Saturday, November 26, 2016

Affordable Housing

I just viewed a documentary about Hamburg.  It reminds me of Vancouver. Private land developers took over Hamburg causing a terrible affordability problem there as well.  It seems affordability is fueled by the knowledge that there is an affordability problem: those that can will borrow, beg and steal for down payments to buy properties before prices get worse thus creating a demand that inflates property values that cannot be reversed.  No government will do anything to lower the value of real estate.  It would be political suicide.

Think about this.  A friend of mine who earns $80,000 a year pays $1,000 a month for a suite in a house.  This low-level suite has two bedrooms and mirrors the upstairs in size.  He complains that his rent is too high.  He pays less than 10% of his income on rent; I pay 50% of my income on rent and my living space is 50% less than his.  Go figure.  Maybe my friend is an outlier.  But then how many outliers are there.  There is no way of knowing.

And remember Libby Davis.  Libby Davis lived in social housing while she was a federal member of parliament.  So much for the NDP and this fighter for social issues.  She could well afford to rent elsewhere and leave that unit open for those that truly needed low-income housing. 

Monday, November 21, 2016

Euthanasia might have been necessary fifty years ago

'I believed that euthanasia was the only humane solution. I no longer believe that.'

In 1969, when I was 15 years old, my adored 37-year-old single Auntie Nancy was diagnosed with very advanced, untreatable ovarian cancer. It was a dreadful time in our close extended family's life. She began to deteriorate quickly and to develop severe pain from the tumour masses in her abdomen. She asked to stay at home and to be allowed to die in peace surrounded by her loving family.
There were no visiting palliative care nursing teams then. There was no medical expertise in pain control. Doctors avoided using narcotics until the final hours for fear of addiction and that they would stop working if started too early. As my aunt began to deteriorate, an experienced private day nurse was engaged. My mother, in tandem with my other two aunts, would stay up every third night with my aunt, turning, toileting, massaging and comforting her. She was in agony and regularly cried out in pain. The doctor eventually prescribed a small dose of morphine to be strictly used every four hours. It had no effect.
My aunt slowly became emaciated and developed painful bed sores. The family increased their efforts. They would care for her till the end. Eventually, after months, she became so desperate that she pleaded to be killed. Please? Please? The visiting nurse, a courageous and compassionate woman, promised to help. She had a cache of unused morphine ampoules from previous patients for desperate situations. Unable to obtain appropriate orders from the doctor, she secretly gave them to my aunt. Finally she was freed of her suffering.
It took many years for my mother to tearfully tell me this very painful story. Her guilt, regret and sense of failure were profound. I was convinced that such mercy killing must be made more easily and widely available if it was true that no other treatment options existed.
But since then my views have changed. Thirteen years after my aunt died, I trained in the newly established speciality of medical oncology. I spent any spare time learning pain control and palliative care. I listened to the experts and to my patients.
I began to see newer emerging team-based palliative care treatment options for those like my aunt. Many more of our patients were now dying peacefully. I could see that euthanasia may not be the answer after all.
The advances in the skills, availability and knowledge in palliative care since those days have been phenomenal. The horror stories of doctors telling nurses to close the doors of the patients who were screaming out in pain were fast disappearing.
I have received many euthanasia requests from patients and families over my 34 years in full-time oncology practice, some very passionate, but I have invariably found that they quickly disappear as reassurance and adequate medication doses provide the comfort that is desired and the newly exposed opportunities for patients and families to share deep and poignant moments of bonding and reflection, or nurse a new-born grandchild, or attend a wedding or a graduation.
If a patient and their family needs help for a comfortable and peaceful death, doctors routinely increase the dose of medications, even if the patient dies sooner as a result. As long as the primary goal of this treatment is the relief of suffering and not to cause death, this is permitted.
This "law of double effect" is a legal grey area that allows doctors to provide optimal care short of primarily trying to kill the patient. Some would call it passive euthanasia. Perhaps it is. However, as a secular humanist, it is a subtle but huge difference that allows me to relieve suffering, to share some of the most profound human experiences possible and to sleep comfortably at night.
As an oncologist with 35 years' full-time experience, I have seen palliative care reach the point where the terminally ill can die with equal or more dignity than euthanasia will provide. It is now very effective and increasingly available for two of the three possible ways of dying, outside of sudden unexpected death, which are advanced cancer and chronic relapsing and remitting organ-specific disease such as heart or lung failure.
Palliative care is also available for people with chronic progressive cognitive diseases such as dementia. This is the fourth way of dying and perhaps the most feared of all.
Euthanasia is unlikely to become available for people in such circumstances because their condition prevents truly informed consent.
Only a fully informed detailed advanced care plan done before any decline, where one can prohibit life-saving interventions such as antibiotics and intravenous fluids if certain conditions are met, can easily and safely produce the smooth outcome that many would desire if combined with palliative care.
Like Andrew Denton and others who have observed unbearable suffering in loved ones and the terrible failures of modern medicine in the past, I had once believed that euthanasia was the only humane solution.
I no longer believe that.
The experiences of countless patients and families should be the inspiration for continuing to improve palliative care, for general introduction of advanced care plans and not for euthanasia with its openness to misuse.
If the Victorian government legalises assisted dying for people suffering from serious and incurable conditions, it will be the wrong choice. It is not necessary and, as outlined in the minority report to government, it will inevitably increase the pressure, both stated and perceived, for some chronically ill patients to move on and stop being a burden.
Ian Haines is a medical oncologist.

Monday, November 14, 2016

Evictions by Triump: passive aggressive torture

Donald terrorized his tenants during the ’80s.

