Monday, July 28, 2014

Wesley J. Smith

This is the inescapable logic of euthanasia: It is much more expensive to care for ill and disabled patients than “compassionately” kill them. As I like to say, it may take $1000 for assisted suicide but $100,000 to provide the care that helps the patient not want end to their lives.

above quote from Wesley J. Smith, Washington, D.C.

DNRs also save money if doctors can convince patients and families that the patient has no quality of life.  It has nothing to do with qualilty of life; it has everything to do with saving health money and spending it on those more worthy: the young, the beautiful, the well educated.  If you are a bum or if you are elderly you are not necessary. Most physicians only want good patients to administer to.

Most patients do not require big dollars care before they die, I remember reading a Canada estimate is $30,000.  

A DNR is you refusing treatment. If someone said to me to do you want a DNR or do you want to live six months longer, I would of course say I want to live six months longer. I want treatment.  DNRs are being pushed on people with pneumonias not only terminal cancer patients like how they were first intended.  Now if you do not have a DNR there is something wrong with you and you do not belong to our disposal society and you are the willing disposee.

Dutch Ethicist: “Assisted Suicide: Don’t Go There”

Theo Boer
This is the original article that was written for the British media.
The Daily Mail published this instead and EPC published this.

By Professor Theo Boer
Authorized version, July 16, 2014

In 2001 The Netherlands was the first country in the world to legalize euthanasia and, along with it, assisted suicide. Various safeguards were put in place to show who should qualify and doctors acting in accordance with these safeguards would not be prosecuted. Because each case is unique, five regional review committees were installed to assess every case and to decide whether it complied with the law. For five years after the law became effective, such physician-induced deaths remained level - and even fell in some years. In 2007 I wrote that ‘there doesn’t need to be a slippery slope when it comes to euthanasia. A good euthanasia law, in combination with the euthanasia review procedure, provides the warrants for a stable and relatively low number of euthanasia.’ Most of my colleagues drew the same conclusion.

But we were wrong - terribly wrong, in fact. In hindsight, the stabilization in the numbers was just a temporary pause. Beginning in 2008, the numbers of these deaths show an increase of 15% annually, year after year. The annual report of the committees for 2012 recorded 4,188 cases in 2012 (compared with 1,882 in 2002). 2013 saw a continuation of this trend and I expect the 6,000 line to be crossed this year or the next. Euthanasia is on the way to become a ‘default’ mode of dying for cancer patients.

Alongside this escalation other developments have taken place. Under the name ‘End of Life Clinic,’ the Dutch Right to Die Society NVVE founded a network of travelling euthanizing doctors. Whereas the law presupposes (but does not require) an established doctor-patient relationship, in which death might be the end of a period of treatment and interaction, doctors of the End of Life Clinic have only two options: administer life-ending drugs or sending the patient away. On average, these physicians see a patient three times before administering drugs to end their life. Hundreds of cases were conducted by the End of Life Clinic. The NVVE shows no signs of being satisfied even with these developments. They will not rest until a lethal pill is made available to anyone over 70 years who wishes to die. Some slopes truly are slippery.

Other developments include a shift in the type of patients who receive these treatments. Whereas in the first years after 2002 hardly any patients with psychiatric illnesses or dementia appear in reports, these numbers are now sharply on the rise. Cases have been reported in which a large part of the suffering of those given euthanasia or assisted suicide consisted in being aged, lonely or bereaved. Some of these patients could have lived for years or decades.
Whereas the law sees assisted suicide and euthanasia as an exception, public opinion is shifting towards considering them rights, with corresponding duties on doctors to act. A law that is now in the making obliges doctors who refuse to administer euthanasia to refer their patients to a ‘willing’ colleague. Pressure on doctors to conform to patients’ (or in some cases relatives’) wishes can be intense. Pressure from relatives, in combination with a patient’s concern for the wellbeing of his beloved, is in some cases an important factor behind a euthanasia request. Not even the Review Committees, despite hard and conscientious work, have been able to halt these developments.

I used to be a supporter of legislation. But now, with twelve years of experience, I take a different view. At the very least, wait for an honest and intellectually satisfying analysis of the reasons behind the explosive increase in the numbers. Is it because the law should have had better safeguards? Or is it because the mere existence of such a law is an invitation to see assisted suicide and euthanasia as a normality instead of a last resort? Before those questions are answered, don’t go there. Once the genie is out of the bottle, it is not likely to ever go back in again.

