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"I'VE helped many, many people to die." Dr Rodney Syme delivers the words quietly, in clinically precise tones. The only hint of emotion comes in the repetition. Not just "many" people. Many, many people.

This 72-year-old with his bright, white hair and measured delivery is Victoria's Dr Death. Quietly, clinically, for many years, he has "helped" people with advice and with a drug, Nembutal, a barbiturate that ends life.

But his private purpose has, in the past few years, increasingly turned into activism. On the steps of Parliament this month he defiantly confessed to helping oesophageal cancer sufferer Steve Guest die two years ago. "I gave him information about barbiturates and I gave him medication," he told a pro-euthanasia rally. Next to him was wheelchair-bound motor neurone disease sufferer Peter Hammond. "I have given Peter the same advice and assistance."

Syme is about to publish, through Melbourne University Press, a book called A Good Death, in which he tells the stories of 15 of the patients he has advised. He repeatedly dares the authorities to do something about his actions, and their refusal both relieves and frustrates him.

In private, he's no raving ideologue. He has that reassuring self belief, close to but different from arrogance, that seems to be taught in medical school and perfected over years of medical practice. Emotion is carefully dissected. Suffering is to be studied and treated, not buried or revered.

It was as a junior registrar in London in the 1960s that he came to understand first-hand the sorts of moral choices that doctors must make. "A woman in her late 80s had been run over by a car and was brought into the casualty department," he says. "She was comatose, she was shocked, she had obviously very severe injuries. I said: 'Quickly, get me a drip, see if we've got matching blood, get an X-ray, blah, blah, blah.' Then a hand came down on my shoulder from behind. It was my senior registrar, a 46-year-old surgeon, very experienced. He put his hand on my shoulder and said: 'Don't worry, son, there's nothing we can do.'

"My training was to jump in and do everything. But this 88-year-old woman, if we had got her to survive the injuries, (we) would have left her shockingly impaired.

"I accepted what he said without question but later I thought more about it: why would he say that?"

It came as a shock to the sheltered, privileged Melburnian. The son of a surgeon who went to an Anglican school, he ended up with a gentle Christianity that quickly diluted into agnostic humanism. But that experience was the first sign that he would have to deal with powerful moral questions.

What he calls his "epiphany" came later, in Melbourne, as a 40-year-old urologist. His patient, "Betty", had terminal cancer in her spine that made her life a "viciously painful nightmare".

"For the first time in my career, I came face to face with intolerable and unrelievable suffering which I had the responsibility to manage," Syme writes in his book. She did not ask for death and he did not offer it. But Syme thought hard about the problem afterwards.

"I knew, absolutely crystal clear, that if I had been in her position I would not have tolerated that pain," he says. "As a doctor, I would have been able to do something about it — and that's wrong. Why should I be able to avoid that sort of circumstance but not my patient?"

Then, shortly afterwards, "Len" walked into his consulting room with incurable bladder cancer, looked him straight in the eye and said: "Isn't there anything else you can do for me?" For a moment, Syme wrestled with his dilemma. Then he made the decision that would define the rest of his life.

"I struggled with my conscience to a huge degree … and I said, I've got to help him," he says. "And I did, in a very naive, spontaneous way which was ineffective and rather stupid. But that, again, taught me a lesson. It's a journey. Each step along the way I learnt something and was able to do something better the next time."

And there was a next time, and a next time, and before long he was president of Dying With Dignity Victoria and had helped many to die.

"With each event it becomes easier," he says. "My conscience has driven me."

It has been a painful experience for him, but one he has not shirked. Is he growing through the pain he denies others? The redemptive power of suffering is a powerful story embedded in religious and secular thought. Friedrich Nietzsche and Kanye West agree that what does not kill us, makes us stronger. Pope John Paul II wrote that suffering connects us to the divine.

Syme won't have a bar of it.

"I don't think we're 'meant' to suffer," he says. "Certainly suffering during life can be instructive and revelatory. We all can learn a lot from being in a position where we are not entirely comfortable. But that's purposeful suffering … (I) just can't see a purpose or value in suffering at the end of life, I can't see that at all."

There is a purpose in his actions: he wants to change the law. He is campaigning for a private member's bill on physician-assisted death that is set to go before the Victorian Parliament this year. But there's another way to change the law.

"I have deliberately become provocative," he says. "I came to realise that while I thought there were very strong reasons to change the law, politicians weren't interested in doing so. So it might be profitable to provoke a judicial test case. The authorities were very happy to let it all just lie under the table. But I wasn't."

He says he doesn't want to go to court.

"It would probably age me incredibly."

But he has imagined, many times, what he would say in court and what he wants the judge to say to the jury in summing up.

"I don't know that I'm naturally provocative," he says. "But I don't like hypocrisy. If I see hypocrisy and dishonesty I get angry and annoyed and I will try to do something about it."

SO IS he the sort of person who tells a waiter exactly what he thinks of the food?

"No. Oh no. I'm not a confrontational person in that sense. I go out of my way to avoid trouble, by and large. Mind you, I love arguing, I like debating. I will often enjoy having a debate with somebody and I'll take a view I don't naturally hold against them just to have a good discussion."

Through his progression from quiet euthanasia proponent to political activist, his family has been supportive. "My wife's always telling me off, we're very different people. But she has never expressed reservations. It was obvious I was sticking my neck out but she never said: 'Oh, I don't think you should do that."'

Even Syme's most fervent enemies seem to have a grudging respect for him. Margaret Tighe, president of Right to Life Australia, detests what he stands for and thinks he should be arrested and charged.

"I think he's dying to be arrested, to be a martyr for the cause, but the law on homicide should be upheld and properly applied," she says. "We are talking about human life. He embraces the principle of a life not worthy of being lived."

But she bears no personal animosity towards the man, whom she's met a handful of times. "I'm not in a position to say he's dishonourable," she says. "He's not of the ratbag element like (fellow euthanasia advocate) Philip Nitschke. He believes in his cause and he's pursuing it."

On the other side of the fence, opinion verges on reverence. Mieke Hammond, wife of motor neurone disease sufferer Peter, says Syme is a "very special", compassionate person. When she and her husband were investigating what was "on offer" in the way of physician-assisted death in Australia, they tracked down Syme and met him for a chat.

"He really took time to explain and talk to us about options," she says. "That made us both feel confident and have something to think about. We went back to see him again and it was then that he gave Peter the 'dedication'." She means the drugs.

"Rodney's compassion for terminally ill human beings and the need for stopping and preventing their intolerable suffering has surely impressed us. He is softly spoken, has lots of patience and is always there when you need him."

RODNEY SYME CV

BORN August 23, 1935, Melbourne.

EDUCATION Melbourne Grammar School and Melbourne University.

CAREER Surgical registrar, Whittington Hospital, London; urology registrar, Cardiff Royal Infirmary; fellow, State University of Iowa; head, urology unit, Austin and Repatriation Medical Centre, Melbourne; chairman, Victorian section, Urological Society of Australasia; chairman, urology study committee, Anti-Cancer Council.

PERSONAL Married with three children.

HOBBIES Birdwatching, chess, bridge, golf.

Nick Miller is health editor.

Money, I hope will not be the root of any evil for the voluntary euthanasia groups within Australia. It shouldn't be at all difficult to ascertain the chaff from the wheat.....I certainly would support its use going to incorporated societies and groups that have had a history of stability and political clout (?)......It is a bit like winning tattslotto to be given $5 million dollars for a cause....brings more grief than joy in the end for some people.....

Subject: VE BEQUEST

There is a lot of buzzing around about how, when, what the executor of Clem Jones estate will do to discharge his bequest to support adoption of a VE law.

I think there is also an assumption that it is just a matter of 'pick me, pick me, and someone or organization will get a $5m cheque. Sorry to advise that is not how these things happen.

While everybody has a right to approach the executors and make their pitch, it would be nice to think that the movement will not appear like a hoard of individuals fighting each other to get in front of the queue.

This email is simply to advise that I intend to approach the executors and ask what their intentions are and respectfully ask if they would be receptive to a proposal or proposals from individuals or organizations with a history of perusing right to die laws.

I will advise what their response is (if any) to you all. That response will determine what the next steps should be.

At this stage it is probably too early to start developing a coordinated proposal to put to the executors however that does not stop everyone collecting their thoughts on the subject in case it comes to that.

If any of you decide to make a direct approach (as is your right) would you please let us all know so we are up front with each other.

I will be in touch as soon as I have any information.