The name ‘Trump’ has commonly been associated with luxury but tenants of the real estate mogul’s condos may say differently. Back in 1981 Trump purchased a large building right off of Central Park in order to convert it into a condo. The tenants of the building refused to move, as was their right, and so Donald orchestrated five years of passive aggressive torture. He would refuse to have leaks fixed, he never took care of pests, and even told a construction crew to work every day at 7AM. Trump would culminate in letting homeless people squat in the building to try and push out tenants. He was sued in court.

from DailySportX 31 October 2016

Friday, November 11, 2016

In memory of November 11.

I still can't believe what they did to Randy and me.  Those precious hours that I was prevented from being with Randy before he died.  Why.  I still want to know why. Randy wanted to see me so who made the decision that I could not see him. Who, a broken medical system that controls 50% of our economy.  Who are these people.

I could not even see Randy on the sidewalk away from the hospital for a few minutes because it was too much work for our gigantic expensive health system designed for patients to arrange as I was banned from accessing all VCH properties. The first time I met Nurse Ratchet in 2010 when Randy was transferred from VCH to GPC she came down on me dictating that if I wanted to visit Randy, I would have to sign a visitor's contract.  Where did that come from: a visitor's contract.  Later I learned this is common practise.

We speak of the fallen soldiers this day.  What about Randy who believed in justice and in country and in family.  What about him.  What about him being badly treated by denying him his rights by our own government (health care system). They are not suppose to be the enemy. We should not be afraid of them.

What about the mothers in Ontario who spoke on national television that they are afraid to talk after being abused by health professionals when giving birth because their children might need medical attention later on.  What about them.

When people are afraid to talk, then the medical system is the enemy.

I am off to the November 11 memorial service at Hastings and Cambie ... Victory Square.

You do not have to be a soldier to die for your country.  Randy also died for his country.


I just returned from Victory Square. I was in disbelief, in awe, at what I saw. It was amazing. The square was overrun with people.  Last time I went to a November 11th event at Victoria Square, maybe twenty years ago, there was relatively no one there.  This time, people everywhere.  Children and doggies and friendship. It energized me and my resolve to continue.  It is a movement: a societal shift from love of self to love of country.   Religion and family are being weakened and redefined.  We have an inert need to belong with a purpose.

We were told to leave our $2.00 poppies at the memorial.  My question:  are these poppies recycled.  No one could tell me.  They should be.

Friday, November 4, 2016

A post by a neuro-oncologist in Texas: the way it is

You heard it here first: the uninsured, underinsured, lower socioeconomic
white and minority groups who have no family support will be "encouraged"
to consider assisted suicide when it becomes legal. Why? because those
are the same people who are being neglected and murdered by our healthcare
system now.”

Physicians are under increasing pressure to not offer patients care.
Sometimes this pressure comes from the hospital or medical staff, sometimes
from the insurance company. One medical staff chief tried to force me to
withdraw from the hospital staff because the nursing staff had complained
to him that taking care of brain tumor patients is "depressing." Another
hospital tried to prevent my patients from being admitted to the ICU
because "it's a waste of resources." I have had numerous calls from
insurance case managers wanting to know why my patients were admitted
instead of being referred for hospice. One of my patients, a thirty year
survivor, was told by his insurance company that he should "consider"
hospice. And this is a man who has a KPS of 90 and has been in remission
over 25 years!

A like scenario happens in Canadian hospitals each day. 

from ALERT

Kathryn Judson, Oregon

Doctors use this type of rationalization to coerce DNRs and withdrawals of treatment.  Although the below happened in Oregon, I was a witness to it happening in Canada. 

Sometimes doctors take the lead in assisting suicide. The following classic letter from an Oregonian is an example.
"Dear Editor, 
Hello from Oregon. 
When my husband was seriously ill several years ago, I collapsed in a half-exhausted heap in a chair once I got him into the doctor's office, relieved that we were going to get badly needed help (or so I thought). 
To my surprise and horror, during the exam I overheard the doctor giving my husband a sales pitch for assisted suicide. 'Think of what it will spare your wife, we need to think of her' he said, as a clincher. 
Now, if the doctor had wanted to say 'I don't see any way I can help you, knowing what I know, and having the skills I have' that would have been one thing. If he'd wanted to opine that certain treatments weren't worth it as far as he could see, that would be one thing. But he was tempting my husband to commit suicide. And that is something different. 
I was indignant that the doctor was not only trying to decide what was best for David, but also what was supposedly best for me (without even consulting me, no less). 
We got a different doctor, and David lived another five years or so. But after that nightmare in the first doctor's office, and encounters with a 'death with dignity' inclined nurse, I was afraid to leave my husband alone again with doctors and nurses, for fear they'd morph from care providers to enemies, with no one around to stop them. 
It's not a good thing, wondering who you can trust in a hospital or clinic. Sincerely,
Kathryn Judson, Oregon"

Wednesday, November 2, 2016

Choice is an Illusion, a blog

Many jurisdictions without legal assisted suicide (medical aid in dying) Bill C-14 already have a significant problem with some doctors and nurses administering lethal drugs to non-consenting, non-dying patients. Or use other questionable end-of-life possible options. 

If you can't control the abuses now, why would you give doctors and nurses more power to abuse patients by legalizing it?

What is happening goes beyond euthanasia, it is the blatant abuse that is an everyday "doubling" practice.  These professionals hasten death because they believe that is best for whatever reason and then they go home to their families and churches without regret.  

If a patient asks for euthanasia, then, it is an expedited "green light."


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