Theo Boer is a professor of ethics at the Protestant Theological University at Groningen. For nine years he has been a Member of a euthanasia Regional Review Committee. The Dutch Government has five such committees that assess whether a euthanasia case was conducted in accordance with the law. The views expressed here represent his views as a professional ethicist, and not of any institution.

Links to important articles:
Netherlands 2012 euthanasia statistics

Blind woman dies by euthanasia in the Netherlands.
Some Dutch pharmacists refuse to fill prescriptions for euthanasia
Mobile euthanasia deaths begins in the Netherlands.

Friday, July 25, 2014


I woke up this morning vomitoid thinking how Vancouver Coastal Health decided that it was going to make sure that I never visit Randy again.  What cruelty they imposed on Randy. 

Recently I received a newletter in which Norman Kunc who has represented the disabled in the BC media say:

I've seen far too many unrequested do not resuscitate orders placed on my friends and colleagues.

So this illegal practice is common and no one is doing anything about it least of all the College of Physicians and Surgeons.

In Randy's case they never had to restart his heart; only give him assist in breathing. And if he wasn't full code, he would have died years ago.

I asked the CPS for direction to where the legislation says it is legal for doctors to place DNRs on patients without the permission of a patient who would surely die without further medical intervention and the CPS so far as been mute on that point.