Regards
Marshall Perron

Archdiocese of Brisbane
09 March 2008

End-of-life issues education

By Carol Glatz

MANY Catholics still need to learn about the Church's teachings on end-of-life issues, such as when it might be morally acceptable to reject or terminate life-prolonging treatments, some participants at a Vatican-sponsored congress said.

While euthanasia and assisted suicide are always wrong, in some situations the terminally ill or dying can withdraw or refuse treatment and still be in line with Church teaching.

To help people make informed and ethical decisions, "much work needs to be done in elaborating on the Church's tradition of reasoning about forgoing life-prolonging treatments to make it practical for health-care providers and persons who are dying", director of the Toronto-based International Association of Catholic Bioethicists Dr William Sullivan.

Dr Sullivan was one of hundreds of scholars, theologians, religious and health-care professionals who turned out for the Pontifical Academy for Life's February 25-26 international congress, which looked at the scientific and ethical aspects of caring for the terminally ill and dying.

The gathering was important because not only is the push for legalising euthanasia and assisted suicide taking root in many parts of the world, but incurable, deadly diseases are also on the rise.

Several speakers noted that even some Catholics might not be clear about what kind of decisions are morally licit, since ambiguities cloud many end-of-life issues.

One difficulty lies in the fact that moral theologians and some medical professionals may be attaching different meaning to terms such as "ordinary", "extraordinary" and "futile" when describing a proposed treatment.

The Vatican's Congregation for the Doctrine of the Faith tried to clear up this problem with its 1980 Declaration on Euthanasia.

The Vatican assigned the terms "proportionate" and "disproportionate" to describe the probable effectiveness of possible treatments.
Whenever a medical treatment is deemed disproportionate because it would cause the patient strain or suffering out of proportion with the benefits, then it is optional.

And the United States Conference of Catholic Bishops issued its "Ethical and Religious Directives for Catholic Health Care Services" in 2001 to help "articulate and apply magisterial teaching", president of the National Catholic Bioethics Centre in Philadelphia John Haas said.

But some recent literature in moral theology has been ascribing new uses for the terms ordinary and proportionate – developments that he said do not seem rooted in the way the Church traditionally has used those terms.
He said the Church must continue to refine the terms "to allow a greater precision in ethical judgment".

Dr Sullivan told Catholic News Service that living wills or advance medical directives are not always wrong in the eyes of the Church.

One case where they might be morally licit, he said, is if a patient developing Alzheimer's disease makes a written request in advance to decline a feeding tube if he or she is refusing to eat because of the disease.

"Now that doesn't mean they are declining basic care. You would provide hand feeding as much as possible, but it is a legitimate advance directive to say that under those circumstances I may not want that intervention" of artificial feeding, he said.

Pontifical Academy for Life president Bishop Elio Sgreccia voiced a word of caution about advance directives in his written presentation.

While the directives help family members know what a patient considered extraordinary or excessive, Bishop Sgreccia said debates on living wills say "the merit of the validity of a document drawn up in advance" is questionable.

He said that from an ethical point of view, living wills "may not be obligatory for patients".

The doctor should not be "bound by clauses" in the document "that he might judge unacceptable either for clinical or ethical reasons" and the document must "not contain directives of a euthanistic nature", he said.

While the bishop said a living will is an important method for letting patients try to avoid "excessive treatments of a therapeutically obstinate nature" and to pledge organ donation, the current tendency of such documents is to include directives "that take the form of the practice of euthanasia".

Mr Haas told CNS that in the world of high-tech medical advancements "the really big area of contention today is this area of assisted nutrition and hydration".

This was made especially apparent during the legal battle over the fate of Terri Schindler Schiavo, a severely brain-damaged Florida woman who died in March, 2005, after a court ordered that her husband could make her medical decisions for her.

Michael Schiavo, the husband and legal guardian, said she would have wanted her feeding tube removed, while her parents said she would have wanted to remain alive based on her Catholic faith.

Bobby Schindler, Ms Schiavo's brother and executive director of the Terri Schindler Schiavo Foundation, said he attended the Vatican congress "to keep educating myself on these issues".

He told CNS that while the case "raised an incredible amount of awareness", incomplete or misleading media coverage also generated "a tremendous amount of confusion" that still lingers.

Pope John Paul II's 2004 allocution said artificial feeding and nutrition of patients in a persistent vegetative state was not "a medical act", but was proportionate and ordinary and therefore morally obligatory.

But Mr Schindler said these teachings were not being conveyed adequately. He said US clergy were being too silent from "apathy or indifference" and not coming to their defence in time.

Much confusion, he said, was caused when the case mistakenly was "lumped into these end-of-life discussions when in fact it was not an end-of-life situation".

"Terri was not dying, the brain injury was not going to kill her," and she died just like anyone else would die "if they took away our food and water", Mr Schindler said.

Mr Haas said that during congress deliberations, Bishop Sgreccia stressed that the concept of "excessive burden has to be applied to the treatment and not to the life" of the patient.

It would be immoral for a person with a chronic condition or a substitute decision-maker to decide the patient's life has become "too burdensome" and to remove the necessary life support.

But, "if the person is dying and the continued use (of life-supporting measures) results in a prolonged and precarious existence, then clearly it can be withdrawn", Mr Haas said.
"The difficulty is people want black-and-white answers," Mr Haas said, "and when we are dealing with these end-of-life questions it's a matter of prudential judgment as to what is going to constitute a reasonable hope of benefit and excessive burden."

Carol Glatz is a correspondent with the Rome bureau of Catholic News Service

Readers' feedback on 'Euthanasia doctor dares police' the article produced here prior to the letters:
Thursday, November 1, 2007

A recent speech by a Buddhist Monk, which is gives a good overview of his perception on the art of dying well.

Our subject tonight is of particular importance to twentieth century people and is also my favourite topic. Because we all die eventually, it is important we prepare for this time and talk about it. One moment we are born, the next we die. Because there's no escape from this process, it is better that we face it than hide from it. Death is a very important part of life. My experience is that most people in the West hardly ever talk about death; it is not considered a proper topic of conversation. It's even hard to ask someone how old they are. When you ask them, they often feel embarrassed or insulted. It is interesting how different cultures have such different attitudes towards this subject. Tibet was not a very developed country in the material sense but spiritually it was highly advanced and we always talked about death. In the West, it seems everyone talks about sex and nothing else, especially the advertising industry. Tonight, I want to share some ideas on euthanasia.

Euthanasia is a problem brought about in part by modern technology. It is often complicated by religious and self-motivated attitudes. I don't want to talk about the views of other religions, as I'm not in a position to judge them, but I will share with you some ideas from the Buddhist perspective and some of my own observations. From the Buddhist point of view, there is not much of a problem with the idea of euthanasia. "Euthanasia" literally means, "To die well" in English, doesn't it? There's nothing wrong with that. The other reason is the Buddhist belief in karma. "Karma" means "causes, conditions and results". Karma has these three different aspects. When you have pain and suffering, this isn't a punishment or anything unreasonable. Whatever you suffer is due to some previous action you have done. If you do something wrong, the results come back to you. It is a process of purification rather than punishment. It is part of
your journey, a passing through of something for duration of time. You are finishing your bad karma, your bad deeds; it is not as though what is happening is bad or useless. It might be a terminal illness, anything. You might discover you have AIDS or cancer, for instance. You might have five, seven or ten years of suffering ahead of you but this is still a part of your life, part of a purification process.

In a way, it's good to know you have only a few months left to do something as you can then spend this time with your family and share your experience with them. In doing so, you will help them prepare for the process of dying that they too will undergo at some stage. You can also use this time to reconcile any differences you might have or to say things you have been meaning to say. In this way, you are not going to feel you have wasted your time or energy. From the Buddhist point of view, this is all part of a purification process.
Something I find interesting is, when someone has a terminal disease and spends that time with their family, that family's grieving process comes to an end when they die. Because they have shared the experience together, the dying person also dies happy in the knowledge they have done there best. They are also happy their family has been looking after them. At that time, they realise all their
time and energy has run out and nothing more can be done. They feel they have given it their best shot and both sides feel it's a good way to finish.

If you understand karma - how everything around you is dependent on causes and conditions - you won't experience many problems when you die. On the other hand, if you don't understand karma, you will make excuses for yourself and many problems will arise. I have seen this myself when working with dying people. Not understanding karma, they blame everyone else for their problems. They blame their doctor, their medication and their nurse. They blame their friends and whomever they think gave them their disease. Their attitude is completely negative. Their situation may be bad but they make it even worse with all the mental suffering they create. Not only do they suffer by blaming everyone around them but also they turn their death into something very cold and black they want
to avoid. Because they don't accept their death, they experience much suffering. Feeling like this, they just want to kill themselves. They don't want to experience their pain and suffering. They also tend to squander all their money with no regard for those they are leaving behind. They make the excuse they are going to die anyway, sort of thing. They think like this because basically they think their pain is unnecessary and useless.

