I chased the American dream.

It brought me back to my father’s deathbed in China.

Mangkuk Wong, the author’s father, in 1987.

By Xiaoyan Huang

I thought for sure he was dead: Whenever I cannot reach my father, now 86, I am convinced the day has come and that he has died alone in his apartment. It was nearly midnight in Shenzhen, China. I tried calling him on WeChat, on his cell, on his landline. No answer. I called his friend to check on him. He answered the doorbell that night and seemed okay, she reported. The picture she sent, though he was smiling, did not reassure me. I’m a cardiologist in Portland, Ore. One look at my father’s ashen color told me his end was near. A week later, he was hospitalized and diagnosed with metastatic colon cancer.

This event had a cruel symmetry, echoing what happened in 2003 when my mother suffered a fall and massive brain bleed. Same apartment. Same hospital. Even the pandemics, then and now, involve related viruses: SARS and the novel coronavirus. My mother had gone into a coma by the time I reached her bedside. After months of hospitalization, she was discharged home, comatose. My father kept her alive in a persistent vegetative state for five more years, with hired help and tube feeds, nearly bankrupting himself. Throughout that time and long after, I was overtaken by guilt. Thirty-four years ago, my parents supported their only child to pursue her education in the United States. It pained me to realize that as a physician, I was unable to save my mother’s life, and as a U.S. citizen, I never gave her the good American life she had asked of me.

This time, I was determined to do right by my father. Though I managed to leverage my connections as an established American cardiologist to get him VIP treatment in his local hospital, he adamantly declined further diagnostic testing or care. My father, a retired university professor, is fiercely independent, a loner. He told me he had lived a long, good life and wanted to die on his own terms. When I gently suggested getting a colonoscopy, tissue biopsy and perhaps advanced cancer therapy, he got mad: “I am fine, I can walk to the crematorium myself!”

Palliative and hospice care are not widely supported in China. When loved ones fall ill, spouses and children often show over-the-top devotion, fearing judgment by other family members and by society at large. In cases of terminal illness, the patients themselves almost never participate in discussions about the severity of the condition (a situation depicted in the 2019 film “The Farewell”). Family members are expected to pursue more aggressive treatment, even if medically futile, espousing blind optimism. The higher the price tag, the better the demonstration of filial piety. Dying at home is generally avoided because of superstition. In China, my father faced intimidating cultural stigma against his wish to stop treatment and die peacefully at home.

I wanted to support him, but it would mean figuring out his end-of-life care on my own. After consulting an oncologist friend, I packed my suitcase full of over-the-counter comfort care medicines. I also had to make arrangements to put my life on indefinite hold — applying for family medical leave, rescheduling appointments, asking colleagues to cover my patients and administrative duties, saying goodbye to my husband and children with no set return date.

Decades ago, I was fortunate enough to attend college in America on a full scholarship. Now it would take every inch of my immigrant success — leaning on all my resources and institutional affiliations — to take the return trip on which I would probably lose my remaining parent and sever my last tie with China. Travel during the pandemic is dauntingly difficult: I needed a special family emergency visa, two negative coronavirus tests within 48 hours of my flight and a time-stamped health clearance bar code from the Chinese Consulate. There were only a handful of flights between the countries each day; it was impossible to buy tickets online. With the help of a childhood friend’s wife, who runs a travel agency in China, I got one. The plane was packed. Everyone wore N95 masks, some with double masks, others with goggles, face shields, hazmat suits and gloves. The flight attendants wore disposable surgical gowns. People hardly ate or drank during the 15-hour flight, trying to minimize bathroom trips.

For two weeks, I was quarantined in a hotel room in Xiamen after landing. The first night, on a sleepless high, I made grandiose plans for catching up on emails and work. By day five, I started exercising by putting all 20 hotel-provided bottles of water into a backpack and pacing the room: 14 steps long, six steps wide, over and over. By day seven, each banging of the door by the hotel staff, announcing meals delivered to a chair outside, made me jump — as did the twice-daily temperature check. Finally, after 14 days and 11 negative coronavirus tests, I was released into the world.

When I finally got to my father’s bedside, suitcase in tow, it was almost anticlimactic. For a surreal second, I felt I was rounding on an elderly patient, as I do every day in my hospital. Reunion in Chinese style, even in such weighted circumstances, is restrained. No matter how many times I had cried in private, there would be no embrace, not even a handshake, no tears in front of him. I instinctively checked on key physical exam findings: Was his neck vein elevated, and legs swollen, suggesting congestive heart failure? I stopped myself just short of probing his abdomen. My hand went, instead, to tuck him into his comforter. At this moment and going forward, I wanted to be only his daughter.

