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The Final Choice

 Sun Herald Article: May 18, 2008

A grieving daughter describes how her father starved himself after· asking his children and grandchildren for permission to die, writes RACHEL BROWNE.  

Wouter den Dulk led an eventful life. He fought the Germans in World War II, migrated from his native Holland to Australia where he raised a family, established a successful business and enjoyed the company of a wide circle of friends.  

So when the time came to die, he decided he was going to do it on his own terms. Aged 90, crippled with agonising back pain, legally blind, partially deaf and confined to a bed in a Wollongong nursing home, den Dulk decided his life - or what was left of it - was not worth living.

In February, he called his four children and 16 grandchildren to his beside and asked for their permission to die.

And then he starved himself. Den Dulk died 12 weeks later on May 4.

His daughter Hanneke Chipperfield's voice cracks with emotion as she recalls her father's determination to die in the same manner as he had lived his life: with dignity. "I understood what he was going through," says Chipperfield, a retired registered nurse with more than 20 years' experience in aged care.

"Where is the quality of life? Where is the enjoyment of living? Where is the challenge left in life?

 "His future was just lying in a chair, waiting to die. He decided he just couldn't do it anymore. "He asked his four children, he asked each in-law and he asked the grandchildren for permission to die. Then he said goodbye to all of us. And he just stopped eating."

 Speaking from her home in Windella in the Hunter Valley. Chipperfield recalls her father as a decent, hard-working man who could do anything he turned his hand to.  

One of seven children, den Dulk was born in Holland in 1917 and left school aged 12 to work for his father, giving all his wages to his family to support them in the lean years between the World Wars.  

He signed up to the Dutch Army to fight the German soldiers who flooded into Holland in 1940, but was taken to Germany as a "forced worker" along with his 18-year-old wife.  

When Holland was liberated in 1945, the couple returned home with their first baby and den Dulk attempted to start a business to support his young family.  

But the post – War years in Europe were economically difficult and the den Dulks made a decision similar to that taken by thousands of other European families - they would start a new life in Australia.

 They left for their new home in 1951, living in a series of migrant camps before finally settling in Wollongong, where the entire family lived in a tent for six months before moving into a proper home.

 The den Dulk's story follows a pattern similar to many post-War migrants. They worked hard, the four children did well at school and all went on to have success in their careers.

"But those early years were horrific for both my mother and my father;' Chipperfield recalls. ''They lived a very, very hard life in many ways before their circumstances improved, mainly due to my father's sheer hard work and determination to make a go of things in Australia."  

But as the years went on, Chipperfield's parents became more frail, with both ending up in a nursing home. After her mother's death, her father, then increasingly incapacitated, announced he wanted to return to Holland to visit his family.  

"Dad wanted to go back to Holland so we went back," she says. "He paid for me and my sisters and my sister-­in-law to go back to Holland to see his brothers and sisters. After four weeks we returned to Australia. He tried to do as much as he could in his last few years."  

Eventually, however, den Dulk's condition deteriorated to the point where he could no longer walk unaided, even though all of his mental faculties were intact.

"He was a smart man who was mentally motivated and had been active his entire life," Chipperfield says. 

"He loved to play bridge and he always won. He would get out and walk every day. He was the type of person who was always doing something; always interested in the world around him.  

"For my father to sit and do nothing was the hardest thing. That was worse than death.  

"I remember one day the people at the nursing home said, 'Mr den Dulk, it's a beautiful day outside, we're going to put you in a chair and you're just going to enjoy the sun'. And his response was, 'How can I lie in a chair and enjoy the sun? I’m doing nothing'.

 "He said, 'I can't do this. It's boring, It's dull. I have no challenge left Mum's not with me anymore and you people have to get on with your lives; you have to live your lives; I can't get in your way. You're all visiting me all the time. I have become a burden'. He just hated what his life had been reduced to."

With her history of caring for elderly people, Chipperfield understood her father's view and knew from experience that the situation could only get worse.

 "I have nursed so many people who couldn't speak; they were just turned every two hours," she says. 'We'd put food in their mouths at one end and clean them up when it came out the other end. That was their life. There is no dignity in that.

"When you nurse people in that state, when you see what happens to people ... " her voice trails off before she continues, "These are people who have led decent lives, they're good people who have given a lot during their lives. And at the end of their life, their dignity is taken away from them."

A week before den Dulk passed away; he made a final request. He asked his daughter to start a public campaign for the right to die with dignity.  

"He said, 'What I’m going through, it's not right. It is undignified. "Please do something about this because it's just so horrific for everybody involved'," Chipperfield says. "Currently, the law states that people are not allowed to die, even if that is their wish."

 Chipperfield does not like the term euthanasia but she is a firm believer in the right to die, a view she believes is shared by many who work in aged care. "It's interesting," she muses. "When my father was doing this, not one of his friends thought it was bad; not one of the staff at the nursing home ­except for one who objected on religious grounds and I respect that - thought that what he was doing was wrong."  

But euthanasia, or assisted suicide as it's often called, remains a vexed ethical issue for the medical and legal professions. "At the moment people risk ending up in jail if they are seeing out the wishes of their loved ones," Chipperfield says. "There has to be a better way of addressing the rights of those people who wish to die."

Chipperfield has written an impassioned letter to the Prime Minister, Kevin Rudd, outlining the circumstances of her father's demise and asking the Federal Government to reconsider the current position on a person's right to die.  

"Why is it illegal to end your own life if this is your wish when life has no meaning left?" she wrote.

"When you read this letter stop for one moment and think how you would feel if this was your life. My father has asked for there to be a structured system put in place, where people at the end stage of their life can nominate to die with dignity. This can be achieved in many ways, although I do have to acknowledge that this is not for every person as not everyone would agree with taking this type of action, but we must give people the choice one way or the other."  

While Chipperfield understands the ethical complexities of the right­-to-die debate, she believes it boils down to one thing. "It has to be an individual choice" she says. "My husband believes in life at all costs and I respect that I would nurse him until he died. For me, if I become a burden, if I have no quality of life, I would choose to die with dignity but at the moment I don't have that choice. None of us do."

 Figures from the Australian Bureau of Statistics suggest that the right-to-­die debate will become a greater issue due to the ageing population.

In 2006, people aged 65 and over accounted for 13 per cent of the population. Life expectancy is increasing and the birth rate remains comparatively low at 1.8 children per woman, although it has gone up in recent years due to Government incentives such as the baby bonus.

"This issue is going to become more prevalent," Chipperfield says.

"Our population is getting older. And there is a large group of post­ War baby boomers who are now entering their 60s. Just think about what's going to happen with them in 10 or 20 years' time. This is going to be a huge issue for the future."  

As the number of older people increases, so too will health problems associated with ageing such as dementia, diabetes, eyesight and hearing difficulties.  

"When I worked in aged care we used to see these chronically ill people with no quality of life and describe it as the long death," Chipperfield says.  

"What happened to my dad was a long death."

 rbrowne@fairfaxmedia.com.au

Preparing for the Final Curtain
By Nick Galvin

(Sydney Morning Herald- Tuesday 7th July 2007 http://www.smh.com.au/environment/ )

An increasing number of people are seeking a more holistic and eco-friendly approach to the end of their lives, writes Nick Galvin (Sydney Morning Herald- Tuesday 7th July 2007).

It's 10 years since Margaret Ward's husband, Peter, died suddenly from a heart attack at their home in far northern NSW.

Margaret remembers her partner of 31 years as a remarkable man - a professional sailor and jazz fan known for his sense of fun and generosity of spirit. With his passion for the natural world and the outdoor life, it was clear that a conventional funeral was never going to be suitable for Peter.

"I knew Peter wouldn't want a church funeral," says Margaret. "About three years before he died, one of his aunts died … and he came home from the funeral and said, 'That's terrible. You line up in a crematorium and one family is coming out and the other is lining up to come in'. It really distressed him. I knew he didn't want to go into a crematorium."

At the time of Peter's death, the couple was managing an organic herb business at Billen Cliffs community near Kyogle. With the help of Zenith Virago, a local celebrant, Margaret and her daughters arranged for Peter to be buried at Billen Cliffs in a simple timber coffin with a bush rock as a grave marker.

"My friend has a nursery and he planted a huge poinciana tree beside the rock and a year later provided all this native flora for the grave," says Margaret. A jazz band played during the ceremony and friends and family were encouraged to include notes to Peter and other keepsakes in the coffin. "Looking back, it was just amazing," she adds. "People are still talking about this amazing celebration and I'm sure it's exactly what Peter would have loved."

And while Peter's burial may seem to have been a little unorthodox, in fact it is representative of a style of eco-friendly burial that is becoming increasingly widely accepted, especially overseas. In Britain, for instance, woodland burial sites are becoming increasingly popular, with more than 200 now dotted around the country.

As the name suggests, these sites generally have established trees with grave sites in between. Typically, the only markers allowed are small wooden plaques. In some cases markers are discouraged altogether, with relatives asked to rely instead on GPS co-ordinates to locate their loved one's final resting place.

The trend is spreading only slowly to Australia. One of the country's first true bushland burial sites is being planned in Lismore on the NSW far North Coast. The land earmarked for the burial site is adjacent to the Lismore Memorial Gardens and consists of about four hectares of bushland dotted with gum trees that are also home to several koalas.

Kristian Whitney, co-ordinator at the memorial gardens, says it would never have been possible to clear the trees to create a conventional cemetery. "We decided the better option was to set up a bushland cemetery where the infrastructure and costs are minimal," he says. "It would also better serve the different mind-sets of people on the Far North Coast." The only markers allowed for the grave sites will be small bush rocks.

"We want to just let the ground be covered by the natural ground cover of the area," Whitney says. "The casual viewer will just see a nice grassy meadow with some tall gum trees sprinkled through it." Conventional coffins will also be banned from the facility, which should be in operation by the end of the year. "We're not going to allow the normal chipboard or MDF caskets," says Whitney. "It will have to be something very organic in its construction. There will be no plastic liners or handles."

There are now a number of "green" coffins (or caskets, as the industry prefers to call them) available, but such are the taboos and rituals surrounding death that coffins made from eco-friendly materials such as bamboo, papier-mache or even cardboard are still comparatively rare.