From the Buddhist point of view, pain is very useful. It is regarded as a type of purification. When you die, there's often more suffering than there is pain but even when you experience tremendous suffering, you still have a degree of freedom. I have asked people who have wanted to kill themselves, why they wanted to die. Usually they say it's because they didn't want to experience
pain. But, how do they know their pain will be gone when they die? This is ignorance. Where is their evidence? Where is their proof? Even if they don't believe in reincarnation, still there must be some uncertainty in their mind. If they were to find out the pain after their death was going to be worse than when they were alive, what would they do then? Do you see what I mean? You have to
think about it.

From the Buddhist perspective, dying is not really a big problem. We accept life and death and simply do our best. The important thing is to look after each other, to appreciate each other. It's a much nicer way to say goodbye. The Buddhist meaning of "Goodbye" is very much the same as the Christian way of saying goodbye. I think the Christian "Goodbye" means "God be with you". Is that
right Paul? Maybe I'm wrong? But then, Buddhists don't believe "God" is something external rather that "God" is like "Goodness".

When we say goodbye, we mean, "Good be with you". Whatever you've done that's positive is with you;

whatever you've done that's negative is with you. When you say goodbye, it means your mind is more focused on whatever's good. When you die, this is your comfort, your companion. You could say the Buddhist approach to dying is more like a funeral, where everyone, including yourself, says goodbye. You generate a positive state of mind, reflecting on the good things you have done in your
life. You concentrate on the positive. That's the Buddhist way of preparing for death.

Euthanasia, from that perspective, is not much of a problem. I can't see any problem with it. However, the twentieth century has brought with it an added complication we didn't have in ancient times. This complication arises due to modern technology. In the past, if you couldn't eat or drink you didn't survive, you would die naturally. There was no such thing as life support. If your body
was falling apart, nothing much could be done. It was final. Your body was gone, the light was turned off, and you couldn't do much about it. Under those circumstances, you couldn't decide to prolong your life, nature decided that for you. Twentieth century technology has its good side and it's bad side. It is good in that it makes it easier to survive but it's bad in that it artificially
prolongs situations and forces you to make life and death decisions you wouldn't have had to make before.

When you couple this with a selfish motivation, you then have a dilemma. If someone doesn't want to die, they may want you to keep them artificially alive forever or others might want to, all for selfish reasons. A person may want to die but others may not want them to die. This happens quite a lot these days. I don't want to judge people but I find the whole situation rather sad. Some people never want to let go which just causes problems. If you really like someone, then your love should be free. If you love with attachment, it is not you have genuine love, there is no entangle, their loved ones are selfish, this caussituation. If you really love someone, you don't try to keep him or her for yourself. In this way, you're free and they're free. This is my observation and also the idea behind Buddhist teachings and philosophy. If you have genuine love, situations become much lighter, more wonderful and open. Everyone deserves
that.

Complications arise when the motivation of your love is negative. It is also possible the motivation to euthanase may be negative too because people are really crazy these days and crazy people do all kinds of strange things. If euthanasia is legalised, it could be used as an excuse for people who don't like old people to get rid of them. Already, when you reach forty, no one seems to
want you much. It's very hard to get a job. Maybe it's started already! What happens when you are in your sixties or seventies and people want your money and don't want you? They mightn't want you to waste your money and think you deserve to die. If euthanasia is legalised, you might not have much say in the matter. This is also possible. Then there's the situation of the physically and mentally
impaired. Where do you draw the line? At the moment, at least, we still have moral values. We feel it is our responsibility to look after our children and our families until they die. At least we still have some kind of morality and dignity in our lives.

When people go crazy, they lose their morality and anything is possible. Under these circumstances, legal euthanasia would be a little bit dangerous. It would also encourage those who don't want to go through pain to take their own life. I know of people who would do that. Some people who suicide leave letters behind saying they don't want their families to go through their problems or they don't
want to spend all their money on their problems when they are going to die anyway. They just want to end their life. This is very selfish; this is the cowboy way of doing things. In cowboy movies, when a horse has a broken leg, they just shoot it in the head. They think the horse doesn't want to live, but this is wrong, actually the horse wants to live. If I had a broken leg, I would still want to live. I wouldn't want anyone to shoot me in the head just because I had a broken leg!

If you compare your feelings with those of others, you would see they felt the same way. Wanting to kill someone is like not caring for them, not understanding their feelings. It is actually very selfish. You should look from the perspective of both sides. If both sides are totally agreeable, then it's okay, if not, then the judgement is yours, not theirs. In doing so, you might even generate a terrible feeling of guilt, which will far outweigh any monetary gain.

Material things in themself are not that important. What is important is human touch, loving kindness, caring for each other. These are what are important. Why I say people are crazy is because people are loosing these qualities. We really need to be quite concerned about this. Sometimes we just get carried away and loose what it means to be truly human. If we loose that, then life just becomes
very plastic. I believe you have to face your death, no matter what. You have to share your experience of suffering with others; you have to share each other's burden, both your sad times and your happy times. This is what it is to be human. We need to understand each other. It doesn't matter if you're young or old, powerful or weak, it's important to share each other's experiences.

In a way, the four-part process of birth, sickness, old age and death is like a work of art. It is something you have to finish. You wouldn't want to cut out the middle because it is a very important part of life. It helps us to prepare for our death. From the time you were born to the time you are fully grown, you are changing. When you are forty, you stop growing. From there on you are heading towards your death. It's like climbing a mountain. When you reach the top, you have to go down. You can't climb any higher; you have to go down. When you're young, you should follow your head but when you're forty and getting older, you must listen to your body and not your head. This is because your head still thinks you can do things your body can't. This is what it means to prepare for death. When you're forty, you have to curtail your daily activities. You need to think more of the quality of your life. You have to preserve your energy and be kind to yourself.

You shouldn't plan for the next hundred years when you're only going to live fifty, then you're over doing it. And you shouldn't think you haven't got enough shoes, that you need black shoes and blue shoes and red shoes and that you need twenty-five of everything to match everything else. When you're dead, you have to leave it all behind, Besides, why do you need all these things? These sorts
of things are not necessities; they are more than you need. If you are happy, harmonious and have reasonable food and shelter, that is all you need.

Otherwise, however much wealth you have, you have that much suffering. If you do not enjoy life, then I think you've wasted it. Some people might say, "Oh, it doesn't matter, when I die I will leave lots of things behind and other people can use them", but actually, the generosity that counts is the generosity you give during your life. When you're dead, what you leave behind doesn't count because it is a somewhat desperate type of generosity. You don't have any choice but to leave it behind because you can't take it with you. When you leave things behind, you don't leave your attachment, anger or jealousy behind with your material things. It is therefore important to think ahead and prepare for your death.

Choice comments: I do hope that the Law Makers understand that these actions are not the preferred choices of people who are already facing the trauma of the dying process. A building should be made available, and people would pay for the privilege...after all they can't take their wealth with them into the next world should it exist. Spend the children's inheritance (those same Law Makers who no nothing to assist the terminally chronically suffering person with legislation) and once they see their parent's money going elsewhere, then we may get some action, if only to protect their own interests. Perhaps our children need to have an incentive to change the laws around the world to bring about change in outmoded perceptions of loyalties. I am inciting selfishness of one's own interest at the expense of the assets one may leave their children.

Dignitas in "trouble", even though trying to demonstrate compassion first and foremost to the desperately ill, should not be an issue for discussion least of all, legal action!....Once again greed has overtaken common sense. The bodies don't need to be removed in full view of the gaze ofvthe passersby......Fire escapes would have done very nicely...rarely accessed by anyone except those in need.

Geneva - A Swiss hotelier is planning legal action against a Swiss assisted-suicide association, Dignitas, after the group helped a German man end his life in one of his hotel rooms last Friday, local media reported.

"It's a disgrace," the owner told weekly newspaper SonntagsBlick, which gave his name only as Alexander M.
"Nobody asked me for permission. I've never had the wool pulled over my eyes like this before," he added.

Dignitas has gained notoriety in recent years by offering assisted suicide to foreign visitors to Switzerland.