A few days later, I brought my father home. Together with a friend of his, I took care of him: shopping for and cooking his favorite meals; helping him shower and dress; dispensing his few remaining pills. Back in his own environment, my father instantly began feeling better, eating more. We still don’t use the word “cancer” or talk openly about his prognosis, but this feels like neither denial nor forced optimism. Instead, we focus on the concrete tasks at hand. When he has energy, I sit by his bed listening to him talk about his life, about history, philosophy and technology. I tell him about his grandsons and their girlfriends, my work and my life.

I began this journey initially stricken by grief, and by fear of reliving the guilt my mother’s death had induced. But I came to appreciate an unexpected symmetry: Years ago, my parents sacrificed to set me free and allow me to pursue a new life in America. In returning to China, I sacrificed to set my father free and help him have a good death. The first choice is relatively common and often celebrated; the latter is unconventional, even frowned upon — seen as almost unnatural in a culture that prioritizes extending life. But the limbo of quarantine, and all the hurdles I had to surmount en route, brought me to a realization: how important it is, for the living and the dying, to share a moment of peace. In that moment, love is no longer measured by the quantity of pills, the number of CT scans or the extent of heroic medical interventions, but by time spent together.

Complete Article HERE!

Never say die

By Kristi Nichols

In March, at the beginning of the COVID-19 pandemic, I emailed my oldest son a list of my financial details, a copy of my will, and my advanced medical directive. I thought it was the prudent thing to do in case I contracted the virus and died. Almost instantly, I received his reply: “Is everything alright, Mom?” I had not expected this response and thought it was a good time to have a conversation about death.

As my children were growing up, I made sure to keep the subject of sex in the conversation. I knew that for my children, having sex was inevitable, and there were important discussions to have before it was too late. I wasn’t worried that talking about sex would cause them to have sex; I was more worried that not talking about it might make their lives more difficult. Sometimes it was uncomfortable, but the more we talked, the more approachable the subject became. It’s the same with death. Learning to talk frankly about death and dying takes the burden off everyone. The thought of me, my family members, friends, or anyone dying is uncomfortable, but we need to talk about it.

As the COVID pandemic death toll continues to rise, more people are contemplating their own death, the death of loved ones, and dying in general. Never has there been such a need to talk about death and dying. We have become a society in which talk about death is taboo. We are born, we live, and then we die. We don’t speak openly about this natural series of events; rather we allude to it. The subject has become a source of discomfort. We avoid talking about it directly, just like sex. For some reason, we no longer die. We “pass away.” Why can’t we simply die?

Birth and death used to be a family, community, and religious event. Death was not hidden in a hospital or “care” facility. Discussions about dying and death were not just between a few family members and a medical professional. People were directly and personally involved in caring for dying relatives. Conversations were necessary to plan futures. Death was considered a natural thing and not a forbidden subject. The word “hospice” derives from the Latin word “hospitum,” meaning hospitality or place of rest and protection for the ill and weary. Essentially, going home.

Death as a taboo is taking its toll. When a dying person has not been able to talk about their death, it becomes an unnecessary source of anxiety and depression. These conversations need to be about practical concerns as well as fear, pain, and loss. When final wishes have never been discussed with family members, they are hard-pressed to make decisions at the end of their loved one’s life. Creating living wills and advanced medical directives is a good way to get the conversation started. Once the subject is broached, it may create more opportunities to express emotions and answer questions.

The psychiatrist Irvin Yalom describes four ultimate concerns: death, isolation, loss of freedom, and meaninglessness. These are the most important concerns of the living, and even more concerning for someone approaching the end of life. Why not encourage conversations regarding these deep subjects. What does it mean to those aging or experiencing a fatal illness when the subject of death is taboo? Should they be embarrassed to acknowledge their own mortality? Should they be kept silent about what concerns them most? How can there be dignity and grace in dying when we can’t talk about death?

Our society’s obsession with perfection renders many people unwilling or incapable of dealing with the painful realities of life, especially death. To embrace the human experience means embracing the full spectrum of life’s events, including death. Dealing with mortality can be overwhelming, but approaching death doesn’t have to be arduous. We shouldn’t have to worry about upsetting or protecting others when we need to talk about important things.