Ivor Hay set up in Adelaide about two years ago manufacturing cardboard coffins. Business is steady but not spectacular, he says. The coffins, which retail for between $300 and $400, are made from a particularly robust "honeycomb" cardboard. "It's a very solid and lightweight material," says Hay. But despite his product being certified for weight of up to 120 kilograms to allay nightmarish fears of coffins splitting or disintegrating at the graveside, Hay still meets resistance from the funeral industry, even in the face of relatives who are adamant they want a cardboard coffin. Typically, funeral directors cite health and safety concerns, but it is hard to imagine that, given the amount of money to be made from the sale of conventional coffins, there is not some self-interest at work as well.

Hay says his customers are a mixed bunch. "Some of them you could call old hippies and alternative people," he says. "But others are old people who think the idea is just fantastic because they have been through the Depression or the war and think a funeral should be just basic."

Virago, the celebrant who helped Margaret Ward plan her husband's funeral, is also a founder of the Natural Death Centre in Byron Bay. "Our aim is to inform, advise and assist people who wish to conduct a more personalised, unique and ecological funeral," she says. Virago estimates there are as many as 50 "eco burials" performed around the area each year. "There is a global movement to bury in the old-fashioned way," she says. "That way the body will dissolve back into the ground instead of becoming a waste product. You are becoming a positive because you are nourishing a tree and actually helping the planet.

"Just like women reclaimed birth in the 1980s, people are now reclaiming death. You don't have to be a radical greenie. If someone says you can either be buried in a straight row under concrete or in a paddock under a tree it's a very easy choice."

When considering the environmental effect of one's mortal remains, cremation - the most popular method of disposal in NSW - is a particularly problematical way to take that final journey. Some of the pollutants generated by the average cremation include nitrous oxide, sulfur oxide, dioxin and mercury. And, of course, carbon dioxide . The University of Melbourne's Professor Roger Short says the average male body produces about 50 kilograms of carbon dioxide when cremated. This does not take into account the greenhouse gases produced by the gas-powered cremation ovens themselves, which are heated to more than 800 degrees for 90 minutes for each body.

Short began considering the idea of greener funerals 20 years ago while visiting the conservationist Kuki Gallman at her Kenyan home. "On her lawn there were these two fantastic trees," he says. "Kuki said the one on the left was her husband who had been killed in a terrible car crash. She had buried his remains in the lawn and planted a thorn tree over him because he loved thorn trees." A few years later Gallman's son was also killed and she buried him under the lawn as well and planted a thorn tree over the grave. "Every evening I sit having a sundowner and look at my husband and son," Gallman told Short. "Each day they grown bigger and more beautiful and I celebrate their life."

This experience stayed with Short, who recently delivered a speech in Melbourne extolling the virtues of "becoming a tree" instead of cremation or conventional burial. He wants to be an oak tree in his native England. "The thought that you might be able to do some good for the planet several hundred years after you have died by promoting the growth of some trees makes you feel a little bit cheerful," he says. "Forget pushing up daisies, we should be pushing up forests instead."

Graham Bird is very sick from Parkinson's disease and knows that, at 71, he doesn't have a lot of his life left ahead of him. So now the passionate environmentalist and former farmer is preparing calmly for his own death. "In terms of being an ecologist, I think death is very much the same as life," he says. "It's just inherent in it. Actually, being frightened of death is really crazy."

And Bird is determined his own passing will have a minimal impact on the planet. If possible, he will have a woodland burial and a simple, low-impact ceremony.

Plenty of good times to be had yet ... Graham Bird chats with celebrant Victoria Spence.
Photo: Natalie Boog (sorry unable to publish photos here)

"It's a last little gesture," he says. "Although it's not nearly as important as reducing our human impacts while we are in the world. I also don't think I would want my body moved far from where I die - I think it's better to be buried close at hand."

Sitting in his small flat in Katoomba, it's hard not to be impressed by the stoicism and dignity with which Bird discusses both his own future and his fears for the future of the planet. He recalls one crystallising moment when, as a young man, he went to work on the North Coast. "I saw how the soil had deteriorated enormously since settlement and how people were putting bananas in incredibly steep hills," he says. "There was one day where I looked way up at a hill and there was a bulldozer clearing land that was obviously for bananas and I thought, 'The gods must be crazy."'

He went on to play a pivotal role in establishing social ecology teaching at the University of Western Sydney and campaign widely on green issues. But his disease is beginning to take its toll. "It tires you out and makes it hard to be [as] effective as you want to be - for instance, I can't really type on the computer these days." Recently Bird has been working with a celebrant, Victoria Spence, who helps people nearing the end of their lives and recently bereaved loved ones.

"Imagine if I came in to a woman who was in labour and said to her, 'Right. Now you are in labour, let's do some birthing classes,"' shesays. "You'd think I was an idiot - it's too late. In the same way, we can't leave the conversation and business of preparing for our life's end until we are experiencing it. It's too late.

"The more we create a relationship with our own mortality the more we are aware of the incredible preciousness of our lives - and by extension the entire planet." Not that Bird is in any hurry to realise his own mortality. As he says: "There are plenty of good times to be had yet … I just think taking death too seriously is quite funny, really."

Nick Galvin
 

Monday July 16, 2007: Herald Sun (Your Money pg 29)

We're dying for a better deal for our beneficiaries

LEGAL
SUPERANNUATION is a tricky subject. So is dying. Combine the two, add in a splash of tax, a dose of new law, a pinch of emotion and the mix would knock out even the best accountant. Millions of dollars are poured into super over a worker's lifetime and, as a result, it becomes a large part of someone's estate.

Recently, YourMoney discussed how new super and inheritance laws can affect the way we set up a will or plan for our children's future.

It goes like this: A beneficiary has to pay 16.5 per cent tax on any super bequeathed to them from their parent's fund — except for any portion the parent contributed from after tax money.

So, to reduce the tax burden for their children, a parent could set up a separate fund to receive these personal contributions.

When they retire and start a pension, they draw the larger amount from the employer contributed fund, leaving as much of the self-contributed money (which is not taxed after death) as possible.

But there are other ways, to reduce the tax liability for your kids.

The key component of the new super law is the ability to withdraw super after the age of 60 tax-free.
"There is nothing to stop a post-retirement age person withdrawing their entire super and just giving it to their children,"

Sydney Hall Chadwick partner Gino Malacco said. "Other valid alternatives include re-contributing funds to a new superannuation fund as after tax contributions if they are under 65.   "If a pension is commenced with recontributed monies, the entire balance will be tax free if paid to an adult child on death," Mr Malacco said.

The retiree pays no tax and the beneficiaries pay no tax, in either case.
He said it could occur in situations where a retiree was diagnosed with a terminal illness and knows roughly how long they have to live.
If it is only 12 months then the retiree could withdraw all their funds, keep what they need to live on for that time, and distribute the rest tax free to their kids.

"A dying retiree might think 'Well, if I leave my super in my super fund and pass away, I know that my beneficiaries are going to get taxed 16.5 per cent on the portion that I didn't contribute. But if they take it out now and give it to the kids, there is no tax paid on it," Mr Malacco said.

Alternatively, a superannuant can put money into their bank account to be used as they need it and. when they die the money gets distributed as part of the whole estate, also with no tax payable.

But there are practical difficulties. If the money sits in a bank account, tax is payable on interest earned. If money goes into shares, tax is payable on dividends and capital gains.

An ethical problem could include the diminution of an estate's value after death if the super funds are distributed unequally before death.

If a favoured daughter is given a large portion of the tax-free super money prior to death, then that is money that didn't go into the estate as a whole and reduces the value of the estate for other beneficiaries.

0 Katharine Towers is YourMoney legal writer: ktowers@iprimus.com.au
 

Wednesday July 4. 2007:

Beauty is in the Eye of the Beholder!

Two men, both seriously ill, occupied the same hospital room.

One man was allowed to sit up in his bed for an hour each afternoon to help drain the fluid from his lungs. His bed was next to the room's only window.

The other man had to spend all his time flat on his back.

The men talked for hours on end. They spoke of their wives and families, their homes, their jobs, their involvement in the military service, where they had been on vacation.

Every afternoon when the man in the bed by the window could sit up, he would pass the time by describing to his roommate all the things he could see outside the window.

The man in the other bed began to live for those one hour periods where his world would be broadened and enlivened by all the activity and color of the world outside.

The window overlooked a park with a lovely lake. Ducks and swans played on the water while children sailed their model boats. Young lovers walked arm in arm amidst flowers of every color and a

fine view of the city skyline could be seen in the distance.

As the man by the window described all this in exquisite detail, the man on the other side of the room would close his eyes and imagine the picturesque scene.

One warm afternoon the man by the window described a parade passing by.

Although the other man couldn't hear the band - he could see it. In his mind's eye as the gentleman by the window portrayed it with descriptive words.

Days and weeks passed.

One morning, the day nurse arrived to bring water for their baths only to find the lifeless body of the man by the window, who had died peacefully in his sleep. She was saddened and called the hospital attendants to take the body away.

As soon as it seemed appropriate, the other man asked if he could be moved next to the window. The nurse was happy to make the switch, and after making sure he was comfortable, she left him alone.

Slowly, painfully, he propped himself up on one

elbow to take his first look at the real world outside. He strained to slowly turn to look out the window beside the bed.

It faced a blank wall.

The man asked the nurse what could have compelled his deceased roommate who had described such wonderful things outside this window.

The nurse responded that the man was blind and could not even see the wall.

She said, "Perhaps he just wanted to encourage you."

Wednesday April 11, 2007:

Rain from Nowhere:   (A story of Rural Hope in Australia in the face of crippling drought)

His cattle didn't get a bid, they were fairly bloody poor, and what was he going to do? He couldn't feed them anymore.

The dams were all but dry, hay was thirteen bucks a bale, Last month's talk of rain was just a fairytale, His credit had run out, no chance to pay what's owed.

Bad thoughts ran through his head as he drove down Gully Road "Geez, great grandad bought the place back in 1898, "Now I'm such a useless bastard, I'll have to shut the gate.

