legally end his life before the ravages of the disease leaves him helpless.
Starmer stressed that he was not decriminalizing assisted suicide or modifying the law on mercy killings, which have been the focus of intense media attention with the claim last week by a BBC television personality that he had killed his partner, who was gravely ill with AIDS.

But he said prosecution would be less likely in cases where the suspect was acting out of compassion.
He said other factors would also make criminal charges less likely, including victims who had made a voluntary and informed decision to end their lives, suspects who reported the suicide to police and admitted their role, and cases where a suspect tried in vain to convince the victim not to choose suicide.
Other mitigating factors that might make prosecution less likely include instances where the suspect provided only minor help in the suicide or was reluctant to provide assistance but did so in the face of persistent demands.

Still, Starmer stressed that prosecution is possible even if all of these factors apply.

He also listed 16 factors that would make criminal action more probable, including cases where the victim was under 18, did not have the capacity to make an informed decision to end their life or had been pressured by the suspect to commit suicide.

Prosecution would also be more likely in cases where the suspect had been guilty of violence or abuse toward the victim or when the victim did not seek the help of the suspect in the suicide.
In addition, earlier guidance that prosecution was less likely if a suspect was a family member or close friend of the victim was eliminated from Thursday's rules.

Richard Hawkes, the chief executive of Scope, a charity that works with the disabled, said the new guidelines threaten society's most vulnerable people.

"We do not support any weakening of the protection offered under the law on assisted suicide, which is exactly what these new guidelines do," Hawkes said.

"Many disabled people are frightened by the consequences of these new guidelines and with good reason. There is a real danger these changes will result in disabled people being pressured to end their lives," he added.....

**Dark Geared God** · 02-25-2010, 05:16 PM

Any question with a single payer?

**bandaidwoman** · 02-25-2010, 05:41 PM

Right now those with terminal conditions feel pressured to end their lives early so as not to be a financial burden to their families. This is already a reality and the only real solution in this country would be a single-payer health care system that made families not financially responsible for their dying relatives. In the absence of a single-payer system, however, maybe the terminally ill really are justified in choosing euthanasia to spare their children or spouse bankruptcy.

**Dark Geared God** · 02-25-2010, 06:11 PM

Originally Posted by bandaidwoman

Right now those with terminal conditions feel pressured to end their lives early so as not to be a financial burden to their families. This is already a reality and the only real solution in this country would be a single-payer health care system that made families not financially responsible for their dying relatives. In the absence of a single-payer system, however, maybe the terminally ill really are justified in choosing euthanasia to spare their children bankruptcy.

have you ever been to a VA hospital?

ask the 25 y/o if he wants them to end his life because he can't move but isn't sick they keep at ya for weeks months years,, until they wear you down thanks but no thanks. i work there and not as a nurse or janitor.

if you could see the memos.... we you already know that don't you

**bandaidwoman** · 02-26-2010, 05:57 AM

Medicare is single payer for my elderly, I don't get pressured to pull the plug.

I have dozens of young newly diagnosed aggressive cancers whose private insurance rescindedthem and left them to die. My 41 year old with stage 4 melanoma had Aetna drop her ( still working as a teacher), by the time I got her on Medicaid and medicare three months later to pay for the 15,000 dollar treatment that would have bought her another three years she was dead.

Who pulls the plug on who?

I have a patient who has myelodysplastic syndrome converted to acute leukemia, at 58 has maxed out on his lifetime limit on his private insurance of 2 million after 7 years of treatment. He has refused further treatment and wants to just die since he does not want to dip into his retirement to fund his medical care so that his wife will have something to retire on. Self euthanasia. He knows by the time I get him on medicare/medicaid which takes at lesast 3-9 months he will be dead.

**bandaidwoman** · 02-26-2010, 06:32 AM

By the way your VA rhetoric is outdated, since the overhaul in the 1990s it provides some of the best care in america, many outcomes studies show superiority over private hospitals
The VA: â€œThe Greatest Story Never Toldâ€ | Health Care | Change.org

and yes I worked at the Atlanta VA center in Decatur. Their cardiac cath lab was more state of the art than Emory's right down the street.

The American Customer Satisfaction Index ranks the VA ahead of any private-sector health care or insurance company, for both inpatient and outpatient services. This isn’t a one-year triumph, either. Look up the same rankings for seven consecutive years (2000-2007 with the 2008 data still pending), and you’ll see the same story.

