4 ways that older people can bolster or improve their mental health

By Jelena Kecmanovic

Older people generally have fewer psychological problems than the rest of the population. They also have shown the least increase in anxiety and depression during the pandemic, despite being most vulnerable to covid-19.

Resilience among the elderly has been attributed to their ability to better regulate emotions, higher acceptance of the ups and downs of life, and wisdom that comes from having learned to see the big picture.

But old age brings many challenges that can harm mental health.

Even after she lost her second husband to cancer, she kept engaged by providing relationship coaching, gardening, walking her dogs, hiking and doing house repairs. “But when my left knee started giving me more and more trouble, so that eventually I could hardly walk, I felt really discouraged and depressed,” Landrum said.

Many older people do suffer from considerable mental health problems. Among those living outside group settings, the rate of clinically significant depressive symptoms is 8 to 16 percent and anxiety disorders is 10 to 15 percent. The elderly living in nursing homes fare worse. Most older adults with depression and anxiety do not receive treatment for it.

Late life depression, in turn, has been found by researchers to increase self-neglect, cardiovascular problems, morbidity, and risk of suicide. It also leads to worse social and cognitive functioning and compromised quality of life. And geriatric anxiety has been linked to heart problems and high blood pressure, among other problems.

Studies have illuminated some risk factors for geriatric depression and anxiety.

Elderly people who deal with significant physical problems or cognitive decline, who are lonely, or who are grieving or dealing with multiple losses are more likely to experience psychological problems, especially depression. So are older people who have a lot of regret about a life not well-lived and who struggle to find meaning in their lives.

Many existential concerns come to the forefront of people’s minds as they near the end of their lives.

They confront questions such as, “Have I led a meaningful life?” “What has my role been in this world?” or “Am I leaving something behind?” How people perceive, explore, process, and talk about these questions can affect their emotional well-being.

Here are four approaches that psychologists like me find can facilitate these explorations and consequently bolster or improve mental health.

Engage in life review

It is a truism that the older people get, the more they reminisce about the events that took place in the past, sometimes very long ago. Psychologically, there is a purpose to looking back.

One of the most influential psychologists of the 20th century, Erik Erikson, considered the last stage of life to be focused on reviewing life, integrating positive and negative memories, and coming away with a coherent sense of a purposeful life. He postulated that people who had a particularly hard time with this process could end up feeling despair.

“In my work with older patients, we often engage with the question, ‘What has it all been about?’ ” said Herbert Rappaport, a clinical psychologist in the Philadelphia area and the author of “Marking Time.” “It is powerful to help them construct their life stories and to witness how this leads to a sense of peace and acceptance of whatever comes next.”

Research shows that life review improves mental health.

But depressed individuals have a hard time recalling positive events or reflecting back on their lives in ways that are not negative and self-critical. They also tend to remember things in a more general, abstract way, without much detail.

A strategy that counteracts this tendency is to intentionally remember positive situations and times in your life, recalling as much concrete and sensory information as possible.

“I worked with an older woman in my practice who was worried about her daughter’s well-being once she’s gone, and she questioned if she’s done anything to help the next generation, and now it was too late,” said Jason M. Holland, a clinical psychologist in Gallatin, Tenn. “Writing about and discussing these feelings and reviewing her life in totality helped her realize that it’s not all negative and that she’s leaving an important legacy with her grandkid.”

Autobiographical writing or recording, storytelling, scrapbooking, making art that honors your life, family genealogy, oral history interviews, arranging old photographs and creating legacy projects are all ways that promote life review.

Consider sources of meaning

Much of popular psychology and self-help urges us to discover or create meaning in life. “I fear that this just adds more pressure for people, that this can become another reason to feel guilty and ashamed — ‘I’ve failed because I haven’t found the meaning of my life,’ ” said psychologist Joel Vos, author of “Meaning in Life: An Evidence-Based Handbook for Practitioners.”

He suggested that people engage instead with the meaningful activities that they are already doing.

In my own psychology practice, I have found that, during the pandemic, many people have gained more clarity about what really matters in their lives. This often centers on going beyond oneself: connecting with others, with the past and future, with God or spiritual concepts, or with nature. Another source of transcendence includes creating something in the world, from a tenderly tended garden to a painting to a nonprofit organization.

“It is never too late to orient yourself toward what’s meaningful. At 90 years old, I am a living example,” said Irvin Yalom, emeritus professor of psychiatry at Stanford University and the author of “Existential Psychotherapy” and “Staring at the Sun: Overcoming the Terror of Death.