"Can't support my wife and kids, not like dad and those before, "Christ, Grandma kept it going while Pop fought in the war." With depression now his master, he abandoned what was right.

There's no place in life for failures, he'd end it all tonight. There were still some things to do, he'd have to shoot the cattle first, Of all the jobs he'd ever done, that would be the worst.

He'd have a shower, watch the news, then they'd all sit down for tea Read his kids a bedtime story, watch some more TV, Kiss his wife goodnight, say he was off to shoot some roos Then in a paddock far away he'd blow away the blues.

But he drove in the gate and stopped - as he always had to check the roadside mailbox - and found a letter from his Dad.

Now his dad was not a writer, Mum did all the cards and mail But he knew the style from the notebooks that he used at cattle sales, He sensed the nature of its contents, felt moisture in his eyes, Just the fact his dad had written was enough to make him cry.

"Son, I know it's bloody tough, it's a cruel and twisted game, "This life upon the land when you're screaming out for rain, "There's no candle in the darkness, not a single speck of light "But don't let the demon get you, you have to do what's right.

"I don't know what's in your head but push the bad thoughts well away "See, you'll always have your family at the back end of the day.

"You have to talk to someone, and yes I know I rarely did "But you have to think about Fiona and think about the kids.”I'm worried about you son, you haven't rung for quite a while, "I know the road you're on 'cause I've walked every bloody mile.

"The date? December 7 back in 1983, "Behind the shed I had the shotgun rested in the Brigalow tree.”See, I'd borrowed way too much to buy the Johnson place "Then it didn't rain for years and we got bombed by interest rates.

"The bank was at the door, I didn't think I had a choice, "I began to squeeze the trigger - that's when I heard your voice. ”You said 'Where are you Daddy? It's time to play our game' "' I've got Squatter all set up, you might get General Rain.'

"It really was that close, you're the one that stopped me son, "And you're the one that taught me there's no answer in a gun.
"Just remember people love you, good friends won't let you down. ”Look, you might have to swallow pride and get a job in town, "Just 'til things come good, son, you've always got a choice "And when you get this letter ring me, 'cause I'd love to hear your voice."

Well he cried and laughed and shook his head then put the truck in gear, Shut his eyes and hugged his dad in a vision that was clear, dropped the cattle at the yards, put the truck away filled the troughs the best he could and fed his last ten bales of hay.

Then he strode towards the homestead, shoulders back and head held high, He still knew the road was tough but there was purpose in his eye. He called for his wife and children, who'd lived through all his pain, Hugs said more than words - he'd come back to them again.
 

They talked of silver linings, how good times always follow bad, then he walked towards the phone, picked it up and rang his Dad. And while the kids set up the Squatter, he hugged his wife again, then they heard the roll of thunder and they smelt the smell of rain.


Murray Hartin
February 21, 2007

Muzza (Murray Hartin) has been asked to pen something for the Salvation Army that can bring awareness to the general public about Rural suicide.

He came up with this poem which I think is exceptional, brought a tear to my eye anyhow. When I went down south at the end of 2006 buying cattle out of the drought areas of NSW and Vic, there was one case a day of rural suicide.

In fact I relayed to Muzza a case where one poor fellow actually shot all of his dairy cows and then himself during the time I was in Victoria .

 

Saturday, March 24, 2007:

A group of students were asked to list what they thought were the present "Seven Wonders of the World" and though there was some disagreements the following received the most votes:

Egypt's Great Pyramids, Taj Mahal,  Grand Canyon, Panama Canal, Empire State Building,  St Peter's Basilica and China's Great Wall

While gathering the votes, the teacher noted that one student had not finished her paper yet.  So she asked the girl if she was having trouble with her list.  The girl replied "Yes a little.  I couldn't quite make up my mind because there were so many."

The teacher said "Well tell us what you have and maybe we can help"  The girl hesitated, then read "I think the seven wonders of the world are.....to see, to hear, to touch, to taste, to feel, to laugh, and to love!"

The room was so quiet you could have heard a pin drop.   The thing we overlook as simple and ordinary and that we take for granted are truly wondrous.

A gentle reminder that the most precious things in life cannot be built by hand or bought by man.

Choice comments: I would have added "the right to free speech" and "the right to read informative printed matter" without it being banned by the Australian Federal Government, without a valid reason.   Things we had that was so simple and ordinary we took the rights for granted until taken from us by controls we knew nothing about. 

Monday March 12, 2007

Prescription drug abuse on the rise: report

The World Today - Monday, 12 March , 2007 12:29:00
Reporter: Jane Cowan

ELEANOR HALL: It's usually illicit drugs that capture the headlines but research in Melbourne shows it is the abuse of prescription drugs that should be arousing real concern across the nation.

And it is a problem that's growing internationally, with the United Nations warning that the abuse and trafficking of prescription drugs is set to outstrip illicit drug abuse.

In Melbourne, Jane Cowan reports.

JANE COWAN: When Melbourne's Turning Point Alcohol and Drug Centre began collecting data from ambulance records, heroin was the drug researchers were worried about.

But the Centre's Associate Professor Paul Dietze says the statistics have exposed another unexpected problem.

PAUL DIETZE: The thing that really stood out for us was that these other drug-related attendances we're actually quite prevalent, and some particular types of drugs were actually as prevalent as heroin, even in that kind of peak period of the heroin glut in the late 1990s.

JANE COWAN: The study of more than 6,000 call-outs over 12-months from February 2005, found that overdoses on over the counter or prescription drugs, like Valium and paracetamol, were twice as common as overdoses caused by illicit drugs.

And while men tend to favour illicit drugs and alcohol, women were the main offenders when it came to the abuse of legal drugs.

PAUL DIETZE: It varies by the type of drug. So if you look at paracetamol, for example, it's often younger women who are taking these in large quantities.

And if you look at the prescription drugs, such as Valium, it's often the older women in the suburbs of Melbourne who are taking these drugs in excessive quantities.

JANE COWAN: It's a problem that's emerging worldwide.

The United Nations' International Narcotics Control Board published a report this month that warned the abuse of prescription drugs had already surpassed the abuse of traditional drugs of choice, like heroin and cocaine, in some parts of the world.

In the United States, the abuse of drugs like painkillers and tranquillisers now exceeds the abuse of practically all illicit drugs except cannabis.

In Scandinavia, illicit demand for the sedative Rohypnol has created the problem of counterfeiting.

Gino Vumbaca is the Executive Officer for the Australian National Council on Drugs, which is the main drug advisory group for the Australian Government.

He says pharmaceuticals have always been abused to some degree and it's unclear whether the latest research reflects a relative decline in the use of illicit drugs or whether the misuse of prescription medication is genuinely on the rise.

GINO VUMBACA: Often people talk about, you know, like the war on drugs or the battle against drugs. It's nothing like that.

What it is, is it's a matter of just moving with what's happening with the times and trends, and it's not something you're going to win and it'll end.

This is something we live with and we deal with and address as appropriately and as best we can.

JANE COWAN: Where in the whole process is it best to act, do you think? Is it at the point of writing the prescription that things need to change?

GINO VUMBACA: Well that's obviously one area, yes, yes. But look, often there is no single strategy or program or policy that's going to address a drug use problem, and you know, you're going to need, at the prescription level with GPs, you're going to need it, you're going to need public education as well, and you're going to need some education and information for people using the drugs about the dangers and the potential for addiction dependence.

And more importantly, the dangers for overdose, particularly when it's mixed with alcohol.

JANE COWAN: The Australian Federal Police was today unable to say whether trafficking of prescription drugs and counterfeiting was a problem in Australia.

The UN advises governments to systematically collect data on seized pharmaceuticals and include the abuse of legal drugs in any drug research.

ELEANOR HALL: Jane Cowan reporting.

WHAT WILL MATTER

Ready or not,
Someday it will come to an end.


There will be no more sunrises,
No minutes, hours or days.

All the things you collected,
Whether treasured or forgotten, will pass to someone else.


Your wealth,
fame and temporal power
will shrivel to irrelevance.

It will not matter what you owned
Or what you were owed

Your grudges, resentments, frustrations,
and jealousies will finally disappear.


So too, your hopes, ambitions, plans
And to-do lists will expire.

The wins and losses
That once seemed important
Will fade away

It won’t matter whether you were beautiful or brilliant.

Even your gender and skin color will be irrelevant.

So, what will matter?
How will the value of your days be measured?

What will matter is not what you bought,
but what you built;
not what you got,
but what you gave?

What will matter is not your success,
but your significance.


What will matter is not what you learned,
but what you taught.

What will matter is every act of integrity,
compassion,
courage or sacrifice that enriched,
empowered or encouraged others
to emulate your example.

What will matter is not your competence.
but your character.

What will matter is not how many people you knew,
but how many will feel a lasting loss when you’re gone.

What will matter is not your memories,
but the memories that live in those who loved you.

What will matter is how long you will be remembered,
by whom and for what.

Living a life that matters doesn’t happen by accident.
It’s not a matter of circumstance but of choice.

Choose to live a life that matters.


Author Michael Josephson.
 

How Things Used To Be

Next time you are washing your hands and complain because the water temperature isn't just how you like it, think about how things used to be. Here are some facts about the 1500s:

Most people got married in June because they took their yearly bath in May and still smelled pretty good by June. However, they were starting to smell, so brides carried a bouquet of flowers to hide the body odor.

Baths consisted of a big tub filled with hot water. The man of the house had the privilege of the nice clean water, then all the other sons and men, then the women and finally the children - last of all the babies. By then the water was so dirty you could actually lose someone in it. Hence the saying, "Don't throw the baby out with the bath water."

Houses had thatched roofs - thick straw, piled high, with no wood underneath. It was the only place for animals to get warm, so all the dogs, cats and other small animals (mice, rats, and bugs) lived in the roof.

When it rained it became slippery, and sometimes the animals would slip and fall off the roof, hence the saying, "It's raining cats and dogs."

There was nothing to stop things from falling into the house. This posed a real problem in the bedroom where bugs and other droppings could really mess up your nice clean bed. Hence, a bed with big posts and a sheet hung over the top afforded some protection. That's how canopy beds came into existence.

