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Update September, 2019


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US health officials report new vaping deaths, repeat warning

In this Saturday, Dec. 22, 2018 file photo, a woman takes a puff from a cannabis vape pen in Los Angeles. On Friday, Sept. 6, 2019, U.S. health officials are again urging people to stop vaping until they figure out why some are coming down with serious breathing illnesses. (AP Photo/Richard Vogel)

Mike Stobbe

New York (AP) — U.S. health officials on Friday again urged people to stop vaping until they figure out why some are coming down with serious breathing illnesses.

Officials have identified about 450 possible cases, including as many as five deaths, in 33 states. The count includes newly reported deaths in California, Indiana and Minnesota.

No single vaping device, liquid or ingredient has been tied to all the illnesses, officials said. Many of the sickened — but not all — were people who said they had been vaping THC, the chemical that gives marijuana its high. Many are teens.

Health officials have only been counting certain lung illnesses in which the person had vaped within three months. Doctors say the illnesses resemble an inhalation injury, with the body apparently reacting to a caustic substance that someone breathed in. Symptoms have included shortness of breath, fatigue, chest pain and vomiting.

The illnesses have all surfaced this year, and the number has been growing quickly in the last month as more states have begun investigations. A week ago, U.S. officials pegged the number at 215 possible cases in 25 states.

It’s unclear whether such illnesses were happening before this year.

“We’re all wondering if this is new or just newly recognized,” Dr. Dana Meaney-Delman of the Centers for Disease Control and Prevention told reporters Friday.

An Illinois health official, Dr. Jennifer Layden, said officials there don’t know when such illnesses first began, but she said there has been a marked increase since spring.

Deaths previously were reported in Illinois and Oregon.

Indiana officials said the person who died there was an adult, but they didn’t say when it happened or release other details. Health officials in Los Angeles said they were investigating a vaping death as well. And Minnesota health officials said that state’s first known vaping-related death was a person over 65 years with a history of lung problems who had vaped illicit THC products and died in August.

Recent attention has been focused on devices, liquids, refill pods and cartridges that are not sold in stores.

New York State has focused its investigation on an ingredient called Vitamin E acetate, which has been used to thicken marijuana vape juice but is considered dangerous if heated and inhaled. State investigators have found the substance in 13 cartridges collected from eight patients. In several cases, the ingredient made up more than half of the liquid in the cartridge.

CDC officials said they are looking at several ingredients, including Vitamin E acetate. But Meaney-Delman added that no single factor has been seen in every case.

Also Friday, the New England Journal of Medicine released a series of articles that give medical details about cases reported in Illinois, Wisconsin and Utah.

An article on 53 illnesses in Illinois and Wisconsin noted that nearly one-fifth of the cases were people who said they vaped nicotine and not anything that contained THC or CBD oil.

For that reason, doctors and health officials are continuing to suggest people stay away from all vaping products until the investigation establishes exactly what’s at the root of the illnesses.

Meaney-Delman said avoiding vaping is “the primary means of preventing this severe lung disease.”

It’s not yet clear what impact the recent illnesses are having on vaping rates, but some health officials are hoping more Americans will become wary.

There’s been a split among public health experts about the value of vaping nicotine. Some argue e-cigarettes are not as lethal as conventional cigarettes and can be a valuable aide to smokers trying to kick the habit.

But others say studies have not established that adult smokers who try vaping end up quitting smoking long term. And they fear that kids who might never have picked up cigarettes are taking up vaping.

The National Association of County and City Health Officials “has long been cautious about endorsing e-cigarettes even before the recent spate of illnesses, because little scientific evidence exists to show that e-cigarettes and other nicotine delivery devices are effective cessation devices,” spokeswoman Adriane Casalotti said in a statement.

The states reporting vaping-related lung illnesses to the CDC are Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Montana, North Carolina, Nebraska, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Vermont, Wisconsin, and West Virginia.