Tuesday, July 22, 2014

Assisted Suicide is a Slippery Slope

Ten Reasons Why the UK Should Not Legalize Assisted Suicide

by Dr. Peter Saunders | London, England | | 7/18/14 6:10 PM
Lord Falconer’s Assisted Dying Bill, due for a second reading in the House of Lords on 18 July, is purportedly based on the US state of Oregon’s Death with Dignity Act (DWDA).
Dignity in Dying, the former Voluntary Euthanasia Society, who are backing Falconer, claim that everything is wonderful in Oregon. But is that really true?
In fact, far from being reassuring, the Oregon experience sounds a loud warning to the UK not to follow suit.
October 1997, Oregon enacted the DWDA which allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal drugs, expressly prescribed by a physician for that purpose.
The Oregon DWDA also requires the Oregon Health Authority to collect information about the patients and physicians who participate in the Act, and publish an annual statistical report.
These annual reports are all available on the Oregon government website and there is plenty of other relevant information in the public domain to draw on.
In order to qualify under the Oregon Act, a patient must be an Oregon resident, 18 years of age or older, capable of making and communicating health care decisions for him/herself and have been diagnosed with a terminal illness that will lead to death within six months.
It is up to the attending physician to determine whether these criteria have been met.
A similar law came into effect in the neighbouring state of Washington in 2009. Annual reports can be accessed here.
So what can we learn about the Oregon/Washington model? Here are ten disturbing facts:
1. There has been a steady increase in annual numbers of people undergoing assisted suicide in Oregon
In 1998 there were 24 prescriptions written and 16 assisted suicide deaths. By 2012 these numbers had risen to 116 and 85 respectively. This is a 380% increase in prescriptions and a 430% increase in assisted suicide deaths in 15 years. The number of assisted suicide deaths in Washington State, increased by at least 43% in 2013.
How would this translate to the UK? There were 56.6 million people in England and Wales in 2012 but only 3.9 million in Oregon. So 85 assisted suicide deaths in a year in Oregon would equate to 1,232 in England and Wales (14 times that of Oregon).
2. The Oregon health department is funding assisted suicide but not treatment for some cancer patients
Barbara Wagner had recurrent lung cancer and Randy Stroup had prostate cancer. Both were on Medicaid, the state’s health insurance plan for the poor that, like some NHS services, is rationed. The state denied both treatment, but told them it would pay for their assisted suicide! ‘It dropped my chin to the floor,’ Stroup told the media. ‘[How could they] not pay for medication that would help my life, and yet offer to pay to end my life?’ (Wagner eventually received free medication from the drug manufacturer. She has since died. The denial of chemotherapy to Stroup was reversed on appeal after his story hit the media.)
Despite Wagner and Stroup’s cases, advocates continue to insist that Oregon proves assisted suicide can be legalised with no abuses. But the more one learns about the actual experience, the shakier such assurances become.
If AS were to be legalised in the UK end-of-life care would be likely to worsen under financial pressures because it costs on average £3000 to £4000 a week to provide in-patient hospice care, but just a one-off cost of £5 to pay for the drugs which would help them commit suicide. Cancer treatments like chemotherapy, radiotherapy or surgery cost much more. Do we really wish to place that temptation before families, NHS managers and Health Secretaries in cash-strapped Britain?
3. Patients are living for many years after having been prescribed lethal drugs for ‘terminal illness’ showing that the eligibility criteria are being stretched
The Oregon and Washington laws, like Falconer’s proposed law, have ‘six months to live’ criteria. But doctors’ estimates of lifespans can be wildly out. Consider Oregon resident, Jeanette Hall, who was diagnosed with cancer and decided to ‘do’ Oregon’s law. Her doctor, Kenneth Stevens, didn’t believe in assisted suicide and encouraged her to be treated instead. It is now 14 years later and she is ‘thrilled’ to be alive. This is Dr Steven’s affidavit filed by the Canadian government in Leblanc v. Canada, now dismissed, discussing Jeanette. This is Jeanette’s affidavit, also filed by the Canadian government in the same case.
The Oregon statistics record patients killing themselves up to 1,009 days after the first request for lethal drugs – almost three years – showing just how hard doctors are pushing the boundaries – and/or how bad they are at guessing lifespans.
4. The vast majority of those choosing to kill themselves are doing so for existential reasons rather than on the basis of real medical symptoms 
The main argument advanced for assisted suicide is unremitting pain. But the Oregon data show that those people citing ‘inadequate pain control or (even) concern about it’ constitute just 23.7% of cases overall. So what are the main reasons given for taking one’s life? In 2013 93% cited ‘loss of autonomy’, 89% said they were ‘less able to engage in activities making life enjoyable’ and 73% listed ‘loss of dignity’. These are not physical but existential symptoms.  But should lethal drugs be prescribed to people who feel their lives no longer have meaning and purpose?
The fact that almost a quarter of patients dying under the Act report inadequate pain control or concerns about pain also shows that palliative care provision in Oregon is unsatisfactory. But surely this is an argument for better care rather than AS.
5. Many people in Washington and Oregon give ‘fear of being a burden on others’ as a reason for ending their lives
I have frequently argued that any change in the law to allow assisted suicide or euthanasia would place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This would especially affect people who are disabled, elderly, sick or depressed and would be most acutely felt at a time of economic recession when many families are struggling to make ends meet.
This fear is again borne out by the American data. In Washington in 2013, 61% of people opting for assisted suicide give the fear of being a burden to family, relatives and caregivers as a key reason. 13% cited ‘financial implications of treatment’. In the same year in Oregon the equivalent figures were 49% and 6%.
6. Fewer than three per cent of patients are being referred for formal psychiatric or psychological evaluation
In an article for The Telegraph, former president of the Royal College of Psychiatrists Baroness Sheila Hollins has voiced concern that proposals to license doctors to supply lethal drugs to mentally competent, terminally ill patients fail to take account of the complex process involved in assessing a patient’s mental capacity. According to Baroness Hollins, assessing mental capacity ‘isn’t like checking the oil or water level in a car’ or ‘the sort of thing that can be done in a single consultation, especially if the decision in question – as it is in this case – is one with life-or-death consequences.’
Commenting on the US State of Oregon, where less than 3% of cases were referred for a formal psychiatric assessment in 2013 she writes: ‘Researchers have found that some patients who have ended their lives under the terms of Oregon’s assisted suicide law had been suffering from clinical depression. Depression impairs decision-making capacity, it is common in elderly people and it is treatable. But in some cases in Oregon it has not been diagnosed by the doctor who assessed the patient’s capacity and prescribed lethal drugs. Oregon’s law requires referral for psychiatric examination in cases of doubt but in some cases that has not happened.’
7. A substantial number of patients dying under the Oregon Act do not have terminal illnesses
In Oregon in 2013 16.9% of those killing themselves under the Act did not have cancer, heart disease, chronic lung disease or motor neurone disease but were classified as having ‘other illnesses’. What were these? A footnote in the annual report tells us that this ‘includes deaths due to benign and uncertain neoplasms, other respiratory diseases, diseases of the nervous system (including multiple sclerosis, Parkinson’s disease and Huntington’s disease), musculoskeletal and connective tissue diseases, viral hepatitis, diabetes mellitus, cerebrovascular disease, and alcoholic liver disease.’
Many of these conditions might be considered life-shortening but it beggars belief that all these cases were terminal (with less than six months to live). These are in the main chronic conditions, again falling outside the bounds of the Act.  And yet the doctors went ahead and signed the forms anyway – further evidence of how medical practitioners cannot be trusted to keep to the legal boundaries.
8. It is virtually certain that there is underreporting of assisted suicide cases in Oregon
The Lancet recently published a long awaited meta-analysis study which indicated that in 2010 in the Netherlands, 23% of all euthanasia deaths were not reported.  Could similar under-reporting be happening in Oregon? It is a virtual certainty.
Oregon officials in charge of formulating annual reports have conceded ‘there’s no way to know if additional deaths went unreported’ because Oregon DHS ‘has no regulatory authority or resources to ensure compliance with the law’.
The DHS has to rely on the word of doctors who prescribe the lethal drugs. Referring to physicians’ reports, the reporting division admitted: ‘For that matter the entire account [received from a prescribing doctor] could have been a cock-and bull story.  We assume, however, that physicians were their usual careful and accurate selves.’
So with an Oregon-type law like Falconer’s we can expect to see steadily increasing numbers of assisted suicide cases year on year in England and Wales, along with an unknown level of under-reporting.
9. Some doctors know the patient for less than a week before prescribing the lethal drugs
In order to assess whether a patient is being coerced or not, it surely must be necessary for the prescribing doctor to know them personally and understand their family situation. But in Oregon there were patients who knew their doctor for less than a week before he/she prescribed them the lethal drugs – further evidence of doctor shopping.
10. The presence of no independent witnesses in over 80% of cases is a recipe for elder abuse
In Oregon in 2013 there was no doctor or other healthcare professional present at the time of ingestion of the lethal drugs in 81% of cases. Also the duration of time that elapsed between the request for the drugs and the actual death ranged from 15 to 692 days with a median of 52 days.
During this time the drugs were kept at the patient’s home. But without an independent witness how can we be sure that the drugs were taken voluntarily and not administered forcefully or secretly by a relative with an interest financial or otherwise, in the patient’s death? If they struggled who would know? And any investigation into possible foul play would have to traverse the substantial hurdle of the key witness (the patient) being dead.
We know that in Britain, according to ‘Action on Elder Abuse’, there are half a million cases of elder abuse annually, many of which involve financial abuse by family members or close relatives. The Oregon law, and by implication Falconer’s proposed law, is a recipe for elder abuse of the very worst kind – killing for money.
The lessons from Oregon are clear. We should not go there. Keep Britain safe for vulnerable people. Note: Dr. Peter Saunders is a doctor and the CEO of Christian Medical Fellowship, a British organization with 4,500 doctors and 1,000 medical students as members. This article originally appeared on his blog. He is also associated with the Care Not Killing Alliance