The floor was dirt. Only the wealthy had something other than dirt, hence the saying "dirt poor." The wealthy had slate floors that would get slippery in the winter when wet, so they spread thresh (the straw left over after threshing grain) on the floor to help keep their footing. As the winter wore on, they kept adding more and more thresh until when you opened the door it would all start slipping outside. To prevent this, a piece of wood was placed in the entrance way - hence a "thresh hold."

They cooked in the kitchen with a big kettle that always hung over the fire. Every day they lit the fire and added things to the pot. They ate mostly vegetables and did not get much meat. They would eat the stew for dinner, leaving leftovers in the pot to get cold overnight and then start over the next day. Sometimes the stew had food in it that had been there for quite awhile, -- hence the rhyme, "peas porridge hot, peas porridge cold, peas porridge in the pot nine days old."

Sometimes they could obtain pork, which made them feel quite special. When visitors came over, they would hang up their bacon to show off. It was a sign of wealth that a man "could bring home the bacon." They would cut off a little to share with guests and would all sit around and "chew the fat."

Those with money had plates made of pewter. Food with a high acid content caused some of the lead to leach on to the food, causing lead poisoning and death. This happened most often with tomatoes, so for the next 400 years or so, tomatoes were considered poisonous.

Most people did not have pewter plates, but had trenchers (a piece of wood with the middle scooped out like a bowl). Often trenchers were made from stale bread that was so old and hard that they could use them for quite some time. Trenchers were never washed and a lot of times worms and mold got into the wood and old bread. After eating off wormy, moldy trenchers, one would get "trench mouth."

Bread was divided according to status. Workers got the burnt bottom of the loaf, the family got the middle, and guests got the top, "the upper crust."

Lead cups were used to drink ale or whiskey. The combination would sometimes knock them out for a couple of days. Someone walking along the road would take them for dead and prepare them for burial. They were laid out on the kitchen table for a couple of days and the family would gather around and eat and drink and wait and see if they would wake up hence, the custom of holding a "wake."

England is old and small and they started out running out of places to bury people. So they would dig up coffins and would take the bones to a "bone-house" and reuse the grave. When reopening these coffins, one out of 25 coffins were found to have scratch marks on the inside and they realized they had been burying people alive. So they thought they would tie a string on the wrist of the corpse, lead it through the coffin and up through the ground and tie it to a bell. Someone would have to sit out in the graveyard all night (the "graveyard shift") to listen for the bell.

Thus, someone could be "saved by the bell" or was considered "a dead ringer." And that's the truth.

Who said that History is boring!?
                                                                                   

This article appeared in an Australian Newspaper.   I felt the contents of the article were about preventative measures in times when one can't even leave a drink sitting unattended in a pub any longer.   A club attending friend of mine told me he takes his glass with him even to go to the toilet,  if he doesn't want to scoff it down unnecessarily......His drink never leaves his sight!  

Sydney Morning Herald Article

Evidence on Brimble's 'spiked drink' 

Geesche Jacobsen
November 17, 2006

DIANNE BRIMBLE may have been given the drug that killed her in a spiked drink in the nightclub on the P&O cruise ship Pacific Sky, an inquest has heard.

The Queensland mother of three might have died from the drug gamma-hydroxybutyrate alone, so high were the levels in her system, a forensic toxicologist told the State Coroner's Court at Glebe yesterday. She had also drunk alcohol, which worsens the effect of GHB.

William Allender said Mrs Brimble probably died between 5am and 6.30am on September 24, 2002 - at least two hours before medical help was called, at 8.33am. She had been given GHB between 3am and 4am, Dr Allender estimated.

He said it appeared she had been given about 2½ teaspoons, or seven to 18 grams, of the drug.

"Therefore it would appear Mrs Brimble either received more than one dose of GHB, or that she received a rather large dose (possibly in her drinks) prior to the disco closing, with a possibility of a further dose thereafter," his report says. "This is supported by the elevated blood level of GHB and the fact that there was still some GHB present in her stomach contents."

This theory appears to contradict evidence by Ryan Kuchel, one of eight men of interest in Mrs Brimble's death. He had testified that Mrs Brimble willingly took the drug, also known as fantasy, in his shared cabin after the nightclub closed at 4am.

Dr Allender said GHB was a disinhibiting drug with aphrodisiac effects at low levels, but was also used by vets to anaesthetise or put down animals.

It affected the central nervous system and breathing, he said.

A passenger, Tracey Muscat, told the inquest yesterday she saw Mark Wilhelm, Letterio Silvestri, Dragan Losic and Charlie Kambouris standing in the corridor about 7.30am.

She said her friend said she had seen them talk on phones, and there was a wet patch on the floor near the stairs.

"They looked odd standing there," Ms Muscat said. "We all made comments that they looked really suspicious … They were very intimidating. They were looking for something - [like they were] trying to see something but not wanting to be seen."

Counsel assisting, Ron Hoenig, said this appeared to corroborate earlier evidence the men had planned to throw Mrs Brimble's body overboard but found there was "too much traffic" in the corridor.

Ms Muscat also reported she met Mr Losic, Mr Silvestri and Mr Wilhelm again later in a lift. Mr Losic was laughing when he told his friends about a conversation with another passenger. "They think we killed her," Mr Losic allegedly said.

Ms Muscat said she also later heard about another conversation in which Mr Losic allegedly said: "They think she died of drugs, but I think they will find she choked on [another man's] cock."

Another passenger, Sterina Gollan, told the inquest yesterday she and her friend were propositioned by a naked Mr Wilhelm, another of the men of interest, early in the morning. "He picked up his [erect] penis and said: 'Would you like some of this?"' she said.

■ A spokesman for P&O said the company had no record of the allegations reported yesterday that Mrs Brimble's sister, Alma Wood, was not allowed to approach the captain to complain about being locked out of her cabin because of the clothes she was wearing. He said the allegation had not been raised before it was aired in court on Wednesday.

"To the contrary - we have a letter written by the members of the Brimble family after they disembarked and signed by Mrs Wood which thanked the captain and other officers for their support," he said.

"Choice" comment on the Guest Book:

Mon 23 Oct 2006
Re: Mohammad Hossain's Intensive Care

I am reminded of SBS Story October 19, which I watched on video yesterday. Mohammad Hossain's Intensive Care by Filmmaker Geoff Burton. Mohammad basically remained comatose throughout his very long stay in hospital, which was some 12 weeks before he eventually died.

I cannot agree with the critic's view in the Green Guide, that the story was perhaps exploitative!

The wife's dilemma was real. Nahida's predicament was palpable. It was her reality to be in a strange country, with different customs, with a dying husband and 6 months pregnant. The solitary figure told its own story. Traveling, living & eating alone, always alone except for her brother in law's instruction "to pray". Did her prayers support her, in her solitary aloneness? I don't think so.

The ICU treated the man as they needed to, in order to help him. Not become personally involved - so they could do their work. The body is a machine, the carers, its mechanics! At some time, they say " this motor will not respond to repairs and with limited time, staffing, and resources they move away from that engine which is unable to be repaired further, to ones that can. This is the reality of an Intensive Care Unit.

What annoyed me about the Nahida's predicament was that she had to ask for a chair, that her brother in law told her to say a prayer a thousand times to Allah (why couldn't he pray 1000 times, he didn't appear to be sick with worry or pregnant!!!) and that the Federal Government refused her brother's visa application. Someone familiar with her to help her survive the drama of a dying husband, a new baby and just surviving! A woman from a culture that relies on family beyond that which the majority of Australians could understand. And as a woman from Bangladesh, with no training to be autonomous - shy and so very desperate - lonely and forsaken in a strange country by circumstances they could never have imagined when they embarked on their studies in Australia.

I heard Prue Goward last night on 774 being interviewed as a Hopeful Liberal Candidate for Goulburn and among the things she said was that for three months after "giving birth" mother and baby should be able to just sit and look at each other, bonding... Nahida had no such luxury as she attended her dying husband's bedside everyday for two months plus, except for her own confinement time. Ms Goward also spoke of women being allowed to dress in the burqa even if seen as confronting by others, and suggested that even modern dress codes by Australia women could be seen as exploitative. "Women generally are exploited by the expectations placed on them" and that was surely the case with Nahida's predicament.

The broader community need to know that ICU is not a television melodrama vehicle for entertainment. That in fact, what goes on there affects people in a very pertinent way. Mohammad, I feel could have been permitted to die much sooner than he did. He had tuberculous meningitis, a life threatening illness rarely seen in Australia, but known of in India. The last scene where he is introduced to his baby daughter and his eyes are dead without expression... Mohammad was dead whilst still breathing.

What does it take for Parliamentarians to understand the necessity to relieve both the "victim" and his family of such intolerable stress? Legalising voluntary euthanasia would eliminate so much suffering. Multiply that story in Liverpool's ICU to around Australia and that is "The Case for the Defence, Your Honor".

I felt no sense of intrusion - putting one's head in the sand and not bringing such stories to the general public means they get buried under the definition of "suicide due to depression" because everyone "talked", but no one actually did anything practical to help.

Mary Walsh
www.yourchoiceindying.com
 

"Choice" found a place for this poem on the website because of the person who sent it to me.   I too like to a "feel good" story.  It comes back to "faith" and whether one has it or not - it can provide a sense of hope when the impossible becomes possible.  A Humanist myself, here is an article that gave my friend "goosebumps", for others to appreciate. 

A drunk man in an Oldsmobile
They said had run the light
That caused the six-car pileup
On 109 that night.

When broken bodies lay about
"And blood was everywhere,"
"The sirens screamed out eulogies,"
For death was in the air.
"A mother, trapped inside her car,"
Was heard above the noise;

Her plaintive plea near split the air:
"Oh, God, please spare my boys!"
She fought to loose her pinned hands;
"She struggled to get free,"
But mangled metal held her fast
In grim captivity.

Her frightened eyes then focused
"On where the back seat once had been,"
But all she saw was broken glass and
Two children's seats crushed in.

Her twins were nowhere to be seen;
"She did not hear them cry, "
"And then she prayed they'd been thrown free,
"Oh, God, don't let them die! "

Then firemen came and cut her loose, "
"But when they searched the back, "
"They found therein no little boys, "
But the seat belts were intact.

