Collaboration and research imperatives for a growing right-to-die movement.

This commentary discusses key controversies surrounding assisted dying that have now evolved, creating further tensions and divisions among assisted dying organizations, adding to existing controversy based on ethical, political, and theological grounds-all shaping public health policy in Canada and elsewhere. The growing worldwide trend in the right-to-die movement is increasingly focusing on medical assistance in dying (MAID) with most service organizations (societies) devoted to a sanctioned, legislatively prescribed approach. While in consequence important changes have occurred in numerous countries and jurisdictions with successful challenges on the absolute prohibition to assisted dying, it is arguably the case that as many-if not more-people are still denied this controversial right to have a peaceful, reliable, and painless end of their own choosing. We examine implications of this for beneficiaries and service providers, while showing how a collaborative and strategic approach that includes all options to access a human right to determine our own end-of-life options can effectively address these tensions for the benefit of all right-to-die organizations, regardless of differences in their respective tasks, directions, and agendas, with each mutually reinforcing the work of the other. We conclude by stressing the essential need for collaboration in terms of furthering research to better understand challenges facing policymakers and beneficiaries and potential liabilities for health professionals providing this service.

RéSUMé: Ce commentaire traite des principales controverses entourant l'aide à mourir qui ont maintenant évolué, créant de nouvelles tensions et divisions parmi les organisations d'aide médicale à mourir, ajoutant à la controverse existante fondée sur des motifs éthiques, politiques et théologiques­tous façonnant la politique de santé publique au Canada et ailleurs. La tendance mondiale croissante du mouvement pour le droit de mourir se concentre de plus en plus sur l'aide médicale à mourir (AMM), la plupart des organisations de services (sociétés) se consacrant à une approche sanctionnée et prescrite par la loi. Alors qu'en conséquence des changements importants se sont produits dans de nombreux pays et juridictions qui ont contesté avec succès l'interdiction absolue de l'aide à mourir, il est sans doute vrai qu'autant de personnes­sinon plus­se voient encore refuser ce droit controversé d'avoir un accès paisible, fiable et et indolore fin de leur propre choix. Nous examinons les implications de cela pour les bénéficiaires et les prestataires de services, tout en expliquant comment une approche collaborative et stratégique qui inclut toutes les options pour accéder à un droit humain afin de déterminer nos propres options de fin de vie peut résoudre efficacement ces tensions au profit de toutes organisations à terme, quelles que soient les différences dans leurs tâches, orientations et programmes respectifs, chacune renforçant mutuellement le travail de l'autre. Nous concluons en soulignant le besoin essentiel de collaboration en termes de recherche supplémentaire pour mieux comprendre les défis auxquels sont confrontés les décideurs politiques et les bénéficiaires et les responsabilités potentielles des professionnels de la santé fournissant ce service.

Violence against women: the state of batterer prevention programs.

While both men and women can be victims, domestic violence usually consists of assaults on women, and most violence against women occurs within an intimate relationship. In the past twenty years, numerous state and provincial programs to intervene in domestic violence cases have developed. The programs tend to focus on treating batterers, although they also offer counseling to domestic violence victims. The jury remains out on the effectiveness of these programs. A major issue is whether the programs use appropriate standards. After an overview of the prevalence and nature of domestic violence, this article provides a discussion of those standards--their nature, effectiveness, and limitations. Another section discusses use of a batterer intervention program in an urban setting. Yet another section explores the implications of intimate partner violence and looks again at the effectiveness of batterer treatment within intervention programs. The article closes with a look at the way one state addresses domestic violence and treats it as a crime. An inescapable conclusion to be drawn from the discussion is that violence against women has its roots in cultural assumptions that must undergo change if the incidence of that violence is to be reduced.

The Impact of a Batterers' Program on Battered Women.

Twenty-five in-depth interviews were conducted with battered women whose partners had completed a batterers' intervention program (BIP) that was administered by a women's shelter in a Canadian urban setting. Interview questions broadly explored women's experiences with the BIP, including what, if any, differences they perceived after their partners completed intervention, and how the women accounted for such changes. Respondents reported a variety of experiences, most of which appeared beneficial for them. Major themes were (a) feelings of enhanced safety, (b) a sense of enhanced personal well-being, (c) feeling validated by program counselors, and (d) increased knowledge regarding abusive behaviors.