I believe the way forward is for us to go back to acknowledging death as what naturally happens at the end of life. We need to revive our conversations about death. It will take courage. It is difficult to face our own mortality and that of those we love. It is always sad and often frightening. Conversations about death remind us that one day, those we care about may no longer be around and maybe, we will die before them. Let’s remember to enjoy and appreciate them now and cherish every moment we spend together! Now is also the time to plan a good death.

If there is one thing I know as a psychotherapist, it’s that talking about our fears eases them. It allows us to be more honest, candid, and at peace. By talking about difficult subjects such as death, you will likely learn that you are not alone and that someone is waiting to have that conversation with you.

Complete Article HERE!

Caring for a dying loved one

There’s no denying that caring for a dying loved one is a heart-wrenching experience. Through specialized quality care, however, patients and their families can continue to share meaningful moments, despite a terminal diagnosis.

Every year, hospices and palliative care centers across the nation unite to raise awareness of available options for end-of-life care. How does hospice and palliative care work? Hospice and palliative care maximize the quality of life of people with advanced or life-limiting illnesses through pain management, symptom control, psychosocial support and spiritual care, among other means.

What can you do to help?

Understanding what to expect and what you can do to increase a patient’s comfort level can help ease their suffering. Consider their unique physical, emotional and psychological needs.

• Re-adjust pillows beneath their head to help with labored breathing.

• Be calm and reassuring. Remind your loved one where they are and who is present. Seek help from a medical team if significant agitation occurs.

• Maintain a comfortable room temperature. Provide warm blankets in case of a chill or install a humidifier in a moisture-deprived room.

• Encourage your loved one to communicate unsaid thoughts. Ask open-ended questions about their beliefs or meaningful life moments.

• Seek clarity about the type of care your loved one wishes to receive, in case they can no longer speak for themselves.

• Invite family members and close friends to show their support and say their farewells.

Is someone close to you facing a serious or life-limiting illness? Visit www.nhpco.org for caregiver assistance and resources.

Complete Article HERE!

Covid Strikes Clergy as They Comfort Pandemic’s Sick and Dying

Pastor Marshall Mitchell of Salem Baptist Church in Abington, Pennsylvania, got his first dose of the covid vaccine in December. He believes it’s his spiritual duty to his congregation and community to take precautions to avoid covid-19.

By Bruce Alpert

The Rev. Jose Luis Garayoa survived typhoid fever, malaria, a kidnapping and the Ebola crisis as a missionary in Sierra Leone, only to die of covid-19 after tending to the people of his Texas church who were sick from the virus and the grieving family members of those who died.

Garayoa, 68, who served at El Paso’s Little Flower Catholic Church, was one of three priests living in the local home of the Roman Catholic Order of the Augustinian Recollects who contracted the disease. Garayoa died two days before Thanksgiving.

Garayoa was aware of the dangers of covid, but he could not refuse a congregant who sought comfort and prayers when that person or a loved one fought the disease, according to retired hairstylist Maria Luisa Placencia, one of the priest’s parishioners.

“He could not see someone suffering or worried about a child or a parent and not want to pray with them and show compassion,” Placencia said.

Garayoa’s death underscores the personal risks taken by spiritual leaders who comfort the sick and their families, give last rites or conduct funerals for people who have died of covid. Many also face challenges in leading congregations that are divided over the seriousness of the pandemic.

Ministering to the ill or dying is a major role of spiritual leaders in all religions. Susan Dunlap, a divinity professor at Duke University, said covid creates an even greater feeling of obligation for clergy, because many patients are isolated from family members, she said.

People near death often want to interact with God or make things right, Dunlap said, and a clergy member “can help facilitate that.”

Such spiritual work is key to the work of hospital chaplains, but it can expose them to virus being spread in the air or sometimes through touch. Jayne Barnes, a chaplain at the Billings Clinic in Montana, said she tries to avoid physical contact with covid patients, but it can be difficult to resist a brief touch, which is often the best way to convey compassion.

“It’s almost an awkward moment when you see a patient in distress, but you know you shouldn’t hold their hand or give them a hug,” Barnes said. “But that doesn’t mean that we can’t be there for them. These are people who cannot have visitors, and they have a lot they want to say. Sometimes they are angry with God, and they let me know about that. I’m there to listen.”