Last week, authorities in the town of Staefa in the canton of Zurich, shut down a flat used by the organisation following complaints by neighbours about the number of coffins seen in the street.

Under Swiss law, a terminally-ill person may be given "passive" assistance to suicide, such as being supplied with a lethal dose of a drug, provided it is not done for selfish motives.

Active assistance, including helping the person to take the drug or administering it, is forbidden.

Swiss news agency ATS said last week that Dignitas assisted 192 people to end their lives last year, up from 138 a year earlier.

AHN Global News Service reported on 19 July 2007

Protests Ahead Of Dr. Kevorkian's First Public Speech

Matthew Borghese - AHN News Writer

Gainesville, FL (AHN) - The University of Florida (UF) has become a battleground for the assisted suicide debate as Dr. Jack Kevorkian plans to make his first public speaking event since his release from prison in June.

Critics of Kevorkian, like the brother of the late Terri Schiavo, Bobby Schindler, have called on the university to drop the engagement. Dr. Kevorkian is "a convicted murderer. He's a man that is obsessed with death... I think the message he's sending to our young kids is dangerous," Schindler told the Gainesville Sun.

However, Steven Blank, chairman of UF's Accent Speakers Bureau says the event, which is free to students, isn't about endorsing one side or the other. "We pride ourselves on being non-partisan. We try not to take any one point of view," and the speech "will be a great way to engage our student body and allow them to come to their own conclusions," Blank tells AHN.

"We aren't bringing him in to try to convince people of his views rather to present an issue on which the student body can choose for
themselves," Blank said.

Nonetheless, Schindler has started an online petition calling the event "an affront to everyone who stands for the value and the dignity of every human life."

"Dr. Kevorkian is determined to instill the future leaders of our nation with his twisted ethics of euthanasia. We need everyone to join us in telling the President of the University of Florida that it is unacceptable to invite Jack Kevorkian to spread his message of death and violence on the campus," the petition reads.

Meanwhile, Blank expects a "full house" when Dr. Kevorkian comes to speak at the Stephen C. O'Connell Center on Oct. 11.

I recently spent three months in JO Middle Eastern countries. Opportunities to talk aboui (his issue are severely limited in Muslim countries but I was able to interview two people, one in Lebanon and one in Dubai, who provided some insights.

In Beirut I spoke with Dr. Assad Rizk, former Minister of Education and Culture in Lebanon, head of the 82 year old Rizk Hospital in Beirut, and a member of the Lebanon Medical Ethics Committee. I met him through Dr. Larry Egbert, Medical Director of the Final Exit Network, who had worked in Beirut.

Dr. Rizk, a urologisl, said that nobody talks about this issue in the Middle East. Patients are rarely told they have fatal conditions; the word "cancer" is almost forbidden. Rather than being informed publicly that detection may result in successful treatments or that people can live with medical problems, nothing is said. Just ten years ago doctors started talking to one or two family members, but still not to the patient.

Though Lebanon (which is about 40% Christian. 60% Muslim) is more open than other all-Muslim countries, the question of hastening death does not occur, though terminal sedation is widely but discretely used There are two Ethics Committees in the Arab world,
in Lebanon and in Tunisia, though Saudi Arabia, surprisingly, is considering starting one. He does not know if those countries have
same rights as Lebanon enjoys. There is in Lebanon a right to refuse treatment: "You can't oblige people to be cured" Dr. Rizk
stated. He admits that it is much harder to stop treatment once the patient is unconscious. The patient's wishes - spoken or in advance directives -- are binding when she is conscious. Patients there don't usually refuse food and water to end their lives, primarily because "no one would oblige them." Everyone in Lebanon has health insurance.

Every hospital in Lebanon has an Ethics Committee. In the Rizk. hospital a Judge heads the committee: there is also a priest, a Shia Imam, a mental health professional, a sociologist, and others including Dr. Rizk himself. In 1985 there was a cross-religious kidney transplant; a Muslim authority had to decide that it was acceptable to give an organ from a person of one religion to a person of another.

It is not common, in Dr. Rizk's experience, for a patient to want to die. There is now interest in establishing a department of palliative care. There are problems with patients who are fed artificially; long-term maintenance of people in persistent vegetative states is non-existent since complications develop after a few months and the patient dies. There are very few hospices or nursing homes since most patients are cared for in the family and die at home, though bungalows are now being set up for the elderly. Alzheimer's Disease is a recent problem and is occurring with people in their fifties,

DNR is legal, at the request of the family; the patient is usually in a coma, though it is difficult to implement and requires a team discussion. There are no advance DNR orders. There have been no court cases challenging or expanding any of these rights.
There is a high rate of depression and suicide in Lebanon, though suicide is taboo in Islam. The economic and political situation, and the fact that the country has been at war off and on for 35 years, are responsible. It occurs among the young, primarily by jumping. The war had one good outcome; it was also responsible for the first voluntary blood donations in Lebanon.

My other source in the United Arab Emirates, specifically in Dubai - arguably the most progressive slate in all of the middle east - did not want to be named. He said that attempted suicide is a crime for which a long prison sentence would be the punishment. Information on this issue is non-existent, and euthanasia is not discussed. He did say that his mother, a nurse, told him about helping suffering people end their lives.

Information from the internet is available so Final Exit and other materials can be purchased though it would not be available in book stores or libraries.

2007-05-19 From: Los Angeles Times, CA, US
Blogging for the right to die
http://www.latimes.com/news/nationworld/world/la-adfg-die20may20,0,4820099,full.story?coll=la-home-center

A young Chinese woman with muscular dystrophy has been thrust into the spotlight with her euthanasia plea to the government.

By David Pierson,
Times Staff Writer
1:42 PM PDT, May 19, 2007

Chinese blogger

Yinchuan, China -- Confined to a rusty wheelchair and unable to control her muscles below her neck, Li Yan seemed destined for nothing more than a short life of pain and hopelessness.

Instead, the 29-year-old with muscular dystrophy has been catapulted into the center of an ethical debate. Li, fearing that her disease eventually will leave her in a helpless state, used her blog in March to ask the National People's Congress to legalize her right to die.

"I don't want to live with my brothers and sisters-in-law after my parents' death, let alone go to an orphanage or welfare institute," wrote Li, a rosy-cheeked woman with plump lips who can't keep from breaking into a smile even when discussing her most morbid wishes.

"I'd be away from heaven and life would be worse than death for me," she wrote, addressing the congress during its annual two-week meeting in Beijing. "So I would like to apply for euthanasia when I'm still able to sit and talk."

The central government has been guarded, hinting in the state media that China wasn't ready to join the few nations that have legalized euthanasia. But in a country where death shadows the underclass in myriad ways ¬ from coal mine explosions and sickening pollution to earthquakes and floods ¬ many people appear to view euthanasia as an act of mercy.

There is no right-to-life movement here like the one that sought to keep brain-damaged Terri Schiavo alive two years ago in Florida. In China, the one-child policy has begotten institutionalized abortion. Capital punishment is common and swift.

"China's atheism education, people's practical mind-set and poverty all add up to a willingness to accept euthanasia," said Zhang Zanning, a professor of medical law at Dongnan University in Nanjing. "I think the supporting rate for euthanasia is very high. In terms of public opinion, now is a good time for legislation."

Li, the daughter of a fertilizer factory worker in this industrial corner of northwestern China, had no idea what the rest of the country thought about euthanasia four years ago when her parents borrowed about $500 ¬ the equivalent of three months' wages ¬ to buy her a computer to get online. Li taught herself to type by holding a chopstick in her mouth. In early March, she copied her plea to the National People's Congress and pasted it to a message board belonging to a prominent national television reporter.

Within four days, her story had fanned out nationwide. Four weeks later, 90,000 hits had been recorded on Li's blog, many people leaving words of encouragement and support for her right to take her own life.

"I understand and support you!" wrote a poster named Caihong. "It has nothing to do with courage, but has to do with dignity! I hope everyone can have a dignified life and death!"

There are no definitive national surveys of popular sentiment on the issue, only snippets like Li's blog. More than 90% of 5,456 people in a poll organized by www.sina.com.cn in March supported Li's right to die.

Zhang, who successfully defended a doctor in 1992 who was charged with murdering a cancer patient by lethal injection, conducted a poll of 463 people in 1998. He said 448 respondents deemed euthanasia humane.

Li's appeal has made her a media star. On a recent day, a crew from state-run network CCTV filmed a foreign journalist interviewing Li in her bedroom. The cramped space was decorated with a heart-shaped mirror. Along the window was a queen bed Li shared with her mother, Song Fengying.