Or how about NEJM

http://content.nejm.org/cgi/content/extract/349/17/1665

or Times

http://www.time.com/time/magazine/ar...376238,00.html

How Veterans' Hospitals Became the Best in Health Care

I have no problems sending my patients to the va here for great care.

I notice most americans never look at primary data before coming to a conclusion

**bandaidwoman** · 02-26-2010, 07:39 AM

Veterans Administration gives better care than private sector | Health Matters | STLtoday

a study comparing va care to medicare advantage ( privatized plans)

**Dark Geared God** · 02-26-2010, 09:38 PM

Originally Posted by bandaidwoman

Veterans Administration gives better care than private sector | Health Matters | STLtoday

a study comparing va care to medicare advantage ( privatized plans)

Do you or have you work there as of now?...they can post all the stuff in the world on line . but on the inside it is a well ...

**Dark Geared God** · 02-26-2010, 09:41 PM

oh tell that to the 10,000 plus that had to get HIV HEP A B C TEST AND MANY OTHERS DUE TO COST CUTS dirty machines ...well people hard core for a payer system won't believe it even if the memo bite them on the ass...anyway...

**bandaidwoman** · 02-27-2010, 06:42 AM

Originally Posted by The Situation

Do you or have you work there as of now?...they can post all the stuff in the world on line . but on the inside it is a well ...

Yes, I was there just 4 years ago, their facilities were brand new, the primary care cllinic personally called each patient after their clinic visits to assess compliace etc. now I transer my VA patients there all the time since my local facility cannot do dialysis or put cardiac stents. I have no problem transfering them there and they get great service. There is not a single VA patient that bad mouths it anymore. Even the old timers have noticed a great improvement.

By the way, my testimonial means nothing, what I showed you was large scale data that backs my testimonial. I am a research clinician, I judge based on lalrge scale data not testimonials. I showed you proof that clinical outcomes are good or superior in VA hospitals, a true testimonial to the good care they give. YOu should probably do the same thing.

**bandaidwoman** · 02-27-2010, 07:13 AM

SpringerLink - Journal Article

These results suggest that the VA and the non-VA patients who had acute myocardial infarction had similar outcomes and generally received care of similar qualities

shows treatment for heart attacks in vas vs private hospitals in newyork. Outcomes were identical or even superior but interestingly the va patients had a more liklihood of getting coronary angiography treatment ( a high tech high expense treatment) vs the low tech cheaper clot busting drugs like the private hospital! I think the data that showed slight superior outcomes is also due to the fact that va heart patients are not discharged quickly ( quick discharges are the hallmark of efficiency in private hospitals and they breathe down our backs about it)

http://ajm.sagepub.com/cgi/content/abstract/15/5/207

We found that in-hospital mortality in 1 VA hospital and a nationwide sample of private-sector hospitals were similar, after adjusting for severity of illness. Although not directly generalizable to other VA hospitals, our findings nonetheless suggest that the quality of VA and private-sector care may be similar with respect to one important and widely used measure

The va has gotten better and better since the mid 1980's, I would have agreed with you if this was 1980 when I was in high school. But not anymore.
It's not to say there aren't bad vas, heck but there are some bad private local hospitals I would not send my dog to...

**Dark Geared God** · 02-27-2010, 04:58 PM

Originally Posted by bandaidwoman

Yes, I was there just 4 years ago, their facilities were brand new, the primary care cllinic personally called each patient after their clinic visits to assess compliace etc. now I transer my VA patients there all the time since my local facility cannot do dialysis or put cardiac stents. I have no problem transfering them there and they get great service. There is not a single VA patient that bad mouths it anymore. Even the old timers have noticed a great improvement.

By the way, my testimonial means nothing, what I showed you was large scale data that backs my testimonial. I am a research clinician, I judge based on lalrge scale data not testimonials. I showed you proof that clinical outcomes are good or superior in VA hospitals, a true testimonial to the good care they give. YOu should probably do the same thing.

Well the one in TN and FL i was sent down there due to the well lets just say cost cutting the hospitals did that gave the vets aids hep and other deseases. most are one point but the miami and several other had been doing this for over 6 years the number of people at risk are far higher than 10,000 like they say when the health and human service sec and the Va sec have a meeting behind closed doors and say play it down your going to do it. just like it happened that was almost a year ago . its covered up..but like most deal it was a CYOA.. but F.Y.I go see for yourself i'm sure most its corrected but i doubt it...reading and seeing changes everything..when it first happen i said no this can happen until i saw it.. the DC Vet hospital is on point but there are many that are not...I'm just saying. i think the one you worked at is good ..but...anyway we could go back and forth...seeing is believing

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