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Belgium became the first country to allow euthanasia for terminally ill children of any age on Thursday when its lower house of parliament passed new "right-to-die" legislation by a large majority. The law goes beyond Dutch legislation that set a minimum age of 12 for children judged mature enough to decide to end their lives. It has popular support in Belgium, where adult euthanasia became legal in 2002. In the Chamber of Representatives, 86 lawmakers voted in favor, 44 against and 12 abstained. Most opposition parties supported it, as well as the governing socialists and liberals. One man in the public gallery shouted "murderers" in French when the vote was passed. The Christian Democrats, although members of Prime Minister Elio Di Rupo's coalition, voted against. Christian, Muslim and Jewish leaders denounced the law ahead of the vote in a rare joint declaration and Catholic bishops have led days of prayer and fasting against it. "This is not about lethal injections for children. This is about terminally ill children, whose death is imminent and who suffer greatly," said Carina Van Cauter, a lawmaker for the Flemish Liberal Democrats who back the law. "There are clear checks and balances in the law to prevent abuse," she said of the legislation, which now has to pass the largely symbolic stage of being signed by the country's monarch. "SLIPPERY SLOPE" The vote has attracted more attention abroad than in Belgium, where none of the major newspapers carried the news of Thursday's vote on their front pages, and television news concentrated on Belgium being in the international spotlight. Children seeking to end their lives must be "capable of discernment", the law says, and psychologists must test them to confirm they understand what they are doing. Parents must also approve of their child's decision. Supporters of the law say these safeguards would rule out the very young and teenagers not mature enough to decide. Opponents have dismissed these rules as arbitrary and warned the new law will lead to a slippery slope of ever wider interpretation and a "banalization" of euthanasia. Brussels Archbishop Andre-Joseph Leonard, head of the Catholic Church in Belgium, asked at a prayer vigil last week why the state wanted to give minors such responsibility when they had to wait until 18 for many other legal rights. "The law says adolescents cannot make important decisions on economic or emotional issues, but suddenly they've become able to decide that someone should make them die," he said. Belgium's rules on euthanasia have come under international scrutiny in the past year after it granted the right to die to deaf twin brothers who were about to turn blind and to a transgender person after an unsuccessful sex change operation. The new law specifies that children seeking euthanasia must be terminally ill rather than just in a state of unbearable suffering, which is the qualification for adults. FEW EXPECTED TO OPT TO DIE Belgian nurse Sonja Develter, who has cared for some 200 children in the final stages of their lives since 1992, said she opposed the law. "In my experience as a nurse, I never had a child asking to end their life," Develter told Reuters before the vote. But requests for euthanasia did often come from parents who were emotionally exhausted after seeing their children fight for their lives for so long, she added. In practice, supporters of child euthanasia say, there are likely to be few minors who will be allowed to die. The Netherlands has had five cases of child euthanasia since the law went into effect there in 2002. The total number of Dutch euthanasia cases has been 2,000 to 4,000 a year. Between 2006 and 2012, there was just one case of a Belgian under the age of 20 requesting euthanasia. Over 1,000 people opt for euthanasia in Belgium annually. Apart from Belgium and the Netherlands, euthanasia is also legal in neighboring Luxembourg, and France is considering legalizing it later this year. Switzerland allows assisted suicide if the person concerned takes an active role. In the United States, assisted suicide is legal in Montana, Oregon, Vermont and Washington states. Source: http://www.straitstimes.com/breaking-news/world/story/belgium-adopts-law-allowing-euthanasia-children-20140214

Senior pet dog in S’pore put to sleep just as dog welfare group offered to care for it source: https://mothership.sg/2020/03/singapore-senior-dog-put-down/ A senior pet dog in Singapore has been put to sleep on Monday, March 23, at 11:15am, merely a day after help to treat it was desperately offered by a local dog welfare group. Details of the incident was put up on Facebook by the dog welfare group, Chained Dog Awareness in Singapore. According to the post, the dog was at least eight years old and allegedly very sick, according to neighours of the household that kept the dog who had witnessed its condition over a period of time. The dog was witnessed to have been dragging its feet and barking a lot, but otherwise, had a good appetite. The dog apparently belonged to the wife of the man that was approached by the dog welfare group with an offer to help the dog seek veterinary treatment. What allegedly happened At least three people made their way to the dog owner’s place on Sunday, March 22 at about 11.30am, to negotiate for the dog to be taken to a vet to be treated for its ailment. However, after the first initial conversation, the dog owner became unresponsive to messages. A contact number belonging to one of the individuals from Chained Dog Awareness in Singapore was left with the neighbour of the household that owned the dog, so that the dog welfare group could still be reached subsequently. Euthanised suddenly On Sunday night, the dog’s owner called the number and agreed to meet on Monday afternoon to discuss his dog’s welfare. A WhatsApp text was sent to the dog owner on Monday morning at 930am to confirm the meeting was going ahead. The dog owner replied and was thankful for the reminder. However, two hours later, the dog owner replied and said the dog had been put to sleep and sent an accompanying vet report of the euthanasia procedure. The owner said it his text the dog was 14.5 years, which was vastly older than the eight years old age previously mentioned by the dog welfare group in its post. The owner also apparently explained in the text message about why the dog was put down: “My dog is healthy but too old already.” Responses The recounting of what happened has elicited strong reactions from dog lovers in Singapore, who are angry that the dog was put down suddenly. They are also perturbed that the dog owner sent a message post-euthanasia that said, “Hope solve the problem”. Anger was also reserved for the animal clinic that put down the dog, as the animal appeared to have been put down in haste.