The 60-year-old matriarch turns her daughter's body at least 10 times a night to ease the discomfort of staying in one position.

"If I can't sleep, my mother can't, either," said Li, sitting on her plaid-cushioned wheelchair with a red blanket covering her legs. "I explain to people, imagine lying down or sitting stiff for two hours without any movement no matter how uncomfortable it feels. It becomes so painful. Like having a mosquito on your finger and you can't chase it away."

Moments later, Li shouted, "Ma! Move my legs."

Song squatted down and lifted the blanket off her daughter. She adjusted Li's legs just a few inches and clasped her daughter's hands together on her lap. She tucked the blanket back under Li's feet before shuffling away.

Song said it was up to her daughter to decide what she wanted for her future. But it isn't easy for her to accept Li's quest.

"When I take my daughter outside, neighbors and friends say, 'Your daughter's still alive? What will your daughter do after you die?' " Song said.

"I just say, 'We'll see.' I don't think so far ahead. I live day to day. It makes me too sad to think about the future. I know it saddens my daughter to think about it too. She has to suffer this pain. As parents, we couldn't do our job. We couldn't cure her."

Li has tried to make the most of her abilities. The cracked white walls in her tiny home are decorated with colorful fluorescent printouts of drawings Li does on her computer, laborious efforts than can take two months ¬ images of floral bouquets, grapevines and classical Chinese musicians in flowing robes she modeled after characters from the wildly popular TV series "A Dream of Red Mansions."

Li shudders at the memory of life before the computer.

When she was diagnosed with muscular dystrophy at 6, doctors said she wouldn't live past 18. A year later, she needed wooden boards pressed against her legs to hold them stiff in order to move. By 10, she was in a wheelchair. She was in school for just half a year before being pulled out because her parents hoped to travel to find treatment.

Li was confined to home. Her eldest brother used his old textbooks to teach her math and Chinese. At least she still had control of her hands, Li said. She loved embroidering. But by 15, her hands began to falter.

"I couldn't go out and play with the other kids," she said, her jet black bangs dangling just above her eyes. "My parents had to work and I stayed home alone. I was so lonely and bored. I felt meaningless."

It was around that time that she first learned of euthanasia. She saw a TV news program about a woman in Europe who had her doctor lethally inject her.

"To die without pain. I thought, that doesn't sound bad," Li said.

She didn't pursue the idea until she was 26, when she decided to starve herself to death. She gave up after a day when her mother pleaded with her to eat.

Last August, Li started a blog titled "No Way to Escape." She wrote about her daily life, her solitude and her disease. After seven months, she had 200 hits on her Web page. All of them were by her. She loved it anyway.

"I felt new things open to me," Li said. "I was able to read and see a lot more. It was like a bridge to a new world."

But if the Internet provided catharsis as a form of expression, it also stifled any hope in Li's mind that she could be cured. Her online research showed that someone with symptoms as severe as hers had little chance of improving. The family could not afford to see a specialist to confirm the fears.

But it was enough for Li. Reading those websites felt like she had let go of any false hope. She believed the pain would soon be too much to bear and that her parents would die and leave her alone.

Now that she was convinced she was going to die young, she wanted to die painlessly and on her own terms.

"I am an atheist. I don't believe in a soul or ghosts. After I die, I will become fertilizer," she said. "I want to donate all my usable organs, such as my cornea, liver, kidneys and even my heart to those who need them."

Li said she does not feel famous. It stings when people accuse her on her blog of seeking fame and fortune. Last week, a foundation offered to pay for medical treatment in Beijing. Li accepted, but she does not think it will make much difference.

A pink gift box rests on her windowsill. It contains a DVD player from a Hong Kong TV reporter who wanted Li to be able to watch the Spanish film "The Sea Inside," about a paralyzed man seeking suicide.

No request to legalize euthanasia was ever officially submitted to the National People's Congress, which is the norm for many of the ideas thrust into the limelight during the yearly session. But Li was encouraged that it lingered in the public's consciousness. Newspapers across the country weighed in.

"Life is beautiful, but more important is the beautiful mind," read an editorial in the Shanghai Daily. "If the mind has lost hope for a dignified corporeal life, why not let it go?"

Wang Yuelan, a resident of Li's suburb, said everyone in the neighborhood knew about the disabled woman who wanted the right to die.

"I support her," said Wang, 38, nodding toward Li's building across from her son's elementary school. "People should be able to make that choice. I can imagine it. My father suffered terribly from stomach cancer."

Despite the outpouring of support, Li still says she'll dedicate what time she has left with her faculties intact to gaining the right to end her life.

On a recent afternoon, she signed on to her online instant messaging service linking her to 300 friends. A month ago, she had 15. Her sign-on name is a line from a Chinese poem:

"The fragrance of a plum flower is conceived in the bitter cold."

Its message: To suffer is to grow.

"I feel really close to this idea," Li said.

I originally received this email in December 2006 and trust that any politician who reads my website will focus on the message about the lengths that people will go to break the law when it is a bad one. A long email - I learnt that it was written encrypted on a home computer, saved to disc and then sent to me from an Internet Cafe. I was warned to take all sorts of precautions to prevent me from being "caught" under the suicide related materials legislation but I believed then as I do now, that as my purpose is solely dealing with the euthanasia debate ongoing I am protected.

I am not inciting suicide nor recommending it as a course of action. However I do believe the government has its head in the sand by not allowing Journalists and the Media to correctly report suicides as they occur...only by the general public, and politicians who don't get told information "on a need to know basis" can the true facts of terminal and chronic illness deaths be addressed.

Palliative care for some is an option, but it does not meet the needs of many more that go unrecorded, untraced or just plain disappear. I heard just the other day of an elderly lady with no near next in kin in this country making her final statement by leaving all of her equipment exactly as she died with no friends coming in to clear up after her death. She wanted it known what she'd had to resort to!

Mary Walsh:

"Two Cases of VE in an Australian State"

Hello Mary,

I am writing to you as a result of having seen you in the SBS program in which you were featured, which aired in November.

As you are a VE activist, there is probably not much I can tell you except for some personal experience of VE that I have. Nevertheless, I wish to share this with you, as you may find it useful.

Firstly, I should tell you who I am. Well, I cannot do that, as I have in the past broken the law in regard to assisting in VE and therefore I could be prosecuted.

To protect myself, I am sending this email from an Internet cafe using a hotmail account that I have created here today, so as to reduce the chance of me being traced. I am also aware of the Australian Law regarding electronic discussion of this matter. For that reason, I will not name specific substances or use official terms, in case scanning programs trace my email content. (However, the government may well be monitoring your email under the current law that came into force in January 2006.)

I will check this email address in a couple of week's time in case you reply. It would appreciate any reply you are able to make, although understand if you cannot. I am happy for you to put this letter up on you web site if you want to. If you do that, there is no need to reply via email at all, as I will look on your site again in a few weeks.

I cannot prove to you that I am not a spy from the Right To Life organisation or some other organisation opposed to VE. On that you will have to take my word, although I hope that the details I provide herein will convince you that I am a supporter of VE, and write to you legitimately.

So, to get to the details, both my parents died via drinking the substance you acquired overseas. I was involved in both cases. The main point I wish to make to you is that the substance does provide a very quick and peaceful end. From the time of intake of the drugs until unconsciousness was only five minutes, and I estimate that death came less than five minutes after that. It was as though they had received an anaesthetic, they quietly went to sleep.

Firstly, my father, who had been healthy all his life, but also a heavy smoker, suffered a stroke. He was aged in his mid 70's. This happened in the mid 1990s. He was left paralysed down the left side. Because it was a left-sided stroke (right brain), his speech was unaffected. Certainly his mind and reasoning were unaffected. He had no trace of dementia or Alzheimer's disease.

From the day of his stroke until his death some months later, he was implacably determined to seek VE. My mother (they had been happily married for over 40 years) was of course devastated by his illness and distraught about the prospect his suffering without improvement, and of the possibility if his death.

Nevertheless, my mother assisted him (and in fact organised) the method for him to end his life. She contacted a person involved in VE who came to visit my parents in their house. This was very shortly following my father's months-long stay in various hospitals after his stroke. This person spoke to the four of us (I was also present, as was my spouse) about the options, and also conducted a long discussion about the possibility of NOT seeking VE.

My mother, my spouse and myself all went over many times with my father his options, but no matter what we suggested, he unbendingly stated that he wanted to die, because his quality of life was unacceptable to him. He had also found his treatment in the hospitals very demeaning, with nurses having to wash him, wipe his bottom, and so forth.