“I still see some patients, but just for a session each because my memory and energy are not what they used to be,” he said. “I connect with my children and play chess and talk with friends. Human connections make life worth living.”

Accept limitations

A common misconception I hear is that acceptance equals passive resignation or giving up. It actually means the opposite; it’s an active process of facing the limitations that come with age, employing courage and wisdom.

“One of the best predictors of successful aging is the ability to disengage from unattainable goals,” said Carsten Wrosch, a psychology professor at Concordia University in Montreal. “While grit and perseverance might be most important for younger people, the elderly with the best psychological outcomes let go of things they can’t do any more and shift toward things they can still do that are purposeful.”

Older adults often struggle with physical or cognitive limitations, with a loss of freedom, and with the ability to control their lives. “Losing control can be the most demoralizing. I suggest adjusting your expectations and finding anything, however small, that you can control,” Holland said.

Dealing with the hardships commonly faced in old age can even be a catalyst for growth. Illness, grief or another negative change sometimes results in an important reckoning. “Significant transition or change can lead to an existential crisis, a chance to reevaluate life and to eventually align it more with your values,” Rappaport said.

Deal with death anxiety

With the coronavirus death toll of at least 750,000 in the United States, many people here have faced death more immediately and more acutely than at any point in recent history. And yet, many still find it hard to talk about death and dying, avoiding news that could trigger death anxiety.

“Numerous studies show that people who have high death anxiety suffer from psychological problems and disorders,” said Rachel Menzies, clinical psychology postdoctoral research fellow at the University of Sydney and a co-author of “Mortals: How the Fear of Death Shaped Human Society.” “In general, death anxiety subsides later in life. But for some elderly, it can be very high and contribute to their depression and anxiety.”

To confront death anxiety, Menzies suggests reading obituaries or watching shows that involve death and dying, especially if these had been previously avoided.

“Visit cemeteries, nursing homes, or funeral homes — anything that will bring you in contact with death,” she said. “That way death becomes a normal part of life.”

Another often evaded topic is a discussion of one’s will and end-of-life preferences and directives. Tackling this now could decrease your fear of death, and provide a sense of dignity and control. And it will be a gift to the ones you are leaving behind.

An exercise I often use with patients, derived from Acceptance and Commitment therapy, a type of therapy which helps people to live with purpose and to stop being hostages of their anxiety and depression — is to have someone imagine their funeral and write their own eulogy and tombstone inscription. This may sound ghoulish, but it not only tends to reduce death anxiety, but also crystallizes the values that are important to people and urges them to put them in place before it is too late.

“Life well lived is the best antidote to death anxiety,” Yalom said.

Complete Article HERE!

Psychedelics Could Be New Frontier in End-of-Life Care

By Jim Parker

Psychedelic medicines may represent a new frontier for end-of-life care, as well as psychiatric treatment. While these substances — including LSD, MDMA, psilocybin and ketamine, among others — remain illegal, grass roots support for decriminalization or medical use is growing. Meanwhile, venture capitalists and other investors are spending billions to get on the ground floor of what could become a new health care industry. 

Much of the research and discussion on medical use of psychedelics has focused on care at the end of life. Interest in the potential medical benefits of these substances became widespread during the 1960s, but research all but stopped after they were criminalized through federal legislation in 1970. The first inklings of a resurgence began in the late 1990s, and momentum has picked up during the last decade.

“The evidence is just so compelling, and we have very little in terms of tools in our medical bag to be able to help people who are suffering from existential distress, anxiety and depression related to a serious illness diagnosis,” Shoshana Ungerleider, M.D., internist at Crossover Health in San Francisco, founder of the organization End Well, said. “We want people to be able to live fully until they die. If psychedelics given in a controlled therapeutic environment with trained clinicians who can help them do that, then these medicines should be more widely available.”

End Well recently produced a conference on the subject of psychedelic medicine for dying patients.

The body of scientific literature on psychedelics for dying patients continues to advance. Johns Hopkins Medicine in 2019 established a Center for Psychedelic and Consciousness Research backed by $17 million in grants.

Researchers have identified a number of clinical benefits, including reduction of anxiety, depression and improved acceptance of mortality, according to a 2019 literature review in the journal Current Oncology. The paper cited studies indicating that the most commonly used psychedelic drugs have no tissue toxicity, do not interfere with liver function, have few interactions with other medications and carry no long-term physical effects. Common side effects tend to be short in duration, such as nausea and vomiting or disruption of visual or spatial orientation.