They thought the woman had gone mad
"And was travelling alone, "
"But when they turned to question her, "
They discovered she was gone.
Policemen saw her running wild
And screaming above the noise
"In beseeching supplication, "
Please help me find my boys!

They're four years old and wear blue shirts;
"Their jeans are blue to match.""
"One cop spoke up, ""They're in my car, "
And they don't have a scratch.
They said their daddy put them there
"And gave them each a cone, "
Then told them both to wait for Mom
To come and take them home.

"I've searched the area high and low, "
But I can't find their dad.
"He must have fled the scene, "
"I guess, and that is very bad."

"The mother hugged the twins and said, "
"While wiping at a tear, "
"He could not flee the scene, you see, "
"For he's been dead a year."

"The cop just looked confused and asked, "
"Now, how can that be true? "
"The boys said, ""Mommy, Daddy came "
"And left a kiss for you."
He told us not to worry
"And that you would be all right, "
And then he put us in this car with
"The pretty, flashing light. "

"We wanted him to stay with us, "
"Because we miss him so, "
"But Mommy, he just hugged us tight "
And said he had to go.
He said someday we'd understand
"And told us not to fuss, "
"And he said to tell you, Mommy, "
"He's watching over us."

The mother knew without a doubt
"That what they spoke was true, "
"For she recalled their dad's last words, "
" I will watch over you."

The firemen's notes could not explain
"The twisted, mangled car, "
And how the three of them escaped
Without a single scar.

"But on the cop's report was scribed, "
"In print so very fine, "
An angel walked the beat tonight on Highway 109.

                                                                                      

August 20, 2006

Pamela Bone, the author of this article has since addressed the AGM of Dying With Dignity Victoria and although "dated" in terms of positioning on my website, I believe her article needs an airing at this time in history as man destroys himself again in warfare.   Pamela is suffering from cancer herself and has since retired from the Age Newspaper due to ill health, but is writing of her journey which should make for compelling reading at a future date.

Religion: good and bad
August 25, 2005

'Without religion, mankind will find reasons to go to war. Yet it remains the case that the best societies in the world are secular societies.'

Governments should not be promoting or favouring religion in schools, writes Pamela Bone.

'Those who can make you believe absurdities can make you commit atrocities," said Voltaire. The books of the major religions contain passages that are absurd and worse than absurd. What are today's kindly Christians to make of this instruction to genocide in the Bible: "Now kill all the boys. And kill every woman who has slept with a man, but save for yourselves every girl who has never slept with a man." (Numbers 31:17-18)?

What are modern-thinking Muslim men to make of the list in the Koran of women who are forbidden to them, which includes (quite rightly!) their mothers, daughters, mothers-in-law, daughters-in-law, and also married women, "except those whom you own as slaves"?

It's become obligatory when commenting on Islamic terrorism to say that this is a distortion of Islam, that Islam is a religion of peace. In fact, as some reformist Muslims acknowledge, the Koran also contains what Christian reformers say the Bible contains: "sins of scripture". In the Koran can be found passages that promote peace and passages that urge killing. Like the Bible, it is contradictory and confusing. An impartial reader might wonder why God couldn't have made his intentions more easily understandable.

So, what do most religious believers do about the "sins of scripture"? Fortunately for the rest of us, they politely ignore them. Religious extremists might believe in the absurdities, but most people do not.

Karl Marx described religion as "the sigh of the oppressed creature . . . the opiate of the people". If he was right it would imply that when people were not poor and oppressed they wouldn't need the "opiate" (the painkiller) of religion. Yet while societies grow richer and freer, religion persists. Atheism is dead and belief in God has won, it has been proclaimed.

But what sort of belief? In numerical terms, religious belief is growing because it is strong in highly populated poor countries. But it is weak in most modern democracies. In Britain the proportion of those stating "no religion" has grown from 31 per cent to 44 per cent in the past 20 years and only 5 per cent of young people go to church regularly. In most of northern Europe about 40 per cent of the population belongs to a religion. In Australia about 30 per cent have no religion.

What about America then? One doesn't quite know what to make of America. Only 9 per cent of Americans don't believe in God, while a further 12 per cent are not sure. Forty-five per cent of Americans say they believe in the Book of Genesis. Yet even there, if the sincerity of belief can be judged by church attendance, religion may not be very strong in people's lives. Only 38 per cent of Americans go to a religious service at least once a month and only a quarter go every week, according to a Harris poll.

The same poll showed some other interesting results: religious believers are more likely to be older, to be female, to vote Republican and to live in the Midwest or South. African Americans are more likely to believe in God than Hispanics and whites. Those with no college education are more likely to believe in God than those with postgraduate education. People brought up as Protestants are more likely to believe than Catholics and much more likely than Jews. Only 48 per cent of American Jews believe in God and only 16 per cent go to synagogues at least once a month.

Perhaps then, if we keep working to improve the lives of all the people of the world, educate them and make them prosperous, might religion not quietly, gradually disappear? (I don't mean to imply that religious people are uneducated or unintelligent because this is clearly not true.) And, I was going to say, what a good thing that would be, the end of this force that has caused so much misery and violence throughout the ages.

But then - the other day I saw the new British film Millions, and in it school children were performing a nativity play and singing The Little Drummer Boy. And I thought, no, you can't say this is bad. It is, in fact, lovely. It is part of my culture. And I understand that Muslims, Jews, Hindus and others have religious traditions they find lovely, whether or not they really believe in the religion.

So much art, architecture, music and poetry throughout the ages has been inspired by religion. So much beauty in the name of religion. And it does concern me a little that my grandchildren learn nothing about religion at their state school, because without knowing those old stories they will not be able to see the connections in literature and art.

Without religion there would still be art. Without religion there is still beauty and goodness. And without religion, mankind will find reasons to go to war. Yet it remains the case that the best societies in the world are secular societies. And given that some people's religious certainties are putting everyone in danger, governments have a responsibility to keep religion low-key. Our government should not be promoting and favouring religion in the way it does.

Let religion be taught in schools, but have it taught as "this is what some people believe", not "this is fact". Let education be the way its founders intended - free, compulsory and secular. It remains the best hope there is for the future.

No, religion will probably never disappear; because some people simply believe, and that is their right (some people simply don't believe and that is our right, too; more religious people need to acknowledge that). Let people believe what they want. But be grateful most people don't believe too fiercely.

Pamela Bone is an associate editor.

                                                                           

---

Aussies not keen on eternal life: study
 July 4, 2006 - 6:54PM

New research shows Australians might not be so keen on finding the fountain of eternal life.

As researchers edge closer to developing anti-ageing drugs designed to extend human life, scientific commentators have debated whether it's a good idea.

Concerned that the general public had not been drawn in the discussion, Brad Partridge, a PhD student at the University of Queensland, set out to find out what people, young and old, thought of the concept.

He discovered that when it comes to life, people are more concerned with quality rather than quantity.

"Contrary to what many in the scientific community have been saying, people are actually much more concerned about the quality of life rather than the length of it," Mr Partridge told AAP.

"There's been a tendency to just assume that of course everyone will be unconditionally interested in living longer, that they'll want it out of selfishness, but that's really not the case."

The preliminary results of his study, to be presented at the 2006 Australasian Bioethics Conference in Brisbane this week, show people are more concerned with ethical and moral issues than generally assumed.

"Of course you've got lots of interest in the concept, but people are more measured than you'd expect," he said.

There were concerns about overpopulation if everyone lived to 150, and many people said they wanted access to euthanasia if they could live longer.

"They're thinking 'if I'm going to live on for ages and ages I might just decide I've had enough, it's not that great after all'," Mr Partridge said.

"So it's not necessarily the dream after all."

Interestingly, older people assumed the young would be more interested in living longer, and younger people assumed the same about the elderly.

In fact, both groups were equally apprehensive.

The results come from a series of focus groups, but Mr Partridge said detailed interviews and a large-scale survey to be carried out next year would give more concrete findings.

Research is under way into life extension with the use of genetic manipulation, calorie restriction and organic substances like antioxidants.

Some scientists claimed people alive now might be able to live to a thousand years, but most were more sceptical, he said.

"The debate has been going on for quite a few years now and it will be much better informed if we have empirical evidence of what the public thinks," Mr Partridge said.

"It could be a long way off, but it's not too early to start planning."

                                                                  

Titled: Dying to be Heard  (A suicide study)

Article taken from an undated (June 06?) Townsville Magazine Page (Savvy 4) author unknown: (single page sent by contributor)

A5 size silhouetted picture head in hand is captioned: Trying to tough it out through hard times is the blokey way, but strong and silent all too often ends with suicide as the tragic result:

We may not be able to multitask, we're the laughing stock of every other TV commercial, and we are, almost certainly, no longer strictly necessary for breeding, but there is one thing at which men are a whole lot better than women: killing ourselves.

Michael Dudley, the chairman of Suicide Prevention Australia, told a conference in Sydney this month that Australian men were four times more likely to kill themselves as women.  Men, he said, "have a stoic kind of attitude and tend to think of emotional problems as some kind of moral problem or character failing.  They just have to tough it out".

Forget war, punch ups, heroin, booze, car crashes and other misconceptions: in the UK suicide is the biggest killer of men between 15 and 35.

The point is made graphically in a startling new poster campaign featuring a gigantic Union Jack overprinted with these words: "Since the start of the war 102 young British men have been killed in Iraq.  Since the start of the war 3054 young British men have killed themselves in Britain."

It's the work of CALM - The Campaign Against Living Miserably - Which after several years as a little known government-funded pilot project in Manchester, is now standing on its own two feet as a charity and expanding to offer its free online and telephone helpline services nationwide.

Its website (thecalmzone.com.uk) is deliberately as much about music and lifestyle as it is mental health.

Men may need help, but you  have to fool them into asking for it: the project was set up by the Department of Health in 1997 after a study discovered that young men would rather be seen dead than ask for help.  Big boys, you see, don't cry.  Things started to go wrong for men in the early 1970s - at about the same time, funnily enough enough, as women's liberation began to change the world.