Some people do recover after a stroke, but my father showed very little signs of recuperation. I think his age was against him in this regard. I know for example that the tennis player Rod Laver recovered quite well after a stroke, but Rod Laver's occurred aged about 62. He was a fit sportsman too, which also probably helped his body overcome the stroke.

In any case, I digress, although I wanted to give you that background into my father's health, and health prospects.

Through the VE contact my mother arranged, my parents were able to acquire the Mexican juice you obtained, and also a supply of one hundred sleeping capsules (or tablets? ?I can't remember). This particular sleeping drug has a delicate margin of therapeutic use, and in overdose is lethal. One hundred tablets is such an overdose. Maybe you know what this drug is, but I am not prepared to name it here.

The person advised to use all hundred capsules (I opened them and combined the powder), mixed with yoghurt, and to eat this mixture. Then consume all the Mexican juice. In the end, this is what occurred (my father drank the Mexican juice without any dilution). He took the mixture around 9:15 PM on a weeknight (not a Friday night), so that next day would be a normal business day rather than a weekend, in order that the doctor would be available and so forth.

The required result was achieved very quickly. My mother lay with him on the bed and he went to sleep within five minutes. I had left the bedroom as soon as he consumed the materials, after firstly of course saying goodbye, which I had also done before he had taken the substances. I went back to my own house about an hour later, after trying to comfort my mother. (My spouse had not attended that night, staying at home to care for our children.)

Before consuming the materials, my mother and I again asked my father whether he was SURE that he wanted to go ahead. He expressed no flicker of doubt.

My mother then slept the night in the spare bedroom of her house and raised the alarm next morning when she found him dead in the bed, saying simply that she found him this way when she woke at 7am. (She slept in a separate room since his return from hospital, or at least that was the story.)

Certainly she did go into the other bedroom that night, rather than lie next to him after he had gone. Their usual GP signed the death certificate. The GP said that my father had probably had another stroke or heart attack in his sleep. Funeral arrangements then proceeded normally, with cremation used.

My mother had a note my father had written in his own (shaky) handwriting ?luckily he was right handed so could still write. It included the date. My mother could have produced this note, in case of any suspicion, or if the doctor was unwilling to write out a death certificate. When that did not occur, she destroyed the note, after the cremation.

Had she been required to produce the note, she would have said that she found amongst his papers after his death. The note simply said that he had planned the whole thing himself, had no assistance from anyone else, and apologised for having taken his own life, but felt he had no prospect of improving significantly and was not prepared to accept the quality of life that lay before him. That way, we were told, it would be very hard for any prosecution to occur.

My mother never remarried, nor ever had another man friend either before or after my father's death. They had always owned everything jointly, so she had no monetary motive for wanting my father dead. She had absolutely NO motive at all. My parents had the perfect marriage. I believe my mother acted out of love, to shorten my father's suffering, although for her to lose him was something she never fully got over.

My mother, my spouse and I all felt at the time that the situation was ridiculous. We are law-abiding people, and sought to assist a loved one in his hour of ultimate need. Yet we could all have been gaoled for our involvement, well perhaps not my spouse, who was not actively involved on the night, but certainly my mother and myself were actively involved.

I will now go into the circumstances of my mother's death. This occurred in the last 12 months. My mother had been ill for many years with a degenerative disease. It was not cancer or any other strictly terminal illness. Over the past five years, she deteriorated quite markedly each year. In 2004, she became worse to the point where she started having trouble caring for herself at home (she lived alone, within 5 km of my house).

A few months before her death, she had a worsening of her condition, which required hospitalisation. She was in hospital for many weeks. When she came home, she was just barely able to cope, she had a lot of help come in, my spouse and I also stepped up our involvement, which had already been increasing over the past few years as she deteriorated.

She had quite a deal of pain, but pain was not the primary thing that caused my mother to decide that the time was now right for VE. She had talked about it for many years, saying that she knew that in the end she would decline to the point where her quality of life and future prospects were such that she would not wish to go on.

As with my father, we sought options. We offered for her to come and live with us, we offered for her to get a full-time nurse or live-in carer, we offered for her to go into an assisted retirement village. However she rejected all these, and abhorred the idea of a nursing home. As she said, she was barely able to move around in her house at home, because she felt so sick. What quality of life is there in that, she said? (As with my father, my mother, who was nearly 80 when she died, was absolutely mentally alert.)

Her recuperative powers were really terrible, worse than my father's. She had been very slow to respond whenever she had been hospitalised with this illness (many times over the past decade particularly). This was in comparison to other patients, her specialist said. Unfortunately my mother had never been physically active (she had led a very sedentary life), and I think this really limited her body's ability to bounce back.

Also, during the past year, she had a trans-ischemic attack (known in the medical world as a TIA), and whilst it does not generally do permanent damage as a full-blown stroke does, it is a warning sign that a full-blown stroke is possible.

My mother was terrified of a big stroke, which would leave her incapacitated, as it did my father. There was a little permanent damage in her case, as her handwriting became very bad and she had some difficult thinking of the correct word to use sometimes. This had not been a trait of hers beforehand. However, she remained rational and clear-headed. In short, she was definitely compos-mentis.

For someone wanting VE, there is a fine line to tread to know when the time is right. If you get too sick (for example, have a stroke and are hospitalised), then you lose control, as VE is virtually impossible whilst you are an inpatient. Certainly, relatives assisting would risk prosecution, as it is hard to set up the kind of scenario that you can at home. My mother was well aware of this.

So, in spite of many conversations about her future, she also seemed set on the idea of VE. She had wanted to travel to Mexico for some years, but had not been well enough. She went interstate four years ago, only just making it, through fatigue and generally being unwell, and frankly she could not in the last two years have even contemplated a trip on the local bus, let alone travelling overseas.

I had offered to go in her place and obtain it, but she would not consider it on the grounds that I may be picked up upon re-entry to Australia.

My mother had obtained a lot of the sleeping drug mentioned above through visits to various doctors. She planned to use that, but was very concerned that whilst it is effective, death generally takes about six hours. She did not want to die alone, and wanted someone (and there seemed no-one else except me who could do this, as only myself and my spouse knew her plans) to stay until she was definitely deceased, but could not see how this was possible. It seemed that the best time to use VE is about 9PM, when there is little chance of friends telephoning, and also it allows a good amount of time before the person is unexpectedly found dead in their bed the next day.
That makes it harder for the doctor to determine the time of death.

My mother had the quite unfounded fear, in my view, that she might wake up vomiting after taking the sleeping tablets and choke on her own vomit, or else the tablets might bring on a stroke rather than death, and without someone else present, she could be in trouble. She was adamant that she wanted someone in the house from the time of ingestion until death, so that any unforeseen possibility such as this would not arise. Nevertheless, she was a sick elderly woman; I did not want to argue with her that this was terribly unlikely. I also understood that she would want someone present, it is a hard enough thing to do, and doing it by yourself would, for many people, make it more difficult.

So this left us with the difficult scenario that I would have to stay at her house until around 4AM to wait and confirm that the drug had done its job.
This would be bad, as if I was seen leaving her house at such an odd time I could be implicated. Also, my car could have been seen outside her house during the night by a neighbour, again raising suspicion. Also my children would find it odd that I had not been in our house that previous night, even when they went to bed, which is usually not until 11PM or so. That would also probably draw attention the next day, after she was found dead.

Luckily, my mother had a contact who, when told of the problem, was prepared to supply one bottle of the Mexican juice to my mother. This was an incredibly kind thing to have done, as I suspect the bottle may have been the one that the donor had stored for himself or herself, for future use.
(This donor is healthy and does not need VE in the foreseeable future, but like other healthy people - myself included - likes to know that it is there and available, in case of unexpected illness.)

That is what happened, the donor supplied the Mexican juice, and no money changed hands - the donor absolutely refused any compensation for the cost of the bottle or for the cost of getting a replacement. A donation was given to a charity in lieu of any money changing hands, and the donor agreed to that.

So my mother just used the Mexican juice. She had read that it is totally effective just by itself. It is indeed incredibly effective, and it worked as I described above with my father.

On the chosen night, I went to my mother's place as usual about 7PM (I had been in the habit of doing that since her illness). We opened the bottle very carefully. It was exactly the bottle I saw you flush down the toilet in Mexico on the TV programme. It had a little round metal seal, then the rubber cap. The rubber cap is very difficult to remove, as it is not designed for that, it is designed to be pierced by a hypodermic syringe. I had to struggle for quite some time with a small pair of manicure scissors to cut it, and even then some fragments of the rubber cap fell into the Mexican juice.