Patients who use psychedelic medicines often report what researchers commonly describe as a “mystical experience,” involving a feeling of unity, sacredness, deeply-felt positive mood, transcendence of space and time, and other effects that study participants found difficult to verbalize, according to the Current Oncology paper. 

“This can be transformative for people with anyone who is wracked with trauma, grief, loss or extreme states of suffering,” Sunil Aggarwal, M.D., co-founder, co-director and practitioner at the Advanced Integrative Medical Science (AIMS) Institute in Seattle, told Hospice News. “There’s also evidence that these substances can also reduce physical pain.”

Aggarwal is a board-certified hospice and palliative care physician and a past chair of the American Academy of Hospice and Palliative Medicine (AAHPM).

All psychedelics are illegal at the federal level and in most states. Oregon in 2020 became the first in the union to remove criminal penalties for all illegal drugs and is now in the process of establishing the nation’s first state-licensed psilocybin-assisted therapy system.

More action has been happening at the local level, with communities such as Washington, D.C., Denver, Ann Arbor, Mich., three Massachusetts cities, and Santa Cruz and Oakland in California voting to decriminalize some psychedelics and permit medical use. Some of these regions are now considering statewide decriminalization.

Connecticut and Texas each have laws on the books that created work groups to study the medical use of psilocybin, MDMA and ketamine. Legislatures in Hawaii, Iowa, Maine, Missouri, Vermont and New York state are currently mulling decriminalization or medical use bills.

In late July, Rep. Alexandria Ocasio-Cortez (D-N.Y.) reintroduced an amendment to remove federal barriers to research the therapeutic potential of psychedelic substances. The U.S. House of Representatives quickly shot down the legislation, though it garnered more support this round than the previous time it was introduced.

“We quite a few years off from having enough trained therapists and a policy pathway for which these can be made more widely available in a controlled therapeutic setting,” Ungerleider said. “There’s just so much interest right now among patients and among family members to learn more about this. All health care professionals need to have an understanding of where we’re at with psychedelics.”

Interest in psychedelics has transcended the research space and entered the business world. The familiar adage, “follow the money,” frequently provides good indicators of which way the wind is blowing.

The psychedelics industry is expected to bring in more than $6.85 billion by 2027, Forbes reported. Many of these investors are seeking to reproduce the lucrative results of the cannabis industry that emerged in the wake of legalization among a number of states. A recent report indicated that 36 states and four territories allow use of medical cannabis products, according to the National Conference of State Legislatures.

The largest investors in psychedelics include the venture capital firms Conscious Fund, Explorer Equity Group and Pala Santo. Earlier this year, Florida-based cannabis and psychedelics attorney Dustin Robinson co-founded Iter Investments, a new venture capital group focused on that sector.

A United Kingdom-based psychedelics-focused pharmaceutical company, Compass Pathways (NASDAQ: CMPS), went public in Sept. 2020 and is now worth an estimated $1.2 billion.

“There’s a unique opportunity to be able to go ahead and develop and commercialize [psychedelics] to a much larger patient population,” health care investor and venture capitalist Andrew Lee told Hospice News. “It’ll be interesting to see how natural pharmaceuticals might work. There’s the nonprofit, sacred path, the pharma path and the botanical drug sort of path. The most important thing is that this is another tool in the toolbox for treating a number of conditions.”

Complete Article HERE!

Book Excerpt: On Death, Dying, and Disbelief

by Candace R. M. Gorham, LCHMCS

Attending the Women of Color Beyond Belief conference for the first time, I did not know what to expect. New to the secular community, I appreciated having a space to draw on my experiences as a secular woman of color. By far the most meaningful event I attended was Candace Gorham’s event, “On Death, Dying, and Disbelief,” based on her new novel. I had never considered how as a secular person, my grief process might be different than what is conventionally taught within our society. Like many things in the United States, the grief process is extremely enmeshed with Christian beliefs of heaven and god. I had often neglected my own grief processes, unable to understand how our belief or non-belief had a direct influence on it.

Coming from an extremely Catholic background, things like “they may have passed, but take solace that they are in heaven” or “they are in a better place” were commonly interlaced in my family conversations about grief. Through this conference event, I learned the importance of learning and practicing secular grief and coping skills as they aligned with my everyday beliefs. This book, written by mental health counselor Candace Gorham draws on her expertise as well as her secular beliefs on how to cope with grief. This is a must-read for any atheist processing grief in a religious world.