For the benefit of forumers without a Business Times subscription. This article will be useful in understand palliative care in Singapore and in the debate over euthanasia. The dollars and cents of caring Hospices in Singapore, all of which run on public donations, are facing a strain on resources, reports MICHELLE QUAH Email this article Print article Feedback Bookmark and Share SPEAKING recently with a volunteer at a local hospice, I was brought to tears by his tale of how an old man was brought in for treatment by his son. The son was later found to have left a fake contact number and address, which essentially meant that he had abandoned his aged and ailing father at the hospice. Caring and sharing: The struggles faced by hospices are increasing every day as the need for end-of-life care grows with our fast-ageing population Shaken by the man's callousness, I was also acutely aware that the hospice, which runs only on public donations, now had to care for this man and others like him, out of its own pocket. These are just some of the struggles which hospices in Singapore - all of which run on public donations - face. And these are struggles and challenges which are increasing every day, as the need for end-of-life care grows with our fast-ageing population. Prime Minister Lee Hsien Loong noted just this month, at Assisi Hospice's 40th anniversary charity dinner, that the need has grown considerably in the last decade or so, with seven hospice and home palliative-care providers now serving 5,000 patients a year. 'The actual need is probably higher,' Mr Lee had said, as there are more who could benefit from such care but are not aware of it or find the subject taboo. Patients are seldom, if ever, turned away because they cannot afford it. All home hospice care provided by the VWOs are also free, borne by the VWOs and covered in part or in full by subsidies. A Today newspaper report last October said that of the 17,000 deaths in Singapore in 2007, only 26 per cent received some form of subsidised hospice or home hospice care - indicating a sizeable unmet need. Extending palliative care Mr Lee also said that palliative care - which includes any form of medical care that concentrates on reducing the severity of symptoms and on improving the quality of life for those with serious and complex illnesses - should be extended beyond cancer to include diseases such as end-stage organ failure and advanced dementia. The importance of palliative care cannot be understated. It is not just about pain management; it's about improving a patient's quality of life, while providing pain relief and the treatment of symptoms, along with emotional and spiritual support. It's also about providing counsel, support and relief to family members. Whether at home or in the hospice, such care allows patients to live out their final days 'surrounded by love and not full of tubes, masks and drugs', Mr Lee had said at the Assisi Hospice dinner. Need is growing While there's no doubt the need is growing, the current strain on hospices - most of which run on full capacity - is also great. At present, Dover Park Hospice (DPH), Assisi Hospice (AH), Bright Vision Hospital (BVH) and St Joseph's Home and Hospice (SJH) are the only full-time, in-patient hospices in Singapore. All four are voluntary welfare organisations (VWOs), depending on public donations - with subsidies from the government - as their primary source of funding. DPH, which has 40 beds, has a waiting list of anything from two to 10 patients. AH, with 35 beds, says that it has a waiting list for its in-patient service almost all the time. BVH's 32 hospice beds are usually fully occupied at any time. Over at SJH, half of its 22 beds are for hospice patients - and these are also fully taken up, most of the time. Palliative day care is also provided by HCA Hospice Care, AH and BVH. Home care - where trained professionals provide palliative care to patients in their home - is provided by HCA, AH, BVH, Metta Hospice Care, Agape Methodist Hospital and the Singapore Cancer Society. Data provided by these hospice-care providers as to their annual running costs illustrate just how much it takes to keep a hospice going: DPH says that its operating cost averages $4 million per annum; AH chalked up a running cost of $4.9 million in 2008; SJH's running cost is $2.7 million a year; HCA's running cost is about $4.2 million a year; Metta's running cost is $500,000 a year. Part of the cost of providing hospice care is funded by the government, through subsidies extended to patients. Patients pay what is not covered by the subsidy. But, for those who cannot pay - for example, the old man who was abandoned by his son - the cost is borne by the hospice, along with all other operating and administrative costs. Patients are seldom, if ever, turned away because they cannot afford it. All home hospice care provided by the VWOs are also free, borne by the VWOs and covered in part or in full - depending on the sum - by government subsidies. For most of the hospices, especially the larger ones, this means that the bulk of their operating costs are funded by public donations - which makes fund-raising such an integral concern for them. For the four in-patient hospices, for example, the Ministry of Health (MOH) has estimated that their 1,600 patients received a total of $3 million in subsidies in 2008 - far short of the operating costs of these hospices. Recognising the growing demand for hospice care - and, perhaps, the current strain on hospices - the government recently announced the release of Medisave for the payment of home hospice services. When asked by BT for more details, MOH said that it was 