Still, there are times, Barnes said, that the despair is so profound she cannot help but “put on a glove and hold a patient’s hand.”

Barnes was diagnosed with covid near Thanksgiving. She has recovered and has a “better understanding” of what patients are enduring.

Dealing with so much suffering affects even the most hardened doctors and nurses, she said. Billings Clinic staffers were devastated when a beloved physician died of covid, and rallied behind a popular nurse who was seriously ill but recovered.

“We’re not only taking care of the patients; we are also there for the staff, and I think we have been an important asset,’’ she said of the hospital’s chaplains.

In Abington, Pennsylvania, Pastor Marshall Mitchell of Salem Baptist Church said he believes part of his spiritual duty is to persuade his congregation and the broader African American community to take precautions to avoid covid. That is why Mitchell allowed photographers to capture the moment in December when he received his first dose of a vaccine.

“As pastor of one of the largest churches in the Philadelphia region, it is incumbent on me to demonstrate the powers of both science and faith,” he said.

Mitchell said he might have credibility in convincing other African Americans, who have been disproportionately affected by covid, that a vaccine can save lives. Many are skeptical.

The politicization of covid precautions such as masks and social distancing has put many pastors in a difficult position.

Mitchell said he has no patience for people who refuse to wear masks.

“I keep them the hell away from me,” he said.

Jayne Barnes, a chaplain at the Billings Clinic in Montana, says it’s awkward not to touch or hug a covid patient in distress. But sometimes she cannot help but “put on a glove and hold a patient’s hand.”

Jeff Wheeler, lead pastor of Central Church in Sioux Falls, South Dakota, said that his church encourages mask-wearing and that most congregants comply. However, the underlying tension is reflected in his message to members on the church’s website:

“As we move forward, we simply ask you to avoid shaming, judging or making critical comments to those wearing or not wearing masks,” it reads.

Sheikh Tarik Ata, who leads the Orange County Islamic Foundation in California, said that the Quran calls for Muslims to take actions to ensure their health and that congregants largely comply with covid guidelines

“So, our members don’t have a problem with mask mandates,” he said.

Covid has hit the Orange County Muslim population hard, Ata said. Religion has become an important source of comfort for members who have lost their jobs and struggled with illness or finding child care.

“Our faith says that no matter how difficult the situation, we always have access to God and the future will be better,” Ata said.

Adam Morris, the rabbi at Temple Micah in Denver, said he has turned to online video to meet with congregants sick with the coronavirus. When meeting with his congregation members in person, such as during graveside services, he worries that with his mask on people might miss seeing the concern and compassion he feels for their plight.

He conducts in-person graveside funerals for a small number of mourners but requires all participants to wear masks.

Observant Muslims and Jews believe it is important to bury the dead quickly after death, Morris said.

“Some traditions and rituals must go forward,” Morris said, “covid or not.”

Complete Article HERE!

50 Million Americans Are Unpaid Caregivers.

We Need Help.

Biden must make good on his promise to support families with sick loved ones.

By Kate Washington

Five years ago I stood in a tiny hospital room wondering how I was going to care for the man I loved most without succumbing to despair.

For four months, my husband, Brad, had been recovering from a stem-cell transplant that saved his life from aggressive lymphoma. The hospital administration said he must go home, but he needed a level of support that, I thought, only a hospital could provide.

His homecoming ought to have been cause for celebration. But I felt anything but joyful. The night before his discharge, unable to sleep, I felt so trapped and terrified that I called a suicide hotline, even though I wasn’t really sure I wanted to harm myself. I was so desperate I needed to hear a compassionate human voice, and I couldn’t think of anywhere else to turn.

Though isolated, I was far from alone: according to a 2020 survey by AARP, more than 50 million Americans now serve as unpaid caregivers for adult family members or friends. That number will rise as the baby boomers age. That’s the bad news. The good news is that with the Biden administration committed to a bold, integrated vision of care, we have a once-in-a-generation opportunity.

The plight of family caregivers, who often compromise work, finances, friendships and their own health to support their ill or disabled loved ones, has long been overlooked in U.S. policy. While some states offer programs to help caregivers, they can be inadequate and hard to navigate. The coronavirus pandemic has revealed many problems in our health system, and few more starkly than the way it both undervalues and relies on caregivers.

I became painfully familiar with caregiving’s challenges during Brad’s months of chemo in 2015, but it was his 2016 stem-cell transplant — a last-ditch treatment for relapsed cancer — that showed me just how broken our system is. When he was discharged, he was immunocompromised, blind, too weak to walk unassisted, and unable to eat more than half his calories.