—Margie Delao, AHA Policy and Social Justice Coordinator

This excerpt comes from “Tip 1” of On Death, Dying, and Disbelief, available for purchase now:

At times I’ve heard a grieving nontheist say, “I still hear their voice” or “I see them,” and they wonder if they are having a spiritual experience. I think it is a sign that the person is in unimaginable pain. Even those who grew up without religion have been exposed to ideas about an afterlife and other spiritual concepts such as demons, angels, apparitions, and more. It is not uncommon for people who believe in an afterlife to also believe that their loved ones can come back and communicate with them. Therefore, it is not unreasonable that you, having encountered that way of thinking much of your life, might manifest those same internalized concepts during your time of extreme vulnerability.

It is okay that you might wish there is an afterlife when you are grieving. You do not need to feel ashamed or silly about having such thoughts either. During this time, you are desperate for any connection to your loved one, and, unfortunately for those nontheists who generally want nothing to do with spirituality, those spiritual concepts seem to be our only possible way to connect with our loved one. Therefore, it makes sense that you wish they were still living somewhere in an afterlife, watching over or even visiting you.

I have a friend who is currently grieving the death of a lover and she and I talk regularly due to our shared understanding of this unique pain. She asked me about my thoughts on the afterlife and whether I wished Tim was in one. I explained that, yes, there had been times I wished he were in a heaven, but I do not dwell on those thoughts because I do not believe in heaven. For me, the thought of an afterlife does not serve a purpose or bring me comfort. It does not make me uncomfortable either. However, for her, it brought her moments of comfort. So, I supported her in her ability and need to simultaneously carry those contradictory beliefs so that she could experience occasional relief, even though she articulated her full belief that there is no heaven. I think she found comfort in knowing that I had had the same experience, which helped normalize her own thoughts, and that I was proof that such a feeling was temporary.

It is also okay for you to “talk to” your loved one, knowing full well that they are not there. If it will make you feel better, tell yourself that doing so is no different than journaling, except you are saying the words out loud. As with journaling, “talking” to a person who is not really there can be a very cleansing experience….

It can also be helpful to verbalize all of the things you wish you had said or could say to your loved one. You most likely carry a ton of regrets, and there are probably a million things you wish you had or had not said. Although your loved one is gone, there is something healing about getting those words out of your brain and out of your heart….

Have you ever had an argument with someone, then later thought of all kinds of comebacks, points, and counterpoints you wish you had unleashed? How did you handle that? Most likely you replayed an alternate version of the conversation over and over in your head a hundred times or called a friend and told them all the things you wish you had said. Then what did you probably say after you vented like that? Whew! I feel better now. That’s because saying things out loud, even when we cannot say them directly to the target, feels good….

You will experience every emotion on the spectrum. You will go through all the stages. You will contemplate and ruminate. You will fantasize and romanticize. And having grown up in a society that places high value on supernatural experiences and entities, the afterlife, and spiritual exploration, it is reasonable that you will find yourself thinking about these things as well. Your friends and family may try to convince you that such thoughts are proof that god is trying to reveal himself to you and you may even wonder about this yourself from time to time. However, whether you are a lifelong nontheist or came to your nontheism after years of study and struggle, you may be uncomfortable with having supernatural thoughts or “experiences” during the grieving process. In those moments, it’s important to recognize that such unwanted thoughts are often simply an expression of the grieving process.

Complete Article HERE!

How different cultures cope with grief


Many cultures cope with grief differently than we do.

I’ve been interested this topic ever since I met my beloved husband Baheej. Both his parents died in Nazareth, the Holy Land, where he was raised, and died after he was already here in the U.S.

So he was worried and was fascinated about how we handle grief here. It was a time when scholars were just starting to study death and dying and the whole issue of grief and how we handle grief here in the U.S.

So Baheej wrote his doctoral dissertation on “The Sociology of the Mortuary,” which turned out to be about how funeral directors here must take over many of the roles that are performed by family and community in most traditional cultures. He joined the Rotary Club in La Crosse, Wisconsin, where he was already teaching in the university, so he could meet funeral directors who were part of the local business community. And he interviewed them and surveyed their network of other funeral directors.

He learned that families turn to the funeral directors when there is a death, and the funeral directors take over most of the arrangements and logistics. They are the ones who know what to do — not just the casket and cremation or burial but most everything: death certificates, transportation, after-funeral dinner logistics, what to do, where and when to go, coordination with the clergy as needed, and giving consolation and emotional support to the family. They take over many traditional family roles because there is no one else to do it, or has the experience and knowledge.

