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One study found depression was reported for 22 percent of Maori men (age 80-90 years) and 23 percent of non-M? ori women (age 80-90 years) and 26 percent of non-Maori women (age 85 years). The 2015 Office for Senior Citizens (Ministry of Social Development) report on Elder Abuse reports that “around one in ten older people … Palliative doctors and nurses report that patients ask for 'help to end it all', not because they are serious about dying, but to show they are up against it and to seek reassurance.

report some form of abuse (closely linked to vulnerability and coercion)”. Mental Health: Effectiveness of the planning to discharge people from hospital. If euthanasia or assisted suicide were available, and a doctor responded positively to a request for 'assisted dying', he or she risks sending the message, however unintended, that the patient's condition and outlook are every bit as bad as the patient fears and that death is the best option.

depicts Palliative Care as a ‘subversive’ element in a health system that is focused on ‘cure’.

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Prisons are places for young, fit and aggressive men, but a number of changes, including longer sentences and stricter parole decisions, mean there are now greater numbers of older prisoners requiring intensive health care support.Disabled people are among the most disadvantaged in terms of employment, interpersonal acceptance, economic stability, freedom of mobility and community access, all variables thought to have a significant bearing on suicide potential. It is disappointing and concerning that disabled people are not mentioned at all in the Strategy. The Ministry of Health Report on suicide for 2013 found that rates of suicide increased consistently with the level of deprivation. Such patients deserve doctors who will support them through their illnesses, not offer them a quick exit.The highest rate was among those residing in quintile 5 areas (the most deprived areas), and the lowest suicide rate was seen among those who resided in the least deprived areas. Suicide Facts: Deaths and intentional self-harm hospitalisations: 2013. The changing set-up of GP medical practices in various countries such as the United Kingdom and New Zealand also makes it much less likely that, in the future, patients will have a single doctor that they see regularly.A cornerstone of Catholic teaching is the belief that every human life has “intrinsic value” and is to be protected and nurtured at every stage of its development.Those who do not conform to the increasingly dominant ableist idea of what a successful life looks like (e.g. The Impact of Exposure to Peer Suicidal Self-Directed Violence on Youth Suicidal Behavior: A Critical Review of the Literature.the New Zealand Longitudinal Study of Aging described less than half of participants as ‘not lonely’, 41.2 percent as ‘moderately lonely’, 7 percent as ‘severely lonely’ and 3 percent as ‘very severely lonely’. While there are many precipitating factors involved in elder suicide, we believe that much more attention needs to be given to critiquing the ageist and ableist societal narrative that is increasingly inclined to equate value of life and personal dignity with health and independence (‘not being a burden’). A focus on the suicide of elders, while ‘targeting’ a particular group and raising awareness of the ‘value’ and dignity of this group, may also work at a universal level by challenging societal attitudes about ‘useful’ or ‘successful’ lives that will assist in suicide prevention for all age groups. There is no mention of prisoners in the Strategy, yet the suicide rate for prisoners is higher than that of the general population. I also told him that should he become sicker or weaker, I would work to provide him the best care and support available.In addition, the much higher suicide rate amongst M? No matter how debilitated he might become, his life was, and would always be, inherently valuable.those who suffer deprivation, disability, mental illness, or the limitations of ageing), are particularly vulnerable to the suggestion that their lives are not worth living. Suicide and Life-Threatening Behavior, 44(1), 58–77. https://doi.org/10.1111/sltb.12055 [21] https://nl/en-gb/news/2016/26/more-suicides Doctors are not necessary for the regulation or practice of euthanasia and assisted suicide Many doctors want no part in euthanasia or assisted suicide, including some who, on a personal level, are not opposed in principle.There is an urgent need to counter the increasingly accepted and relationally impoverished societal narrative which equates the value of a person’s life with their subjective perceptions about the quality of their life, all too often based on factors that reflect an ableist or functionalist worldview. We note that the Strategy provides little specific or material direction for how suicide rates might be reduced, that organisations or agencies are not identified as taking a lead, and that the ‘Activities’ are very general. [19] Haw, C., Hawton, K., Niedzwiedz, C., & Platt, S. Suicide Clusters: A Review of Risk Factors and Mechanisms. As stated in “An Open Letter to New Zealanders” signed to date by more than 300 doctors, “Doctors are not necessary in the regulation or practice of assisted suicide.” There is evidence that the key reason proponents of a law change insist on the ongoing and unquestioned association between euthanasia/assisted suicide and the medical profession is a political one – a means of providing a cloak of medical legitimacy while promoting the idea that euthanasia and assisted suicide are a form of ‘medical treatment’.Many such ‘legal’ requests could potentially hide what would otherwise have been regarded as tragic suicides linked to a reactive depression that is directly related to abuse or neglect or to the limitations of ageing – a depression that can and should be treated. While it is still premature to make definitive comparisons of suicide rates in jurisdictions that have or have not legalised euthanasia, it is worth noting that in the Netherlands the number of completed suicides (excluding premature death by euthanasia) has risen from 1,500 in 2003 to 1,871 in 2015, that is from 9.6 to 11.1 per 100,000 population (euthanasia was legalised there in 2002). If assisted suicide/euthanasia were to be legalised, young people and others at risk of suicide would be faced with two competing paradigms - ‘acceptable suicide’ and ‘unacceptable suicide’. Other key medical professional groups within New Zealand have similar views, including the Australia and New Zealand Society of Palliative Medicine .The concept of ‘acceptable’ suicide, for those who find their lives intolerable and not worthwhile, will be in direct conflict with the fundamental goal and message of suicide prevention programmes. In view of recent attempts to change the law regarding assisted suicide/euthanasia, the Strategy needs to address and challenge this potential development, which would impact significantly on the approach and messages of suicide prevention initiatives. The British Geriatrics Society position on Physician Assisted Suicide (2015) also speaks directly to the impact assisted suicide will have on medicine when it states that “crossing the boundary between acknowledging that death is inevitable and taking active steps to assist the patient to die changes fundamentally the role of the physician, changes the doctor-patient relationship and changes the role of medicine in society …

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