“He’ll need attendance 24 hours a day,” his oncologist told me. I stared, panic rising.

“How am I supposed to do that? We have two kids,” I said. Even meeting our family’s most basic needs would be impossible.

“Well, usually family steps in and it works out fine,” the doctor replied, waving away my concerns. Our family had been extremely supportive but couldn’t drop everything indefinitely. A nurse suggested organizing shifts of friends, but my friends, like me, were working parents.

Besides, caring for Brad wasn’t simply watching him. He came home with 35 medications that had to be administered on a mind-boggling schedule, as well intravenous nutrition that I had to hook up, a complex procedure that I learned to perform in a hasty training session from a nurse. He needed blood sugar tests and assistance with toileting, showering and other intimate acts at which even close friends might well balk.

Insurance does not cover home attendants even when medically necessary. Our benefits did pay for skilled nursing visits and home health aides for assistance with showering twice a week, but for the 24-hour care the doctor prescribed, we had to pay out of pocket. The summer after Brad came home, we spent more than $21,000 on in-home care, dipping into savings and an inheritance from my mother to do so. We were very fortunate to have those resources; for many families, it would be out of reach.

It’s often noted that the United States is alone among rich nations in not providing maternity leave; support for child care is likewise abysmal. Similarly — but often more invisibly — we leave millions of caregivers with little or no support in managing the financial, logistical and emotional difficulties of helping ailing parents, spouses and children.

The Biden-Harris campaign made an ambitious caregiving plan a key plank of its platform. Early signs from the new administration are promising. Mr. Biden’s $1.9 trillion coronavirus emergency relief package includes measures benefiting caregivers: extending stimulus payments to cover previously overlooked adult dependents, tax credits, and paid family and medical leave. Some of these benefits would help family caregivers of all kinds; others specifically aid those tending people with Covid-19.

Although pandemic relief is the most urgent priority, change must not stop there. The plan Mr. Biden rolled out during the campaign proposed an integrated approach to supporting child care, care for older people, paid care work, and family caregivers. Among other measures, it floated a $5,000 tax credit for unpaid caregivers, Social Security credits for those who must leave their jobs to provide care, and 12 weeks of guaranteed paid family leave.

The plan would also offer wider access to home- and community-based long-term care and support services. Gaps in Medicaid coverage for these services has resulted in long waiting lists and made it harder for people to receive needed care at home.

Such changes would clearly benefit both family caregivers and paid workers, who are disproportionately women of color. With few job protections, in-home workers have long had difficulty finding stable, well-paid work, a plight worsened by Covid-19. The Biden policy team has argued that its plan would create up to three million jobs in care work and education, benefiting populations hit hard by pandemic job losses.

The changes wouldn’t help just caregivers like me; what’s good for caregivers also benefits those who need assistance. Expanding home care can keep frail elderly people out of nursing homes, the drawbacks of which have been painfully exposed by the pandemic. Easing financial strains and burnout for caregivers can mean better, more compassionate treatment, which in turn can improve quality of life and outcomes for our most vulnerable citizens.

Even though I had support systems and family to help, and we could afford supplemental care, my husband’s long medical ordeal was almost unbearably stressful. Supporting a catastrophically ill person will never be easy — but in the United States today, it’s far harder than it needs to be. Our system largely abandons those with less privilege than I have to struggle alone caring for those we love most. The result for many is burnout, bankruptcy and profound suffering.

Though my husband remains chronically ill, he has recovered his vision and his independence. There are millions more out there now as desperate as I felt five years ago, crying for relief. A Biden administration primed for change, with the slimmest of Democratic Senate majorities, means there’s a real opportunity to reform and mend our broken systems of care. If we are to have the caring society we all deserve, caregivers and recipients alike, we must not lose that chance.

Complete Article HERE!

Muslim Funeral Rites Explained

by

For many years, Muslim funeral rituals have attracted attention from Christian counterparts mainly because of their simplicity.

Yesterday, two high profile octogenarians, who played key roles in Kenyan politics and civil service, were laid to rest.

One, ex-minister Simeon Nyachae, a Christian of a Seventh Day Adventist (SDA) faith and Senator Yusuf Haji of the Muslim faith. The two funeral services sparked debate on social media with a section of Christians seeking answers on Muslim funeral rites.