Sunday, July 20, 2014

The Secret Language of Doctors

I have been reading Dr. Brian Goldman's 2014 book on doctors' slang and how it relates to the inner workings of hospitals.  It isn't much of a stretch to understand how doctors think...the medical culture...and what happened to Randy and me.

I was wanting to put the pleadings on the internet but Clark, Wilson said they would sue me. I do not understand how they can do that but I do not have money for a lawyer to defend me.  I still do not understand how Clark, Wilson allowed hearsay into the pleadings.  Lawyers are supposed to filter out such things before they are presented to the court.  But then with our trajectory towards star chamber justice (secret tribunals) maybe it is now acceptable.


Thursday, July 17, 2014

Thank you for the cards.

I want to thank all of you who sent me sympathy cards after Randy's death.  Each one of them were expensive cards with thoughtful comments.  They are still a comforting memory of Randy as I view them and reread the comments ... thank you.

I just got another card in the mail. You have no idea what a simple card means in these times of grieving.

VCH knew Ramdy was dying and yet they attempted to put a 100% ban on me visiting him based on consultants who would do anything to stay in the good reimbrusement guarantees from VCH.  Neither of them spoke to me and yet they decided I was a danger.  Randy had no one with him from Janaury 2014 to April 13 2014 except for short periods of time.  The police won't even get involved as there was no evidence to the hearsay hate promoted by GPC. The GPC mob has to remain a mob otherwise I would be vindicated  and they would be fired for unprofessional conduct or worst yet get promoted en mass.  All you have to do is read the pleadings to see how bizarre they are.  Nothing else for these professionals to do except spend four years persecuting me and denying Randy his right to see me.  Name one concrete thing I did that would harm anyone.  Nothing. Each incident was precipitated by GPC.