A sick person may have considerable trouble opening that bottle, you might want to be aware of that, although I suppose you know, from having opened it in Mexico.

I strained the Mexican juice through a tea strainer to remove most of the rubber pieces from it. We then diluted it 3 parts Mexican juice to 1 part Blackberry juice concentrate, to make it more palatable, added two teaspoons of sugar, and stirred. It was now in an ordinary kitchen tumbler, ready to drink. My mother tasted it, and said that it was drinkable (not too bitter). All this time I had also had an oven pan underneath the liquid when it was in the bottle then the drinking glass. (In case of spillage, the Mexican juice would be retrievable from the pan.)

So we went to the bedroom, where she got into bed. We said our final goodbye and she drank the entire contents of the glass. She was careful to handle the glass well after I gave it to her, so that her fingerprints would be well and truly on the glass after mine had been. SHE then put the glass in the bottom drawer of her bedside cabinet, and I did not touch it again.
I spoke to her about my love for her and my satisfaction with my life, and after a few minutes she lost consciousness, her speech slurring a little in the last few seconds before her eyes shut. It was very gentle.

The next morning she was found by the helper that came each day to assist her (the helper had a key to let herself in). The helper rang me, which was good, because I was, after feigning shock and surprise, able to tell her to ring my mother's usual GP and not the ambulance. The GP came, arriving at my mother's house before I did. By the time I arrived, the death certificate was already almost completed. He said she had suffered a heart attack in her sleep during the night. That was listed as the cause of death. With a death certificate, I was able to ring a funeral director and have the arrangements proceed as normal. There was never any hint of a problem here, nobody in the slightest suspected what had happened.

My mother had written a note in her own handwriting, which I was careful not to touch. (After her death, I realise she made the mistake of not dating it. I still have it, from the handwriting it can be seen that it written in her final two months - after her mini-stroke. When I go public with this story in some year's time, as I plan to do, I will have the note as supporting evidence.)

The plan was that in case of any suspicion, specifically refusal by the doctor to sign a death certificate, I could, some days later, claim that I had found the note amongst my mother's papers. It stated that she had gone down the VE path of her own accord and with no knowledge or involvement of anyone else.

That's why it was important for her to leave the glass in her bedside cabinet - it stayed there whilst the doctor attended to her and whilst the undertakers came for her - in fact it stayed there until after the cremation. Then I finally retrieved it and threw it out.

We were advised to leave a scenario that would be plausible in the case where an investigation did take place. That's why the Mexican bottle was simply disposed of in the kitchen bin, sure, it could have been found there in case of investigation, but it would be consistent with my mother putting it there. It could be reasoned that, alone, she opened the bottle, poured the contents into a glass, went into her bedroom and drank it, leaving the glass in her bedside cabinet.

No attempt should be made to wash the bottle for instance, or get rid of it, as that would imply outside help, we were told. Also, the person assisting should use no gloves. (It is possible to detect this during an
investigation.)

The overriding approach should be not to do anything that would not be normal. It would not be normal for someone to wear gloves in the house, so don't. It would not be normal for a person about to die to wash up a bottle, so don't. And so on.

Another tip is that when the person is found dead, you should call the usual doctor, not the ambulance. We made that mistake with my father. When the ambulance staff realised he was dead and not able to be resuscitated, they called the police. The ambulance staff then stayed until the police arrived. The police were then present until the doctor had signed the death certificate. Then only left then. It was an unnecessary and unpleasant complication.

Also, the doctor should have seen the person recently, as in that case they are more able to write out a death certificate immediately. In reduces the chance of an autopsy. A thorough autopsy can reveal the presence of Mexican juice. Both my mother and father ensured that they had a consultation with the GP very shortly before the appointed date they had chosen.

I realise that you personally may wish to not proceed in this covert way, because you prefer the role of a VE activist, but my mother wanted it the secret way. She felt that there was a societal stigma. She thought this stigma wrong, as she was not ashamed of her use of VE, but still wanted it this way, mainly, I think, to protect me. She also told me that she did not want her still young grandchildren to know that she had done this, mainly because it is against the law, and she thought they may not understand. When they are adults, my spouse and I plan to tell them about both their grandparents.

Anti-VE people who read this article may accuse me of matricide because I stood to gain financially from her death. She was not a multi-millionaire but was reasonably comfortably financially. It is true that I was a major recipient of her assets under her will.

All I can say to that is that I was already a fairly wealthy person, and the inheritance of my mother's estate has not altered my way of life. I still live in the same house, work in the same office, catch the same public transport to work, and have not been (nor do I plan) any overseas travel.
I've not bought any boats, fast cars or other consumer items since her death.

The proceeds of my mother's estate are in fact invested, with a view to giving my children a start when they become young adults. And that was always going to happen, whether my mother died now or in five or ten year's time (given her condition she had no plausible chance of living longer, as research on the web regarding her condition, and her specialist's opinion, will confirm). So there was no tangible overall benefit in her leaving us sooner rather than later.

The other point is that those who assist in VE are usually close relatives, so it is a no-win situation, as they can usually be accused of attempting to coerce the person into VE because of thoughts of the will.

However I know that I have a clear conscience in this regard. Both my parents absolutely and implacably wanted VE, and I was grieved to lose them.
I regarded it as an act of love that I could assist them in this final wish, after all they had done for me. I think the same is true for the vast majority of other people. In my view, very few people would want their parents dead prematurely.

If I were in your position, where your family appears to not be in agreement with your planned use of VE, I would check myself into a motel and do it there by myself. I do not think there is any chance of failure with the Mexican juice. That way, you can leave an open note, and your family does not need to be involved in the practicalities. It will only require a family member to identify you when your remains arrive at the mortuary.

There is a mountain of religious people who oppose you, please do not underestimate that. I believe that they are still very firmly in the minority of the general public. Although you and I fiercely disagree with these opponents, they are not stupid, and they certainly know how to mobilise themselves and campaign loud and hard for the outcome they want.
Their tactics is the most successful political tactic down the centuries:
the scare campaign. Works every time!

Also, be aware that putting material like this up on the web could lead to an opponent seeking to infiltrate the VE network and then blow the whistle.
But I still think that this material should go up and be made public, as people have a right to know you can use VE underneath the law and succeed, and also not leave a legal problem for your loved ones after you have gone.

Although you and I and most other people support VE, the opponents are very well organised and can mount a very loud campaign whenever the chance of legalisation arises. I do not think the law will be changed in my lifetime.

My approach, when my time comes, is to simply act in the way my mother did.
However I plan to get the Mexican juice myself (and for my spouse) well ahead of when I need it. Luckily, I have a way of getting it here in Australia, due to my line of work. I cannot be more specific. Maybe when I am older I will become a vocal advocate.

I think Dr Syme is the best spokesman the movement has, as he is articulate, measured in what he says, very intelligent, and only talks about the issue - he does not attack his opponent with personal abuse or trite cheap shots, as many of the anti-VE people do.

Best Wishes, and I think you are a remarkably strong woman for taking the stance you do.

http://www.france24.com/france24Public/en/administration/afp-news.html?id=070307194358.igv2iibr&cat=null

AFP News brief
French doctors in call for legal euthanasia

Some 2,000 French doctors and nurses issued a joint call for euthanasia to be legalised in the country, arguing that mercy killings are already widely practiced by the French medical profession, in a text to be printed Thursday.

In the manifesto, to appear in the Nouvel Observateur weekly, all claim to have helped patients to "die with dignity" in the past, using drugs to alleviate their suffering and precipitate death.

"Because, without a doubt, illness was defeating therapy, because despite suitable care, physical and psychological suffering were making the patient's life unbearable, because the patient wanted to end his life, we carers, in full conscience, have medically helped
patients to die with dignity," they write.

"The majority of those who care regularly for patients up until death, use -- in the circumstances cited above -- chemical substances to precipitate an end that has become too cruel, in full knowledge they are breaking the law."

The manifesto comes days ahead of the trial of a French doctor and nurse, accused of deliberately causing the death of a woman suffering from terminal cancer in 2003.

It calls for charges against the pair to be immediately dropped and for the law criminalising euthanasia to be revised as soon as possible.

French legislation adopted in 2005 made it possible not to artificially prolong the life of a terminally-ill patient who asks to stop treatment, as well as administer pain relief drugs that may accelerate the patient's death.