By 1979 the suicide rate for women in the UK was dropping sharply, and carried on dropping through the 80s and 90s, whereas the rate for men was steadily climbing.

By 2003, the suicide rate for women was 5.8 suicides per 100,000; for men it was 18.1.

It doesn't help, of course, that men are just so damn good at it.

Whereas the exit of choice for most women is the notoriously unreliable overdose, when a man's gotta go he really goes for it, hanging his shattered hopes on a rope.   And hanging is a method seldom mistaken as a cry for help.

The changes and advances that have taken place for women over the past 30 to 40 years have been enormous, but in the rush to equality and beyond,  no one has much bothered to help men adjust to the new world order.  And if young men are not expected to be the breadwinners any more, not expected to be the central person in the family and are not even needed as biological fathers, what exactly is their role?

It may be no coincidence that the suicide rate dropped during both world wars, when a man's purpose was clearly defined.  Now that traditional male roles are becoming increasingly unnecessary, even despised, men are at a loss.

Of course, there's an alternative explanation for the disparity in suicide rates.

A study of 293 female students by psychologists at the State University of New York in 2002 discovered that those who were regularly "directly exposed to semen" were less depressed, thanks to the absorption of mood altering hormones.

Men: good for women's mental health, but no so great for their own.

Help is everywhere.  Under this "optimistic" heading there was a list of phone numbers, however I've only listed one of them.

Men's Line: A national telephone couselling line for men who want to talk about family or relationship concerns.  Men's Line provides information, support and referral 24 hours a day from anywhere in Australia for the cost of a local call, Phone 1300 789 978,  mobiles and payphones excepted.

Choice: I rang this line this afternoon to talk of the need for men to be seen as innocent until proven guilty when bureaucrats accuse men of incest in the face of compelling evidence to the contrary.  I met Krystian on the steps of Parliament House where he has been on a hunger strike now for some 48 hours plus.  The Victorian Department has demanded that his wife choose between him and his children,  He sees his daughter, under supervision,  for two hours per fortnight from memory.   He will sue for defamation of character I think,  and is very angry that repeated overtures to the Department have failed to have the order against him revoked.  I've seen the fat file of paperwork and read some of the reports.    I believe him to be innocent of the allegations, and in addition,  the police are not taking any action. 

Men, like women,  commit suicide when they feel powerless in the face of overwhelming stonewalling by the authorities, be it health, allegations of child molestation, financial ruin, unemployment,      Talk, talk, talk and then what?   As I've said elsewhere I feel so much better now I have stopped feeling positive.   Krystian is optimistic about the outcome because he feels a great lack of justice and is fired up accordingly!  He thinks that because he knows the truth to be the truth - that will suffice.   I wished him well......

When I first was sent this article I didn't know whether I should put it under Diary for maximum reading, humor because of the stupidity of its implications two thousand years on.   Whether I should forward it to the Humanist Society for them to address it?    It was difficult to allocate a category.   What is really scary for me is that Laws are created from the same book that these excepts were taken from:  It would be funny if it wasn't so very serious for those of us who want choice and dignity in dying,  two thousand years later some people have not evolved in their thinking.   I understand that medical technology had not been invented when the Bible was written - but obviously human life was never so precious then as it is treated today.   Is this another case of selective "I can't recall". parts of choosing which words of the Bible man wants to live by in today's society?.   Where is the sanctity of life stretched in a way that Christian Doctrine bases so much emphasis on it in the Bible?.  It is also said "unless you become as little children, you will not enter the kingdom of heaven".   Not too much of that in this greedy, power, oil hungry world where man kills forests, farms animals, gives millions to bribes for political and financial gain.....and kills people in the name of democracy!  

What makes a war more legal to kill than compassion for a body that has ceased to function preventing quality of life?

Dear Dr. Laura,
Thank you for doing so much to educate people regarding God's Law. I have learned a great deal from your show, and I try to share that knowledge with as many people as I can. When someone tries to defend the homosexual lifestyle, for example, I simply remind him that Leviticus 18:22 clearly states it to be an abomination. End of debate.

I do need some advice from you, however, regarding some of the specific laws and how to best follow them.

a) When I burn a bull on the altar as a sacrifice, I know it creates a pleasing odor for the Lord (Lev 1:9). The problem is my neighbors. They claim the odor is not pleasing to them. Should I smite them?

b) I would like to sell my daughter into slavery, as sanctioned in Exodus 21:7. In this day and age, what do you think would be a fair price for her?

c) I know that I am allowed no contact with a woman while she is in her period of menstrual uncleanliness (Lev 15:19-24). The problem is, how do I tell? I have tried asking, but most women take offense.

d) Lev. 25:44 states that I may indeed possess slaves, both male and female, provided they are purchased from neighboring nations. A friend of mine claims that this applies to Mexicans, but not Canadians. Can you clarify? Why can't I own Canadians?

e) I have a neighbor who insists on working on the Sabbath. Exodus 35:2 clearly states he should be put to death. Am I morally obligated to kill him myself?

f) A friend of mine feels that even though eating shellfish is an Abomination (Lev 11:10), it is a lesser abomination than homosexuality. I don't agree. Can you settle this?

g) Lev 21:20 states that I may not approach the altar of God if I have a defect in my sight. I have to admit that I wear reading glasses. Does my vision have to be 20/20, or is there some wiggle room here?

h) Most of my male friends get their hair trimmed, including the hair around their temples, even though this is expressly forbidden by Lev 19:27. How should they die?

i) I know from Lev 11:6-8 that touching the skin of a dead pig makes me unclean, but may I still play football if I wear gloves?) My uncle has a farm. He violates Lev 19:19 by planting two different crops in the same field, as does his wife by wearing garments made of two different kinds of thread (cotton/polyester blend). He also tends to curse and blaspheme a lot. Is it really necessary that we go to all the trouble of getting the whole town together to stone them? (Lev 24:10-16) Couldn't we just burn them to death at a private family affair like we do with people who sleep with their in-laws? (Lev. 20:14)

I know you have studied these things extensively, so I am confident you can help.
Thank you again for reminding us that God's word is eternal and unchanging.
Your devoted disciple and adoring fan.
                                                                               

In the May edition of the Humanist Society of Victoria, Newsletter there was an article written by, Valerie Yule, creative thinker, author and HSV Member,  under the heading "Is Doing Good, Any Good?" which I wanted to share with others.   Unfortunately I am unable to reproduce the whole article but a few paragraphs, perhaps a little out of context,  reinforced my views of all actions have consequences, both bad and good depending on whether you're the participant or the observer.  Those who attended the Dying with Dignity Victoria AGM and read my article attributed to Pamela Bone, the grievously ill ex Age Journalist will remember her comments on a friend who worked in the Healthcare Industry attributed the need for suffering in others in order to allow them to develop empathy with the ill.  No one in the room shared her friend's view of their need for suffering in order to make her feel better about the compassionate side.  Quite correctly - Ms Yule has picked up that the "Do-By' do not always appreciate the actions enforced on them by the "Do-gooders"  - but she doesn't pick up on a vital word - Choice - but that is another discussion topic!  That item, relating to Pamela Bone,  I wrote for inclusion in the DWDV Newsletter is published under Additional/Related Readings/VE Articles beneath the item for the Humanist Newsletter on explaining my views on Voluntary Euthanasia and a little of its history.

"Do-gooders may have no inkling about the consequences of what they do,  that they think has been good.   A Children's Hospital doctor was proud of his clever operations so that seriously spina-bifida babies survived - until he saw what happened to the children he saved, and to their families.  As a psychologist, I helped the survival of a 3 year old child, constantly hospitalized for failure to thrive; his mother cared for him for 14 more years as he slowly deteriorated from an incurable neurological disorder.

Do-gooders seeking to bring life can also bring death.  Terrible human suffering has been relieved and prevented by Westerners bringing Western medicine and stopping inhuman practices.   But population balances had been kept sustainable by the cruel means of disease, famine, wars, infanticide, forced celibacy, cannibalism and human sacrifices.  When these checks and balancers have been removed without replacing them with more humane means of keeping a sustainable population, populations have exploded beyond the continued bearing of the earth.

The do-badders have killed their millions deliberately, with holocausts from the beginning of human history, castles with dungeons, murderers, enslavers, starvers and ravagers.  They have killed more than the do-gooders, but the notoriety goes the to the bad done by those intending to do good - the Maos, Torquemadas, and the like.  Oliver Cromwell and Lenin meant well.  So, it was thought did Robespierre, and the doctors who for centuries bled patients to death.  Where should Halliburton be placed, and the manufacturers of torture instruments and weapons of horrible destruction in the free world?  And their employees? sic

The problem may lie in a devil's scripture, "The means justify the end"  For in practice, every action is its own end, regardless of whether it is intend to be only a means to a good end.  And every action can have unforeseen circumstances that perhaps could have been foreseen.

The do-gooders may seem proud of what they are doing.  'Look at me"  This self-righteousness can be attributed to them regardless of whether it is true or not, and even though the "do-badders" may be prouder still.  Do-nothing seems benign, although "We have not done what we ought to have done" is daily confessed in churches as a sin that is as serious as what they have done,  that they ought not to have done.  "The only reward of virtue is virtue....tart, cathartic virtue" (Ralph Waldo Emerson).  The reward should not be to feel good.

People often do not want to have "good" done to them.  They do not want the indignity of being "one down" and a means for others to be one up.  They may not see the supposed "good" of being good at all.   Sometimes it is a very good real good, but for the sake of protecting their personal fragile ego, the Done-By reject it.   And if you ever had good done to you against your will you will be firmly on the side of those who are Done-By.

None of all that makes good argument against attempting to "do good".  They are arguments for the way you go about it."

Euthanasia campaigner, Lesley Martin,  speaks of time in prison (DVD, The Promise, available from (website since defunked) tells the story of the trial leading up to Lesley's imprisonment.  Details under Related Readings/Film)

30.04.06

Euthanasia campaigner Lesley Martin spent seven months at Arohata Women's Prison after being convicted of manslaughter for the so-called mercy-killing of her dying mother. About to launch her second book, Martin talks to Keith Richardson about life as an inmate:

How much of a culture shock was prison?

