‘Ex­is­ten­tial dis­tress’ said to lead peo­ple to as­sisted sui­cide


The rea­sons pa­tients want to end their lives has more to do with psy­cho­log­i­cal suf­fer­ing than phys­i­cal suf­fer­ing, a study based on in­for­ma­tion from the Uni­ver­sity Health Net­work in Toronto and pub­lished in the New Eng­land Jour­nal of Medicine has found.

The UHN study rep­re­sents all 74 peo­ple who in­quired about as­sis­tance in dy­ing from March 2016 to March 2017. Most were white and were di­ag­nosed with can­cer or a neu­ro­log­i­cal dis­or­der, such as amy­otrophic lat­eral sclero­sis (Lou Gehrig’s dis­ease).

Canada’s Med­i­cal As­sis­tance in Dy­ing law, or MAiD, al­lows for adults with se­ri­ous and in­cur­able dis­eases in an ad­vanced state to seek help end­ing their life. At the UHN, which op­er­ates four large hos­pi­tals in Toronto, pa­tients must go through sev­eral lev­els of eval­u­a­tions, and if they meet the cri­te­ria, they can go to the hospi­tal to re­ceive a lethal med­i­ca­tion in­tra­venously.

For many peo­ple, death from a ter­mi­nal ill­ness may be syn­ony­mous with pain. Much of the dis­cus­sion about as­sisted sui­cide fo­cuses on com­pas­sion­ate pal­lia­tive care for can­cer pa­tients and about suf­fer­ing that can’t be con­trolled by even the strong­est opi­oids. But that’s not what the peo­ple in the new study re­port.

“It’s what I call ex­is­ten­tial dis­tress,” said re­searcher Made­line Li, an as­so­ciate pro­fes­sor at the Uni­ver­sity of Toronto. “Their qual­ity of life is not what they want. They are mostly ed­u­cated and af­flu­ent — peo­ple who are used to be­ing suc­cess­ful and in con­trol of their lives, and it’s how they want their death to be.” Mar­i­juana ex­tract helps some kids with epilepsy, study says A medicine made from mar­i­juana cut down the num­ber of seizures in chil­dren with a se­vere form of epilepsy in a study that strength­ens the case for more re­search into pot’s pos­si­ble health ben­e­fits.

The study in­volved 120 chil­dren and teens in the U.S. and Europe and was the first rig­or­ous test of a liq­uid ex­tract from cannabis, with­out the in­gre­di­ent that makes pot smok­ers high.

For those on the drug, seizures with con­vul­sions dropped from around 12 a month to about six. The num­ber did not change for those given a placebo.

The drug is called Epid­i­olex. It is not sold any­where yet, but its maker is seek­ing U.S. Food and Drug Ad­min­is­tra­tion ap­proval.

The New Eng­land Jour­nal of Medicine pub­lished the study last week. Study finds that speed­ing up sep­sis care can save lives Min­utes mat­ter when it comes to treat­ing sep­sis, the killer con­di­tion that most peo­ple prob­a­bly have never heard of, and new re­search shows it’s time they learn.

Sep­sis is the body’s out-of-con­trol re­ac­tion to an in­fec­tion. By the time pa­tients re­al­ize they’re in trou­ble, their or­gans could be shut­ting down.

New York be­came the first state to re­quire that hos­pi­tals fol­low ag­gres­sive steps when they sus­pect sep­sis is brew­ing. Re­searchers ex­am­ined pa­tients treated there in the past two years and re­ported last week that faster care re­ally is bet­ter.

Ev­ery ad­di­tional hour it takes to give an­tibi­otics and per­form other key steps in­creases the odds of death by 4 per cent, ac­cord­ing to the study re­ported at an Amer­i­can Tho­racic So­ci­ety meet­ing and in the New Eng­land Jour­nal of Medicine.

That’s not just news for doc­tors or for other states con­sid­er­ing sim­i­lar rules. Pa­tients also have to reach the hospi­tal in time. Strapped UN health agency spends big on travel In­ter­nal doc­u­ments ob­tained by The As­so­ci­ated Press show that the World Health Or­ga­ni­za­tion rou­tinely spends about $200 mil­lion (U.S.) a year on travel — far more than what it doles out to fight some of the big­gest prob­lems in pub­lic health, in­clud­ing AIDS, tu­ber­cu­lo­sis and malaria.

As the cash-strapped UN health agency has pleaded for money to fund its re­sponses to health crises world­wide, it has also been strug­gling to get its own travel costs un­der con­trol.

On a re­cent trip to Guinea, WHO chief Dr. Mar­garet Chan stayed in the pres­i­den­tial suite at the Palm Ca­mayenne ho­tel. The suite has an ad­ver­tised price of 900 euros a night. WHO de­clined to say who picked up the tab, not­ing that her ho­tels are some­times paid for by the host coun­try.

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