The text was adopted in response to the high-profile trial of a Frenchwoman who helped her quadriplegic son -- left blind, mute and paralysed by a car crash -- to die in 2003. Both she and her doctor were acquitted in the case.

Wednesday 31 January 2007
In search of a ‘good death’
More people may support the 'right to die', but they often change their views when their own time comes.
Kevin Yuill

This week spiked is running a series of articles on the changing nature of Britain, as captured in the new British Social Attitudes report published last week. Here, Kevin Yuill interrogates the claims that more people support euthanasia.

The website of the UK group Dignity in Dying, formerly the Voluntary Euthanasia Society, currently has a photograph showing a smiling bunch of people holding placards saying ‘82 per cent’ – signifying the fact that 82 per cent of the British public support calls for more liberalised assisted suicide laws.

If the new British Social Attitudes Survey, published last week, is accurate, those in the picture will still be smiling. The survey shows that, despite the setbacks over the Assisted Dying Bill in the UK House of Lords and the stalling of campaigns for assisted suicide in the United States, Australia and elsewhere, 80 per cent of people in Britain say that the law should ‘definitely’ or ‘probably’ allow a doctor to end someone’s life at the person’s request if they have an incurable and painful terminal disease.

[Dignity in Dying - 82 per cent] (a photo not reproduced here pictured a group of pro choice individuals)

The figures bear further inspection, though. Things aren’t quite so clear-cut as some of the headlines – such as ‘Four out of five want to give doctors the right to end life of terminally ill patients’ – suggest. Only 60 per cent say the law should allow a doctor to assist a patient to commit suicide. This is significant because this scenario is precisely what the Assisted Dying Bill, which will shortly be introduced to parliament yet again, is proposing. Less than half support it for those with incurable and painful diseases from which they will not die, or for those completely dependent on others for all their needs (but not in danger of death).

The methodology of the survey, though only the highlights are currently available, appears questionable. There are apparently five imaginary ‘scenarios’ through which the survey sums up support for a change in the law. The nature of the exercise is instructive, because, as we shall see, the issue of assisted suicide is largely imaginary.

However, the exercise may also lead to inaccuracies. Whereas we might support a doctor’s action in relation to an individual in one of the given ‘scenarios’, it does not follow that we would support a change in the law. Though most would support the action of a soldier on the battlefield shooting a comrade who was dying hideously and painfully in order to end his pain, it would be ridiculous to legislate for such a rare event.

There is an old and honourable tradition within British law of looking the other way in certain circumstances. Doctors, for example, have long helped to ‘speed along’ the death of a terminally ill and hopeless patient without needing the law to sanction or oversee it. Family members and friends have accepted this in their own ‘scenarios’, but that doesn’t necessarily mean they would support a law to determine when, where and how such end-of-life intervention can occur. There is a difference between supporting the actions of a doctor in certain scenarios and supporting the encroachment of legalistic rules and regulations into these areas of life and death.

The survey shows that support for euthanasia is weakest amongst people who regularly attend a religious service. People who attend a religious service once a week or more supported euthanasia in an average of 1.4 out of five scenarios, where those who never or practically never attend a religious service supported euthanasia in an average of 2.8 of the five scenarios. Those who state that they believe in the ‘sanctity of life’ (those opposed to abortion, suicide and the death penalty) are also more likely to be opposed to euthanasia. So those who agree strongly that ‘suicide is never justified’ supported euthanasia in 1.9 out of five scenarios, while those who disagree strongly that ‘suicide is never justified’ supported euthanasia in 3.3 out of five scenarios.

The link between religion and attitudes to assisted dying is perhaps the most interesting aspect of the survey. It implies that the only bastion against a change in the law is religious sentiment. But why do those apparently bereft of religion have a more liberal attitude towards euthanasia and assisted suicide, and, according to the survey, to suicide in general? Why should it be the case that those who do not adhere to traditional religious beliefs are more willing to support the ending of human life in certain circumstances?

Those with religious sentiments generally believe there is some sort of rhyme and reason to the world, some sort of meaning that makes them more comfortable with accepting their fates. When a situation over which the individual has no control arises, they reason that ‘it is in God’s hands now’.

Those who do not attend church are not, however, necessarily irreligious. Suspicious as they have become about many secular forms of authority, including priests and doctors, they are also suspicious of God and any plan He may have. Rather than rejecting God, though, and moving to an understanding of their existence within a world of men and women, they often simply feel abandoned by God. Many seek to replicate the religious promise of eternal life by making permanent their independence, their control and their ability to decide their own fate. To many, helplessness would represent the end of their own selves.

This is why such a discrepancy exists between those who would like to have the option of suicide at the end and those who actually take up this option. In Oregon, where it is legal for physicians to prescribe deadly medicines to those suffering from a terminal illness, only a handful – less than one per cent – of those who request information about how to end their own lives actually goes through with the act. Assisted suicide, it seems, is primarily an issue in the imagination of those for whom dying is a far-off prospect – they support euthanasia in certain ‘scenarios’ raised by survey compilers, and some of them support a change in the law, because they imagine a scenario in their own futures where they might be dependent and helpless. That support for euthanasia appears stronger amongst young people and the able-bodied seems to suggest that it is motivated by fearful imaginings more than by cast-iron support for doctor-administered death. This can be seen as a kind of faux religion, with its longing for a ‘good death’.

Outside of these groups, assisted suicide tends to be resisted by the old, by those involved in the hospice movement, and by doctors. Perhaps that is because experience of dying brings home the social nature of human life, that we live through the beneficence of others both past and present.

Kevin Yuill is lecturer in American studies at the University of Sunderland. He is the author of Richard Nixon and the Rise of Affirmative Action is published by Rowman & Littlefield. Buy this book from Amazon(UK) or Amazon(USA).

reprinted from: http://www.spiked-online.com/index.php?/site/article/2796/

(the flickering light at the end of a very dark tunnel by well be Cardinal Carlo Maria Martini who has broken ranks within the Catholic Church's Holiest of the Holy Vatican. I recommend him for his courage.....But is he alone? or will there be others prepared to face the reality of the twenty first century and its technologically mine field where the dead keep right on "living".

2007-01-22 From: The Guardian, UK
Vatican divided as cardinal says patients should have right to die
http://www.guardian.co.uk/religion/Story/0,,1996307,00.html

Tom Kington in Rome
Monday January 22, 2007
Guardian Unlimited

The front page of a mourner's newspaper reads 'excommunicated'
following the death in December of Piergiorgio Welby.
Photograph: Filippo Monteforte/AFP/Getty Images

The Vatican's rigid opposition to euthanasia has come under fire from within its own ranks after it denied a religious funeral to a paralysed man who had asked to be removed from a life-saving respirator.

Cardinal Carlo Maria Martini, the influential former archbishop of Milan, said yesterday that terminally ill patients should be given the right to refuse treatments and that the doctors who assist them should be protected by law.

On December 20 a doctor in Rome unplugged the respirator which for many years had kept alive Piergiorgio Welby, who had muscular dystrophy.

Although the Vatican has agreed that protracted treatments for the terminally ill can be ended by doctors if no cure is possible, the Vicariate of Rome denied Welby's family permission to hold a Catholic funeral, claiming Welby's "desire to end his life, expressed frequently and publicly, is contrary to Catholic doctrine".

In an article published yesterday in the Italian daily Il Sole 24 Ore, Cardinal Martini, 79, said cases like Welby's were likely to multiply, and that the church "should pay closer attention to the issues".

Cardinal Martini, who suffers from Parkinson's Disease, called for Italy to follow France's example and introduce legislation allowing patients to request the ending of treatments.

Cardinal Martini said he opposed active euthanasia, where a patient requests a fatal injection, but also opposed "unreasonably obstinate" treatments that keep the terminally ill alive.

"Avoiding drawn-out therapy need not mean looking for death, but accepting that you cannot stop it," he said.

An Italian court decided in December that Welby had the right to refuse therapy, but he could not exercise it because there was no law explicitly permitting it. The doctor who unplugged his respirator, Marco Riccio, is under investigation by Italian medical authorities.

The case divided Italian politics, with government coalition parties such as the Radical Party defending Dr Riccio's action and Luca Volonte, from the conservative Christian Democrat Union, calling it "murder".

The row came as the Italian parliament was set to debate a bill for living wills which would allow people to specify treatment preferences in the case of an incapacitating illness.

The Pope appeared to refer to the Welby case in a Christmas Day speech when he said: "What are we to think of those who choose death in the belief that they are celebrating life?"