Landmark euthanasia trial opens in the Netherlands

A judging panel presides in the court case for on a 74-year-old woman suffering from dementia who was euthanized three years ago despite some indications that she might have changed her mind, as the trial opens in The Hague, Netherlands Monday Aug. 26. The landmark euthanasia trial seeks to pinpoint what to do with dementia patients who have previously stated their wish to die under certain circumstances but later might have second thoughts. (AP Photo/Aleks Furtula)

Raf Casert & Aleksandar Furtula

The Hague, Netherlands (AP) — A landmark euthanasia trial opened in the Netherlands Monday seeking to pinpoint what to do with dementia patients who have previously stated their wish to die under certain circumstances but later might have second thoughts.

The court case centers on a 74-year-old woman who was given fatal doses of drugs three years ago despite some indications she might have changed her mind. The doctor in the case is accused of making insufficient efforts to find out whether the patient still wanted to die.

She is charged with breaching the euthanasia law and, if the judge rules the request of the patient was insufficient, that charge could in theory become murder. But the prosecution is not seeking any penal sentence against the doctor and does not question her good faith. Instead, the prosecution centers its case on setting out a better legal framework for the future.

“We think the doctor has not acted carefully enough and thus passed a threshold. But at the same time, we also say that this threshold is not very clear,” said public prosecution spokeswoman Marilyn Fikenscher, underscoring the arguments that the doctor acted with good intentions.

“She does not need to be punished,” Fikenscher said. The daughter of the patient who died also strongly defended the doctor.

It is the first such case since the 2002 legalization of euthanasia in a nation that has long been a trailblazer in the intentional ending of a life if suffering becomes overwhelming. The Netherlands’ 2002 euthanasia law decriminalized the practice if it is carried out by a physician who adheres to strict conditions.

Officials began probing the case last September, when they found the doctor had added a tranquilizer to the patient’s coffee and then had family members hold her down while delivering the fatal injection of drugs.

During Monday’s opening session, the doctor, now retired, said she was fulfilling the patient’s written euthanasia request from 2012. By the time she died, the woman suffered from “deep dementia,” the doctor said, a condition in which brain functions such as analytical thought, abstract reasoning and planning are quickly ravaged.

The doctor testified that because the patient was not mentally competent, nothing the woman said around the time of her death was enough to invalidate the written statement. She said the patient could no longer fathom the meaning of such concepts as euthanasia and dementia.

But Dutch prosecutors argued that the patient’s written request was unclear and contradictory. In 2012, upon learning of the onset of her Alzheimer’s disease, she filed a euthanasia declaration that said she “certainly did not want to be placed in an institution for demented elderly.”

“I want a humane farewell for my loved ones,” the patient wrote. She later added to the declaration that she wanted euthanasia to take place “when I, myself, consider the time ripe.”

The Netherlands is one of five countries that allow doctors to kill patients at their request, and one of two, along with Belgium, that grant the procedure for people with mental illness.

Euthanasia involves doctors actively killing patients with an injection of drugs but in assisted dying, patients are provided with a lethal solution that they must drink themselves.

For those with late-stage dementia, euthanasia is still possible if the person made a written demand specifying the conditions under which they want to be killed and if other criteria are met, namely if the doctor agrees the patient is suffering unbearably with no prospect of improvement.

The outcome of the trial is set to be announced in a weeks’ time.

Dutch prosecutors are also examining two other criminal investigations into doctors who performed euthanasia in questionable circumstances; another two cases were recently dropped.

Steven Pleiter, Member of the Board of the Levenseinde Kliniek end-of-life hospital, said the case should not give the impression that the Netherlands takes such life-and-death issues too lightly.

“This is the first case that (has happened) in about 50,000 cases of euthanasia, and so there is a very careful practice in the Netherlands,” Pleiter said.

 


HEADLINES [click on headline to view story]

US health officials report new vaping deaths, repeat warning


Landmark euthanasia trial opens in the Netherlands