"I literally felt as if I was in emotional shock when I arrived there. In some way it was the peak of what had been a very long, drawn-out period of stress anyway. So by the time I arrived at Arohata, I was pretty much wiped out. When I was being programmed into the system there, the guard said to me he was concerned because he felt I was too calm. In that way I think I had shut down on a lot of levels and was just going through the motions".

How difficult was it to settle into the prison routine? Is there routine?

"There is a routine. It's quite different to what we experience on the 'outers', as they call it. You're told by the officers about the cell rules and ring rules but the actual rules of prison are something you have to learn by trial and error, by shutting up and keeping your ears and eyes open."

Can you take me through a typical day?

"We have lockdown, which is any period of the day ... They can just lock you up. Unlock is in the morning. Normally, at 6.30am, you're
unlocked and have until about 7 or 7.15 to eat breakfast, which comes on a trolley. If you don't get to the kitchen in time, quite often
your milk ration will be missing. First day I was there, there was a big fight in the kitchen between two women over milk rations. I had a job in the library for the first four months so I'd head off to the library at about 8am. At 11am we'd have lunch. One day it would be a barbecue bun with some coleslaw in it, or a slice of cheese or tomato, or something like that. The next day, it's four slices of bread, the cheap, white plastic stuff, with spaghetti or a tablespoon of cold creamed corn, or jam sometimes, or a real scraping of Vegemite. They didn't like doing Vegemite sandwiches, because the women would try to get the yeast from the Vegemite and the bread, and then make homebrew with sugar and fruit and things. Dinner was at 4pm. Then you basically have free time until about 8.30pm, and you're locked down for the entire night. Every three hours during the night the guards would do rounds of the wing. They'd bang on the outside windows and then they'd come and bang on every door and shine a torch through the peep-hole to make sure you're awake or moving and that you're not dead in your cot. But when that prison population blow-out was happening and people were
being held in court cells, what they actually did was close down our wing early and relocate the staff to the courthouses. So we would be unlocked at 8am and locked down at 4.30pm. It was a long time for women to have nothing to do, to be locked in your cell at night."

What about personal products. I understand there were restrictions?

"You could buy dye and some very basic shampoos on what's known as a buy-out form if you have money in the trust account held for you at the prison. No-one handles money because obviously you'd get it stolen or you'd be beaten up for your money. They gave you a list of things on Monday which you could buy, and a balance. You could spend up to $60 a week. There was no way of buying make-up, we weren't allowed perfume or any kind of deodorant spray or aerosols that could be used as weapons, or be lit and be used as torches. We weren't allowed manicure sets or nail-files or scissors. I wore make-up for every visit on Saturday and Sunday, and lipstick to keep myself cheered up but the rest of it went by the board. It was right down to basics."

I gather there was some suggestion you might be moved to another prison and there was some support from the other inmates.

"I'd had a bit of a run-in with the guards and it resulted in a misconduct charge against me. I had to defend myself in the little
court they hold - and I won. I was very unpopular with one of the middle-managers there. His first managerial decision was to transfer
me to Waikeria prison and I just refused to go because I'd settled in at Arohata. I didn't want to go through learning a whole new set of faces and guards and changing my environment again. But also for my [ex-] husband, Warren - he'd become acclimatised to the routine of getting to Arohata. I was on anti-depressants - I had been for about a year prior to the trial, just as tension and stress were building. I was weaning myself off those and felt a move would only stress me again. Also I had the appeal coming up ... my lawyers were in Wellington and I needed access to them. Sometimes their reasons for transferring people were nothing to do with the person or their legal process and their family environment. And it's never discussed with you first - you're just told. The other women offered to barricade themselves in my cell with me. I said 'we don't need to do that, I'm just going to refuse to go'. I made sure I was up and dressed, my bed made, and I was just sitting on it, reading, when this manager came in to tell me I was going. He could see I hadn't moved a single thing off my walls or packed anything. He said: 'What do you think you're doing?' I replied: 'I'm not going',... and he said: "Right, that's it, you're locked. Breakfast, lunch and dinner until further notice," and just slammed the door and locked me in... I got one of the other women to call Warren for me and call the Ombudsman. I was unlocked within the hour and nothing further was done... The whole system there is disempowering and unhelpful. We don't have a corrections system at Arohata. We have a penal system. Whereas a lot of people in the general public might relish this idea, and be of the mind that all these miserable bastards should be locked away for life and throw away the key, these are real people and they need very specialised psychological help and intervention and remodification rather than being in a system that keeps undermining them. I've come out feeling very inadequate. I'd been sitting in a cell for seven months and now I'm part of this bigger environment and it's really daunting for the first few days. I can only imagine what it would be like if I'd been in there for 10 years."

Was that the only time you had a run-in of that nature?

"No. My birthday fell on a Saturday. Warren had couriered four cards to me that the children had made. The prison withheld them, so they didn't get to me on that Saturday. There was no reason for it other than it's another example of this gradual undermining and sticking pins in people constantly. Come Thursday, my girlfriend brought a card in for me. She was concerned the guards wouldn't let me have it at the gate, so she smuggled it in. I read it and put it on the floor next to my chair so the guards could see it. After about half an hour they saw the card and terminated the visit without me being able to say goodbye to the children at all. So Warren and the kids had driven five hours for a 40-minute visit. I was so angry and upset that I refused to be strip-searched by this particular guard. She threatened to force-strip me with a number of other guards. I pointed out another guard and said I'd be strip-searched by her but 'you two bitches can wait outside'. So then I was put on a misconduct charge for calling them bitches. I called the site manager as a witness because he'd phoned Warren and apologised to him and said the termination shouldn't have taken place. The prosecuting guy was the one who was then made middle-management. I won that strike against them. But around that time I was also called
to the office and one of these middle-managers... showed me all these incidents the guards had registered against me. One was when I was first there and I was in this round room with a blue, two-litre ice cream container as a toilet, because you're stripped of absolutely everything. I was there for three days and I refused to use the container for anything other than wees. And so they incidented me for that - I had refused to use it as a toilet. I was horrified at what they had seen to be incidents, the black marks against my name, so I started conducting my own little vendetta and filing complaint forms every time a guard swore or did something they shouldn't, or whatever. I filed about 12 of these over two days and then my pen ran out and they wouldn't give me another pen, so that was it. I had the stuffing taken out of me."

Has this made you change your views on the whole euthanasia debate?

"No, this has actually strengthened them. I was prepared as much as anyone could be for going to prison and now, having experienced
prison, I am even more committed. I don't believe anyone in my position should have to spend a day there, especially when they're
still traumatised and grieving from being put in that position in the first place."

What has your case done for the whole euthanasia debate in NZ?

"Euthanasia supporters now know they have a voice in me. They can add their own stories to mine and remain anonymous. When you have social reform issues like this that put people at legal jeopardy, it takes one to kind of break the mould and say 'this is really what's
happening, do with me what you will', but I know that I'm speaking for a lot of people. People have really seen me step up and assume that role of leadership, for want of a better phrase."

You say you didn't take home detention but you did apply for it later, but it was turned down, right?

"I didn't want to take home detention in the first instance because I had spoken to the head of probation in New Plymouth and she had said 'if you get a custodial sentence you are much better off spending half of it in prison and half at home, as home detention is a lot more stressful than people realise'. It is an invasion of your home by the custodial system. It creates stresses at home that you wouldn't even realise before you embark upon it. Warren and I discussed it. We had only been together two years and in that time we've courted and married; I moved from Wanganui to New Plymouth; separated from my 21-year-old son, brought my 10-year-old son with me - he's left his friends behind - we've blended two families, four children; we've moved houses twice; we've built a house; Warren was made chairman of the National Party electorate in New Plymouth; I set up Exit New Zealand; we had the parliamentary bill come and go, university touring public speaking debate; I've done a nationwide touring public-speaking series; we had a high court trial and seven months of prison... So by the time I went to Arohata, Warren and I were at our wits' end, we were absolutely at snapping point. We had issues of our own, being newly-weds. It was a horrendously stressful time, very unsettling and stressful, and I challenge any couple to survive that and remain intact. By the time I went to Arohata, we had to have some breathing space. I could not have stayed on home detention without us divorcing. By the time I applied for home detention, I was deemed to be a threat
to society. That was kind of a kick in the bum, because I did think it should have been open to me."

What would your late mother have thought of the whole saga?

"My parents would be very distressed if I were in prison at any point in my life for any reason - more distressed as a result of helping mum, because they would feel that was an absolutely inhumane way to treat somebody who had helped one of them by acceding to their wishes. My mother would not enjoy her dying experience being public information in the same way that I don't enjoy it at all, but I believe she would have supported wholeheartedly trying my best to do something about it. This may seem churlish of me, but I think she'd actually be more supportive of my sister's reaction to things."

The relationship with you and your sister is not harmonious, is it?

"Well, it hasn't been for years, actually. Louise had issues against me for her own reasons for a number of years. Before the book went to print, I gave the manuscript to her to read and she signed a form, agreeing on everything. I made it very clear that if she disagreed
with anything at all, that was the opportunity to discuss it. She didn't, she was completely in support of everything I had done for
mum. But, once the media started picking up on her, she just couldn't resist the urge to vent her spleen over all these other issues, and
that's just really disappointing."

What motivates you?

"Arohata has touched me. You can't live with these women for seven months and not understand the process of criminology and what an
incredibly complicated, specialised thing it is. And I couldn't nurse for 17 years without feeling for dying people. I seem to have landed with a strong sense of justice in these areas which are very difficult for us as a society to approach and deal with and address all the shortcomings within them.

This is hard for me because, when I was younger, I was very frivolous. I was the one at the parties and the beach, worrying more about a suntan than anything else - so this has been a maturing process. If you think about maturing as shedding a layer of skin each year, going to Arohata was like ripping 20 layers off at once. It was a very raw experience. I've grown a much tougher skin as a result."

 

2006-04-06 From: The Herald, Glasgow, UK
Live your afterlife to the full
http://www.theherald.co.uk/features/59581.html


Ron Ferguson
April 06 2006

Not long after he was diagnosed with terminal cancer, the Orcadian poet, George Mackay Brown, was at dinner in our house. Seated next to him was journalist Maxwell MacLeod. When Max asked GMB how he was coping, George replied, in that gentle lilt of his, "Well, we're all dying, but I'm dying just a little faster than you."