It’s true, we often don’t know what to do, and are sometimes far away from family, and we partially rely on clergy if religious. But we rely heavily on those professional funeral directors who are essential parts of that first week. In my case they not only arranged many things here, but also arranged the whole transfer for burial in the family plot out of state, which involved coordination with a second funeral director there.

Here we just don’t have much social support or social protection. This was extreme in Baheej’s case because no one around him (except me) even knew his parents had died.

We basically dress in black or muted colors for the funeral but usually not the next day. Friends or neighbors may bring a hot dish or a cake. As we know, we are expected to get a grip and “get better” after a few weeks or a couple months. We do the best we can, mostly on our own. We don’t have many “after funeral” traditions or other social protections. We are expected to go back to work and act normal.

We do have some music about death and grief, but that’s only if you listen to a lot of music. One nice old song I like goes this way: “There are holes in the floor of every room, and she’s watching over you and me.” The raindrops “are her tears falling down.’ It’s a father consoling his son over the death of his wife and mother of his little boy.

There are many songs about loss and death. Some are about a lost love because of a breakup or divorce, many are about grief over death of a loved spouse, parent, child, friend.

But if we look abroad, there are many cultural tradition of consolation — such as mourning poetry, mourning jewelry, mourning dress, and ways of discussing and acknowledging the death.

One famous mourning poem in Nazareth is “Oh God, how could you take the center jewel from the necklace,” written by a father on the death of his daughter. My beloved Baheej read it to me because he sent it to a friend years ago who had lost his young daughter in a car accident.

The mourning jewelry idea was widespread in Victorian England after Prince Albert died and Queen Victoria went into mourning for the rest of her life.

Black clothing for a long mourning period happens in many cultures. Also men wearing black arm bands signals grieving. Not just the day of the funeral but for a period of time. Baheej’s beloved grandmother, Leah, wore only black the rest of her life after her eldest son drowned in Brazil after he emigrated there in the early 1900s.

In some cultures there are lots of other rituals and vocabulary to support grieving people, such as photos by grave stones, which I’ve seen in Mexico and Italy.

The point is: Many cultures have a range of social protections after a death, so all the community knows what happened and can extend themselves and be supportive.

By social protections I mean some outward signs, but also neighborhood and community awareness, and the ability and motivation to get personally involved and talk about the death with the bereaved. Of course, we don’t live in Nazareth or some other traditional culture with centuries of such customs, so we will have to do the best we can. But awareness may help.

Complete Article HERE!

Mum’s final moments with champagne and cigarette at assisted-dying clinic

Dawn Voice-Cooper, 76, who said her life had become an “unbearable” battle, slipped out of consciousness while surrounded by friends at an assisted-dying clinic in Switzerland

Dawn Voice-Cooper received her final wish at an assisted-dying clinic in Switzerland

By Amy-Clare Martin

A woman who spent the last few years of her life fighting for the right to die has been given her final wish after travelling to an assisted-dying clinic in Switzerland.

Dawn Voice-Cooper was surrounded by her friends while she sipped champagne, had a last cigarette and listened to her favourite song for the final time.

Facing a daily battle against a series of incurable health problems, including severe arthritis, brain bleeds and epilepsy, Dawn, 76, was determined to end her life on her own terms before the quality of her life, which she described as “at times unbearable”, deteriorated any further.

Dawn enjoying a glass of champagne on her final morning
Dawn enjoying a glass of champagne on her final morning

Her tearful last words to her emotional friends and the medical staff at her bedside were simply: “Thank you, thank you everyone.”

Minutes later she was dead, after receiving a fatal dose of ­barbiturates, reports the Mirror, which was invited along to cover her final journey.

The former mental health worker and mother of one had described her life as being the “endless, often difficult, and usually painful, daily management of several, incurable issues”.

Dr Erika Preisig with Dawn at the clinic
Dr Erika Preisig with Dawn at the clinic

She said: “People often tell me, ‘Oh you look fine, you look young, you’ve got a bit of a limp’. But they don’t know what’s really going on inside me, the pain and the difficulties – the daily management of my ailments and my injuries.”

Opponents of assisted dying fear any legalisation will push disabled and elderly people into ending their lives early out of fear of becoming a care burden.

Reporter Amy-Clare Martin with Dawn the day before she went to the clinic for the final time
Reporter Amy-Clare Martin with Dawn the day before she went to the clinic for the final time

But Dawn hoped that by sharing her journey she could show that rigorous safeguards can stop abuse.