Saturday, July 12, 2014

18 November 2013

Tomorrow will be the 13th of July 2014, the third anniversary of Randy's death in the ICU at VGH.  The only thing I am able to do is think abut what happened when Dr. Dunne and the staff of GPC arranged to have Randy boxed.  I was able to save him then (November 18 2013) but after I got 100%$ banned from GPC I couldn't save him any more. Not even the police could help.  No one.  I am vomitoid with the horror of it all.


Friday, July 11, 2014

Death by Dehydration

 Death by dehydration is also happening in Canada.

 The Sad Fate of Casey Kasem: Death by Dehydration

by Bobby Schindler | Washington, DC | | 6/12/14 5:21 PM

A Los Angeles Superior Court Judge reversed his own ruling, permitting Casey Kasem’s daughter, Kerri Kasem, to remove her father’s food and hydration (via feeding tube), which will result in his death by starvation and dehydration. Kasem’s wife of 33 years, Jean Kasem, is fighting for the life of her husband, with her attorney, Steve Haney, calling the judge’s decision, “the functional equivalent of a death sentence.”
Growing up in the 70’s, I was introduced to Casey Kasem’s easy to recognize voice as each week he counted down “American Top 40″ hits for almost four decades on a radio show heard around the world. Kasem was also the voice of the character Shaggy on “Scooby-Doo” cartoons for 40 years.
caseykasum2According to reports, Kasem is stricken with dementia and Parkinson’s; typically, treatable conditions. Once Kasem begins the process of dying by having his food and water removed, he will endure a death that no family member should ever have to witness. It is cruel and barbaric and could take days, and often weeks to play itself out, torturing not only the patient, but those who love him as well.In stark contrast, St. John Paul II who also had Parkinson’s, was afforded a feeding tube as part of his end of life care, and subsequently died naturally.
I watched my own sister, Terri Schiavo, anguish through almost two weeks without food or water and there are no words that can properly describe the inhumanity. In her last days, we would not permit our mother to visit Terri, in an effort to spare her additional torment, as blood pooled in Terri’s eyes, and her skin and lips were terribly cracked because her tissues were lacking any moisture. Terri’s body turned different colors of blue and yellow and her breathing became so rapid, it was as if she was outside sprinting. I could go on.
Indeed, the disagreement between Kasem’s family also raises the issue of the dangers of health care initiatives. It places the interpretations into the hands of “quality of life” minded family members, healthcare professionals, hospital boards and ethics committees, not to mention some Judges who have no regard for the dignity of human life.
Make no mistake about it, countless conscious and unconscious persons die by deliberate starvation and dehydration every year. Typically, we only hear of the cases in which there is a family disagreement or in cases where there is a celebrity involved. And with an accepting culture, laws that permit this behavior, and a government controlling our health care system under the guise of “compliance”, this scenario will become more common and the pre-mature death of our medically vulnerable loved ones will increase significantly.
We live in a very troubled and an increasingly dangerous America. Our culture has lost sight of God’s supreme right over when life begins and when it ends, and has “turned on its head” the true meaning and value of suffering and compassion.Those of us who wish to defend life in all stages, especially for the most vulnerable, are demonized when we ask the obvious question: where is the humanity in deliberately denying someone’s most basic rights – food and water? Tragically, what was once considered barbaric has now become part of everyday life.

Thursday, July 10, 2014

The House of God

I just finished reading the classic novel of life and death in a American Hospital: The House of God, by Dr. Samuel Shem.  With over two million copies sold, The House of God, has been said to be the most important medical novels of the twentieth century. It was published in 1978.

It was written before DNRs and when doctors did everything to keep patients alive.  The most important reason for reading the book was I was looking for swear words used 40 years ago and they were all there.  These words are still being used now so they are not swear words; they are part of our everyday language.

The mindset of Vancouver Coastal Health is still in the 1950s.  All one has to do is go to an emergency room at VGH and listen to what patients and doctors are speaking.  So called swear words are used in everyday speak; they are nothing more than an expression in shorthand of fears/feelings/conclusions of patients.