Indeed. It's coming yet, for a' that. There's only one way out of this life; that's today's cheery wee word from this dark Presbyterian column. Listen: death is nature's way of telling you to slow down. Or, as someone put it, death is just another way of saying: "Yesterday was the last day of the rest of your life."

Yet if death and taxes are the only things we can be sure of, why is it that we talk a lot about taxes, but never seriously about death? There is a conspiracy of silence here. But the refusal to countenance one's own mortality can have consequences for other people. For instance: where and how would you like to die? Do you wish to be buried or cremated? What kind of funeral would you like to have?

These questions were raised in Esther Rantzen's fascinating 90-minute BBC2 programme, How to Have a Good Death. By interviewing terminally ill people, their close relatives and medical staff at the sharp end of the dying business, she raised the issues which every sentient being should consider sooner rather than too-later.

In a nationwide poll commissioned by the BBC, it emerged that 66% of us haven't discussed how we'd like to die and only 38% have made a will. While 67% of us wish to die at home, very few will actually achieve that. And though 62% don't want to be artificially fed when in a coma, only 8% have made a living will which makes these wishes known.

When questions about our death are put to us, it seems that we do have strong preferences. Yet these preferences are most often neither discussed with close relatives nor written down. The inevitable consequence is that even though death is the one certainty of our lives, the chances are that we won't take steps to make possible the kind of death we would like.

The circumstances of our own demise are not within our control. Death may arrive unexpectedly. Apart from that, is it possible to die well? Both from the programme itself and from my own experience, I'd identify a number of things which might characterise a "good death".

The dying person would be at home or in a place of peaceful comfort, would have financial affairs in order, would have little or no "unfinished business" in terms of restoring broken relationships, would have said fond farewells to dear ones, would have the kind of medical care which minimised suffering, and – if a religious believer – would be at peace with their God.

It's unlikely that all these factors would be present. Apart from unresolved personal issues, the fact that so many people die in busy hospitals distorts the process. Doctors and nurses tend to regard death as a failure and an affront to their skills, and they often subject dying patients to interventions which are

both painful and pointless. "Don't just do something, sit there," might be more humane counsel.

We need a revolution in palliative care in this country. Those who do it best are the staff of hospices. They take good care of patients and they explain to them exactly what is happening. They also have expertise in pain relief. The lessons from the hospice movement need to be incorporated into general hospitals.

A few health authorities have thankfully woken up to this need.

In Esther Rantzen's excellent programme, those who were dying were our teachers.

Asked what message he would like to pass on to the living, Stan, a brave and dignified man, said that we should treasure every day and tell those dear to us that we love them.

It was simple and profoundly moving. So here's your homework. You can do this as a religious or non-religious Lenten discipline, whatever your age and state of health. Ask yourself what kind of death you would ideally like to have, and communicate that to your dear ones. Get your affairs in order and leave documentary evidence that will make life easier for those left behind. Make a will, and a living will. (Dorling Kindersley have published a very helpful book, How to Have a Good Death, to go with the programme.) Write down what kind of funeral you would like. One man told his minister that he wanted to be buried over by the oak tree in the cemetery, "if I'm spared".

You might want to think about your own attitude to life after death. As Homer (of the Simpsons) said: "I'm gonna die! Jesus, Allah, Buddha – I love you all!" The incomparable Woody Allen observed: "I don't believe in an afterlife, although I am bringing a change of underwear."

What else? Tell those dear to you that you love them. Then have a good day. And have a good death. If you're spared.

Living between life and death

By Kayley Mendenhall / The Bulletin
Published: April 02. 2006 6:00AM PST

Jack Triperinas is working to write something meaningful and lasting in a spiral-bound notebook he hopes to pass on to his children and grandchildren.

Shirley Andrus takes joy in little things, like cross-stitch projects, puzzles and watching the birds feed outside her windows.

Siv Marsh’s one wish would be to go on a barefoot cruise and help sail the ship, never telling anyone she has an unhealthy heart.

All three Central Oregon residents have been diagnosed with terminal illnesses and have been told by physicians they have either months or a few years to live.

And each has dealt with the news in a different way.

“It’s horrible to have the diagnosis, to be on the fence. You don’t know which way you’re going,” Triperinas said. “Every time you hurt you think, ‘This is it.’”


Although Oregon is the only state in the nation that has made physician-assisted suicide legal, according to those who work in end-of-life care, most terminal patients choose to live with their diagnoses. Many, said Jim Elmslie, director of the Hospice of Bend-La Pine, find the time to be immeasurably valuable.

A matter of time

For patients diagnosed with a terminal illness, the reaction to the news is as individual as the person, said Dr. Erik Fromme, a palliative care physician at Oregon Health & Sciences University in Portland who specializes in end-of-life issues.

“There are as many different ways of handling the end of life as there are in handling life,” Fromme said. “Usually the way people handle the end of their lives is a reflection of how they have lived their lives.”

Some want to know their prognosis for survival right away, he said.

Others never want to hear how much time they have left.

Citing a study conducted in Australia and published in the Journal of Clinical Oncology in 2004, Fromme said there was no clear consensus from a survey of cancer patients on when to discuss prognosis or on who should start the conversation ­ the patient or physician.

“My practice is to try to feel them out. What have your doctors told you about your illness and what’s likely to happen next?” Fromme said. “Most people say they want to know. Some say they want to know but will then immediately change the subject.”

Jim Kronenberg of the Oregon Medical Association said that in his experience, all physicians have different practices when it comes to predicting a prognosis for a patient. On the other hand, Kronenberg said, most people he knows also have different opinions on if they would want to hear their own likelihood of survival.

“How long do I have? That’s the first question I would ask,” Kronenberg said. “There may be people out there who don’t want to know.”

But Triperinas, 73, who was diagnosed with pancreatic cancer more than a year ago and knows he is likely going to die from his disease, said there is still uncertainty in knowing.

Last fall, when he had been living with his diagnosis for eight months, Triperinas said he debated whether to finish building flower boxes for his Prineville home. He figured there was no point, as he would be dead before the flowers bloomed.

He didn’t build the boxes and now that spring is descending upon Central Oregon, he plans to dig up the bulbs already planted in his yard to give away to friends.

As a former psychologist, Triperinas puts a lot of emphasis on the power of thought. His light blue eyes shine as he questions his own actions, pondering things like why he’s still scared to be “knocked off.”

“It’s the roughest spot to be between life and death, somehow,” he said. “We’re all there. But to have somebody tell you, ‘It’s between this time,’ and you think ‘When?’ I don’t think we can handle not knowing. That’s just part of being. We want definitive terms. We want answers.”

Marsh has a different attitude altogether.

Diagnosed with congestive heart failure more than two years ago, Marsh, now 69, was told she might not live two months. She no longer fears death and said losing that fear has, in some way, given back her life.

“I can gripe about today knowing tomorrow might be the same way, but I’m still going to be here,” she said. “I’m pretty happy with my life the way it is. The longer it goes on, the stronger I’ll get.”

Both Marsh and Triperinas said they have no interest at this point in taking advantage of Oregon’s Death with Dignity law. They also said they wouldn’t take the right away from others.

In 2005, 38 Oregonians used the law to end their lives, according to the Oregon Department of Human Services. Since the law went into effect in 1997, 246 Oregonians have used it.

Even the few who go through the paperwork to receive a lethal dose of prescription medication often end up not using it, said Elmslie of the Bend-La Pine hospice. Every year, he said, his organization sees about 500 patients through their deaths and in the institution’s memory only one has used the Oregon assisted-suicide law.

To live or to die

Triperinas has the paperwork for an advance directive, also known as a living will, but hasn’t yet written a word on it. The idea of filling out his “last will and testament” seems to him to be a counterproductive use of time.

Rather than focusing on dying, he said he’s interested in living.

“The (hospice) nurses asked, ‘Who are you going to get to take care of you when you can’t?’” Triperinas said. “I don’t like to think about that.”

A friend recently gave him an article on pancreatic cancer, but Triperinas said it made him worry that his cancer is metastasizing to his other organs. He has pains that radiate from his stomach around to his back and he recently decided to visit his doctor, who he hasn’t seen since last summer.

After the initial diagnosis, made from a MRI scan that showed a 3-inch-long tumor on his pancreas, Triperinas said he decided against going to Portland for a needle biopsy of the mass. He didn’t want to aggravate it and wanted time to think about his options. Physicians told him that nearly 99 percent of pancreatic tumors are malignant, he said.

“I’m afraid of getting caught in a cycle of hospitals,” Triperinas said. “It’s tough to think about.”

Although he has written some thoughts on wills for his weekly writing group, actually preparing one, Triperinas said, is more about death than life.

Sue Stafford, Transitions coordinator for the Hospice of Redmond-Sisters, said her job working with terminal patients has taught her the importance of both taking care of yourself at a young age and also having your affairs in order. She said she asks all her clients if they have filled out advance directives to make certain their end-of-life wishes are followed.

“Some people know exactly what they want and they don’t want their family burdened in making the decision,” Stafford said. “Others think, ‘If I put it in writing, I’m giving in. I’m saying I’m going to die.’”

She has seen patients who were determined to overcome their illnesses, refused to hear statistics and lived for years longer than expected. She has also watched people who vowed to fight a disease succumb within a month.

Fromme agreed that there is little evidence that having a terminal diagnosis will lead a person to die more quickly than they would without knowing.

“I’m not sure the giving of the information determines how long they are going to live,” Fromme said. “I’m not sure we have that much control.”

Some patients are referred for hospice care, meaning they typically have less than a year to live, and get well to the point of not needing it anymore, Stafford said.

Marsh, of Redmond, is one of those patients. She has been moved from hospice to Transitions, the program for people thought to have roughly 12 to 18 months to live, Stafford said.

“You never would have expected that she would be doing as well as she is now,” Stafford said. “You absolutely have to take it a day at a time.”

Looking ahead

Marsh credits much of her recent renewed energy to an increased social calendar that includes twice-weekly church attendance and a weekly tai chi class at t