Nyachae, who died on February 1 at the Nairobi Hospital aged 88, was laid to rest two weeks later at his Nyosia village in Kisii County. His remains had been preserved at the Lee Funeral Home for 14 days before being flown to Kisii on Sunday.

On the other hand, the late Garissa Senator, who died on Monday morning, was interred at the Lang’ata Muslim Cemetry, in Nairobi, miles away from home, less than 24 hours after his death. He was 80 years old.

The cost of giving a loved one a decent send off took centre stage on the social media debate, with many Kenyans agreeing that Muslim burials cost way less.

Mohammed Hersi, a hotelier and vocal commentator on social media, took to his Facebook page to explain what happens when a Muslim dies.

In Muslim, Hersi said, the burial of a loved one should take place as quickly as possible after death and preferably within 24 hours.

Where the cause of death is uncertain this may and should be determined prior to burial.

The person who has died is washed as quickly as possible after death and wrapped in a simple white shroud For men, up to three pieces of cloth may be used for this purpose, for women, five.

In many countries, a coffin is not used, but in the UK, where this is often forbidden, a coffin is permitted.

Hersi revealed that the Muslim rarely transport a body.

“You get buried where you passed away…For us your burial is where death (maut) will find you, ” he wrote.

The Muslim burials timings are mainly dictated by prayers times.

The Muslim community prays five times a day: Fajr at 5am, Dhuhur at 1pm, Asr 4pm, Maghrib 6.30pm and Isha 8pm.

“Most of the burial prayers would coincide with the 1pm or 4pm prayers for various reasons ranging eg to allow immediate family like children to arrive etc, ” he said.

“We try and avoid evening or nighttime burial unless it is a case of an accident and departed ought to be laid to rest as quickly as possible.”

Preparation of the body 

The body is prepared either at home or even at some mosque.

Ghusl is the full-body ritual purification mandatory before the performance of ritual and janaza prayer.

The remains are wrapped in a simple plain cloth (the Kafan) which costs less than Sh500. After that, instead of a coffin, the deceased is transported to the mosque in a Janaza that is returned after use and reused by another family.

“Our mosque in South C does that very well and a few masjid in Mombasa, ” he added.

When a Muslim passes on in town, it becomes the responsibility of fellow muslims to give the departed brother or sister a decent burial.

The body is then carried away in a Janaza and is placed at the back of the mosque awaiting the normal prayers to happen.

Immediately after the normal prayers, an announcement is made informing worshippers of the presence of a body of a departed brother or sister and requested to join the family in burying their kin.

“It is considered a blessing to take part in such even if you were not known to the departed. We then bring the body to the front of the congregation, ” he added.

Before the body leaves for its final resting place, the family led by the eldest son and the Imam ask if there is anyone who owed the departed anything or if the departed owed anyone anything.

The son or immediately male family member are expected to take responsibility for the debt.

“We then all stand behind the Janaza and final prayers are led by the imam. Sometimes we have more than one body so they are all laid out in a line, ” he said.

The service takes less than 10 minutes and thereafter the body is picked by young men, who mostly are not even known to the deceased, and taken to the final resting place.

Once at the graveyard immediate family members preferably sons and brothers to the deceased will go inside the grave which is always ready.

The body is removed from the Janaza and placed inside a grave that has a mould of mud which acts as a pillow where the head of the deceased is placed. Additionally, the body faces the right side towards Mecca (the Muslim community faces Mecca when praying).

Wooden planks are used to enclose where the body is placed and if there is no wood, concrete slabs can be used.

Once done the family members step out, the grave is filled with soil.

Unlike in Christian funeral rituals, Muslims don’t observe protocols as everyone is considered equal regardless of their status.

“Once done a quick sermon is given hardly 5 to 10 minutes and we are done. We make no speeches and there are no protocols at the mosque or at the burial site based on your worldly position, ” he said.

“At the mosque and burial site we are all equal.”

In Muslim funeral rites, women are not allowed at the gravesite. If they attend, they can only watch from a distance.

Complete Article HERE!

Terminally ill people should be offered choice on assisted dying, says doctors’ group

Clinicians tell committee procedure can be introduced in ‘safe and fair manner’

By Sorcha Pollak, Patsy McGarry

Irish society has a responsibility to offer the choice of medically assisted dying to those suffering with a terminal incurable illness, a network of 100 doctors has said.