SLURPERS: Doctors striving to lick their way up the academic medical cone towards the top.  (from House of God).  The reason why health professionals refuse to say anything negative publicly about their colleagues.

On Sunday July 13 2014 will be Randy's third month since he died at VGH.  I gave him a green burial.  It was a perfect funeral with good memories.  I laid bunches of carnations on his grave.  Carnations have a long life span (three weeks).  When I get some extra money, I will purchase the space next to him.  It is wonderful and peaceful under the trees among nature.    .

Tuesday, July 8, 2014

Randy's Stuff

I haven't been able to unpack Randy's belonging yet.  I just couldn't.  I was afraid that if any of his belongings were missing and I would become upset and I am tired of being upset.  GPC won't even let me on site to pick up his stuff.  A friend of my went there and she said that Randy's stuff was in garbage bags in a common area that anyone could rifle though.  I asked for an inventory but GPC refused to do one.  I know his memory foam pillow which I purchased for him went missing in December 2013 and his stand for his television was thrown out without notifying me.

I want to know why Karen Marshall, a security guard, put a choke hold on me when I was attempting to remove Randy lawfully from GPC: October 2013.  Paladin Security isn't suppose to touch anyone so why did she do this to me.  Practising her martial arts on an old lady.  I told the police I wanted her charged and the police did nothing. And there was Brad who stood at the entrance to the visitior's room when I was inside in a boxing stance with his fists up threatening to punch me if I attempted to leave the room.  Once you get labeled by VCH you are open season for abuse. Where do these people come from that encourage violence.


Saturday, July 5, 2014

I am so sorry, Randy.

I am so so very sorry Randy that I did not fight hard enough to keep you safe.  How could they do this to us in our counrty at the hands of our most educated physicians in the world. Every single time you were at VCH or St. Pauls I begged them not to send you back to GPC as it was not safe, and they did it anyways.They won't even investigate  GPC was not his home; it was purgatory from where there was no escape. How could they have allowed this to happen. He was suppose to have gone to GF Strong but at the last minutes they decided that he was never going to be a productive member of society so he was sent to GPC. Them deferring to a head nurse.  This is what this terrible terrible injustice came down to Tanu and her control freak management.  She even scared staff so that they would report things the way they knew that Tanu wanted.. She even scared off visitors that came to see Randy..  And management also would collude and back her up as well.  Her bullying forced every manager of GPC to quit but like all successful bullies she is still there dictating that she was able to ban me one hundred percent from GPC from my Randy in life as well as death and she can continue and no one can stop her..I am still angry over the fact that I was not notified of Randy's memorial service at GPC.  I wonder who went,  You would never think that a health facility would treat people like they do but they do. 

I am sorry Randy.  I am so sorry.

Wednesday, July 2, 2014

Forgive but Do Not Forget

Forgive But Do Not Forget.  I do not know what this means.  I was told to do this but I do not understand it.  How can you forgive a bunch of professional health care providers that put Randy and me through hell for four years with their over cautiousness as if I would harm someone.  What about them, them that are guilty of culpable homicides like the Timer "accidental' death.  Them putting on Randy two Do No Transfer Orders when he was in need of acute care so that he would die if he needed care more than what George Pearson Centre could offer.  What legal right have doctors to do this.

On two occasions I found Randy needing acute care and him having a do not transfer order on him and then what happens I get banned from seeing Randy for ninety days with management saying it will be extended forever..  They wanted Randy to die without me being with him as I might call 911 again.  Ro Ang the manager of George Pearson Centre said that all patients have a DNT on them.  I was shocked and still am as on November 18 and December 26, 2013 staff refused to send Randy to VGH because of these orders.  I had to force a call to 911. If Randy didn't go to VGH, he would have died a not good death at GPC.

It has been nine months since I contacted the College of Physicians and Surgeons to do something.  I haven't heard anything from them.  If I am to follow the advice of forgive then the college must be assuming that I am forgiving Dr. Dunne for his culpability.

Because of what Dr. Dunne did and when previously we asked that Dr. Dunne be removed as Randy's physician: this never happened.  Something about policy.  Once you have a physician in residential care you can't have him removed. You are forced into a deadly alliance.  Randy knew Dr. Dunne wanted to kill him but he couldn't do anything about it and neither could I.



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