'working with providers of palliative care on the implementation details and will share these at a later stage when ready'. R Akhileswaran, CEO and medical director of HCA - the largest hospice home care service in Singapore, and a hospice day-care centre - explained that 'as all the hospice home care services run by VWOs in Singapore is free of charge, the release of Medisave . . . might help only those patients under private hospice home care services who pay a fee for the service'. He went on to say that 'those patients under home care services funded by either MOH or NCSS (National Council of Social Services) or both will be means tested' to determine the level of subsidy that they will receive. In other words, they will not be fully subsidised and will receive less if they belong to a higher income bracket. Either the patients or the home-care providers will have to make up the shortfall. Dr Akhileswaran said that MOH funding for home hospice care has been raised recently to $153 per nurse visit and $207 per doctor visit - with the exact amount of funding depending on the patient's income level. He added that NCSS funds 25 per cent of the MOH funding per visit, ie $38.25 (25 per cent of $153) per nurse visit and $51.75 (25 per cent of $207) per doctor visit. MOH also recently raised the level of subsidies provided to patients at in-patient hospices. It increased its subsidy tiers from four to nine in September, estimating that half of the subsidised patients will get more subsidies as a result of the change. The level of subsidy will also depend on the patient's total family income. Those with a total family income of less than $1,440 will have 75 per cent of their in-patient bill subsidised, those with an income level of between $1,441 and $2,200 will get 70 per cent, and so on. The subsidies are based on an increased estimated norm cost of $259 a day for in-patient services, up from $242 a day previously. Patients can also withdraw up to $160 per day from their Medisave for hospice stays. Still, the bulk of the funding for hospices comes from public donations. For example, DPH has to raise the bulk of the $4 million that it needs each year to provide subsidised and often free care for its patients. In March 2009, before MOH increased the level of subsidies for hospice care, a DPH taskforce estimated that the MOH subsidy covered only 33.2 per cent of the hospice's running cost, with patients paying 11.8 per cent and donations accounting for the remaining. Over at AH, according to its annual report last year, its almost $5 million in operating costs was funded primarily by donations, with government subsidies amounting to $1.2 million and patient fees totalling some $816,000. HCA gets the bulk of its funding from subsidies. According to its latest annual report, its total expenditure amounted to $4.12 million, of which $3.81 million came from MOH and NCSS funding. But donations from the public fell, due to the economic downturn, to $930,000, from $1.21 million the year before. 'Nearly 85 per cent of the patients at our hospices are heavily subsidised,' said Tan Kee Wee, chairman of the Singapore Hospice Council, the umbrella body for all organisations actively providing hospice and palliative care. 'Although the government provides the subsidies, they are insufficient to meet the hospices' annual budgets. Any shortfall has to be raised through donations and fund-raising activities,' he said. 'I am extremely gratified that the hospices work very hard to raise funds on their own through activities like charity dinners, charity fun days, and walkathons. Just last month, the Voices for Hospices concert, organised by BVH, helped raise nearly $100,000. And this Sunday, we have a walk organised by Dover Park Hospice.' It's clear that the various hospice-care providers in Singapore could do with more support and financial help, especially with demand for such end-of-life care increasing with an ageing population. The need for alternative forms of palliative care, not currently provided here, will only add to the demand. 'The demand for palliative/ hospice care will continue as our population ages and live longer. It is through such generous donations from the public that our hospices are able to provide the excellent care and services to our patients,' Dr Tan said. For more information on hospice and palliative care, please visit the Singapore Hospice Council's website at www.singaporehospice.org.sg The Dover Park Hospice (DPH) is raising funds this weekend, through its inaugural SUNday Walk, which will kick off from Raffles Place Park and end at Clarke Quay. Funds raised through the walk and its joint activities will be channelled towards continuing and expanding DPH's service offering and capacity, and the provision of subsidised care for those terminally ill patients who are unable to pay for their stay. Please visit DPH's website (www.doverpark.org.sg) or its SUNday Walk page (doverpark.org.sg/sunday/) for more information

Life Last night my wife and I were sitting in the living room, taking about life........ In between , we talked about the idea of living or dying. I said to her : "Dear, never let me live in a vegetative state, totally dependent on machines and liquids from a bottle........... If you see me in that state, i want you to disconnect all the contraptions that are keeping me alive. I would much rather die." Then my wife got up from the sofa with this real look of admiration towards me...... and proceeded to disconnect the TV, the Cable, the Dish, the DVD, the Computer, the Cell Phone, the iPod, and the Xbox, and then went to the fridge and threw away all my beer !! *...... I ALMOST DIED !!!