In its submission to the Oireachtas justice committee which is considering Dying with Dignity Bill, the Irish Doctors supporting Medical Assistance in Dying (IDsMAiD) group writes that medically assisted dying can be introduced in a “safe and fair manner”. It argues that in cases of terminal illness, “patients deserve to have their choice respected”.

The Bill tabled by People Before Profit TD Gino Kenny, which seeks to legalise assisted dying, passed to committee stage last October after a vote in the Dáil.

Members of the Irish Palliative Medicine Consultants’ Association (IPMCA) have criticised the wording of the bill saying its definition of what constitutes a terminal illness is too broad.

IPMCA chair Dr Feargal Twomey said “the bill as it stands was very open to significant misuse and abuse”.

However, the IDsMAiD submission, signed by 100 doctors across Ireland, states the bill’s criteria for qualifying for assisted dying is appropriately “conservative and restrictive” and that the safeguards proposed are “conservative, balanced and fair”.

Comprehensive regulation, monitoring and reporting of assisted dying must take place if the Bill passes to ensure accountability, transparency and to foster trust in the public, says the group.

However, it argues that the “hypothetical fears” that such legislation would harm Irish society are “insufficient reason to condemn people with terminal illness to unnecessary suffering”.

While palliative care can control and alleviate the symptoms of many patients, it “cannot eliminate all pain and suffering for all patients”, states the submission. “MaiD should be seen as complementing palliative care rather than any attempt to diminish it,” it states.

The group supports the bill’s provisions which state that assisted dying would only apply to competent adults, residents in Ireland and people with a terminal illness that is “progressive and incurable”.

It notes that a person should not qualify for assisted dying on the basis of a mental illness alone and further research is required before this is considered. Legislators should follow Canada and Victoria in Australia by excluding mental illness as qualifying as a terminal illness to “eliminate any doubt or confusion on this issue”, it says.

Access to assisted dying for patients with advanced dementia remains an “evolving issue due to the need for advanced consent”, it adds.

Dr Brendan O’Shea, a Kildare GP who helped draft the submission, says assisted dying will never be relevant to most people who die in Ireland but that for a small number, it is a “vitally important” option. Dr O’Shea, assistant adjuvant professor in public health and primary care at Trinity College Dublin, said the Bill was currently “short on detail” but that he believes all missing elements would be drafted in as the legislation passes through the Oireachtas.

“We feel most strongly that details around regulation need to be discussed,” he said, adding that medical practitioners, scientific experts and the public should be consulted during the process.

Ireland should be guided by evidence from other countries who have had similar legislation in place for years, said Dr O’Shea. The Canadian model is “well-funded, well regulated and conservative in its approach” while the Dutch approach should also be carefully examined, he said.

Dr Brian Kennedy, who was also involved in the submission, says his views were shaped by his time working as a palliative care doctor. “For the vast majority it is enough and most people in most circumstances can reframe to coping with live with their illness. But there are circumstances the patient, family and healthcare workers have to deal with which are simply too terrible for all concerned.”

Dr Kennedy believes offering the choice of assisted dying to terminally ill patients would help with Irish people’s “death anxiety” and is about putting the patient “front and centre”.

In other submissions to the committee, both the Catholic Church and the Presbyterian Church in Ireland have come out strongly against measures in the Bill.

In its submission, the Catholic bishops said the Bill failed “to recognise the reality that many patients who request assisted suicide are depressed and “to require care givers to provide adequate palliative care for the terminally ill person.”

This meant “someone might decide to end his or her own life without ever having experienced what palliative care has to offer and, thus, making this decision without being fully aware of the other options available to them,” they said.

They found it “unsatisfactory” that the Bill “gives more weight to the irreversibility of the condition than to treatments which, even temporarily, relieve the symptoms. This leads to an unacceptably loose understanding of terminal illness.”

In their submission, the Presbyterian Church said the Bill would “leave vulnerable members of our society open to abuse, duress or the weight of a perceived expectation that they will relieve others of the burden of caring for them.”

Former moderator of the church Rev Dr Trevor Morrow, who had been minister at Lucan Presbyterian Church in Co Dublin for 31 years, said “our experience as pastors is that the components that contribute to a peaceful and dignified death are social, emotional, financial and spiritual. By focusing so restrictedly on the physical aspects of dying, this legislation fails to take account of these factors which can help to mitigate, or exacerbate, human suffering and distress”.

Complete Article HERE!