The children’s writer, from Sevenoaks, Kent, began to consider assisted dying in 2017 and made her application to the Lifecircle clinic in Basel two years ago.

The application process required her to submit her medical history, explain her reasons for wanting an assisted death and prove she was mentally competent. Once in Switzerland, she was assessed by two doctors separately before being taken to the clinic.

The emotional final goodbyes
The emotional final goodbyes

Unlike the better-known Dignitas, where patients drink a lethal cocktail of medication, Lifecircle sets an IV drip which recipients operate themselves.

Inside the clinic, Dawn signed her own death ­certificate. She hugged her friends, fellow campaigners Alex Pandolfo and Miranda Tuckett, before a nurse ­positioned her bed in front of the window to look out at the trees.

“It’s beautiful here surrounded by the trees. I think it must be the most beautiful place to die,” she said.

Dr Preisig helps prepare Dawn for her last moments
Dr Preisig helps prepare Dawn for her last moments

Lifecircle president Dr Erika Preisig asked Dawn four final questions on camera, to confirm she knew what she was doing and the consequences of taking the lethal drugs.

Then, listening to Nick Drake’s Day is Done, with her friends holding her hands, Dawn released a valve on the IV.

Following a police report, which takes place after every assisted death at Lifecircle, her body will be cremated and her ashes scattered by Dr Preisig.

Alex, who has early onset ­Alzheimer’s and who also plans to die at Lifecircle, said: “It was one of the most beautiful and loving deaths I have witnessed in contrast to the unacceptable and prolonged tortured deaths of my beloved mum and dad and the death my Alzheimer’s may bring to me.

“Dawn’s story and experience of both pain and then peace through the support of Lifecircle will be used as I continue to ask for an evidenced based parliamentary inquiry into humane voluntary assisted dying in the UK.”

Complete Article HERE!

‘Quick and painless death’

— Easier said than done

By Michael Cook

The central goal of right-to-die organisations has not changed much over the past 150 years. In 1872 a British writer, Samuel D. Williams, wrote a book advocating the use of the novel anaesthetic chloroform to give patients “a quick and painless death”. In 1931 the British eugenicist Dr Killick Millard proposed legalisation of euthanasia “to substitute for the slow and painful death a quick and painless one”.

Now that legalisation has arrived, however, doctors have realised that a Q&P death is easier said than done.

Writing in a recent issue of The Spectator (UK) Dr Joel Zivot, a Georgia physician, expresses his doubts about whether lethal medications are the way forward. He studied the autopsy reports of more than 200 prisoners executed with lethal injections and found that many may have died in great pain.

“The death penalty is not the same as assisted dying, of course. Executions are meant to be punishment; euthanasia is about relief from suffering. Yet for both euthanasia and executions, paralytic drugs are used. These drugs, given in high enough doses, mean that a patient cannot move a muscle, cannot express any outward or visible sign of pain. But that doesn’t mean that he or she is free from suffering.”

Dr Zivot believes that pentobarbital, which, it seems, is used in Oregon in 4 out of 5 assisted suicides, caused pulmonary oedema – the lungs fill with liquid secretions and the person can die in agony. “Advocates of assisted dying owe a duty to the public to be truthful about the details of killing and dying. People who want to die deserve to know that they may end up drowning, not just falling asleep,” he writes.

Nor is death necessarily quick.

In Oregon, where statistics are gathered about the mode of death, the median time to death throughout the 23 years of the Act is 30 minutes but the maximum time is 4 days and 8 hours. The median time for people to fall unconscious is 5 minutes, the maximum is 6 hours.

At least in the United States, doctors who participate in assisted suicides are aware of these issues. Dr Lonny Shavelson, a California physician who specialises in this novel field, has helped to organise the American Clinicians Academy on Medical Aid in Dying. This provides a forum for doctors to establish a best-practice for helping people to die.

It turns out that the very diseases from which the patients suffer can make the drugs less effective. Dr Shavelson spoke with Medical Xpress last year about some of the difficulties:

“Shavelson and [his colleague retired anesthesiologist Dr Carol] Parrot have identified which patients are more likely to linger, and can recommend adjustments. People with gastrointestinal cancer, for example, don’t absorb the drugs as well. Former opiate users often have resistance to some of the drugs. Young people and athletes tend to have stronger hearts and can survive longer with low respiration rates.

“We’re learning. Hypothesis, data and confirmation. This is what science is,” he said. “Our job is to stop the heart; that’s what they want us to do.”

Complete Article HERE!