Sunday, August 26, 2018

If There’s a Will, There’s Definitely a Way!

Addiction, Procrastination, and Laziness:
A Proactive Guide to the Psychology of Motivation

Author: Roman Gelperin
Publisher: Self-published, Middletown, DE, 2018



This is a small book (114 pages) which packs a big message. The bottom line is this: There is hope for behavioral addicts, procrastinators, and the lazy who want to control or stop their addictions, procrastinations, or laziness. As I read the book, I was reminded of the old riddle:

           Q: How many psychologists does it take to change a light bulb?
           A: Only one, but the light bulb has got to want to change!
You and I (assuming we are concerned about our addictive habits, our procrastinations, and/or our laziness) are the ‘light bulb’. Roman Helperin is the ‘psychologist’.
He holds to the idea that “Nearly all self-observant persons will concede that they are not in full control of their behavior.” Then he explains why. . . and what can be done about it.
Helperin starts his book off with five examples which almost every reader can identify with – either personally, or they know someone just like that. Each example represents a multitude of other cases readers may be familiar with.  They are:
1.     The person who has a project to complete but keeps putting it off until the last minute.
2.     The person who really wants to go to the gym to work out but seems to be unmotivated to do so.
3.     The smoker who wants to stop.
4.     The person who cannot stop playing video games.
5.     The person who cannot get out of bed in the morning.
For each of these Helperin shares their frustrations. He takes us through their mental and emotional feelings.  He helps us understand their fear and the impact of not succeeding. He explains the various motivations and pleasures of wanting to succeed but also those associated with continuing in their present condition.  He distinguishes between ‘acts’ and ‘results’, contending that people do not necessarily pursue ‘acts’ that they are involved in, but rather the ‘results’ of those acts.  He shows us that there are both positive (pleasure) and negative (pain) forces for both stopping and commencing any given activity.  The greater forces win out. But our ‘willpower’ can overcome a force. It all makes for interesting, although sometimes, complex reading. 
But he doesn’t leave us there. He introduces us to some very practical strategies (what he calls ‘Our Toolbox’ to conquer the challenges before us.
For starters, we need to understand how our physical environment impacts our ability to stand up to the challenge we are trying to overcome. The frequency of applying such changes improves the likelihood of success with respect to what we are trying to achieve. The success of this is augmented by its frequency. A second strategy is to target the pleasure of overcoming the challenge. Involving others who can act as social motivators to your pursuit can also be very beneficial to your goals.  He introduces a technique called ‘splitting your attention’ to make the hard tasks more doable – but he cautions that some tasks become impossible when attention is split.  (I found this section most interesting, as I reflect on watching television and working on an essay at the same time; or watching my grandchildren working on homework – especially math – and listening to music with their headphones. His comments on this are most interesting.). And there are a number of other equally helpful tools he presents for us to utilize in our different situations.
Finally, Helperin returns to his five examples and applies all the theory he has discussed to each of them, explaining what each person could do to be successful.  Where there’s a will to achieve something or to quit something or to change one’s behavior – there’s definitely a way!
This book is recommended for all those (from teenagers and up) who recognize they’re currently behaving in ways they would rather not. Counselors will also find it a great guide to help their clients overcome addiction, procrastination, and laziness. Well worth the time and effort to check it out.


n Ken B. Godevenos, President, Accord Resolutions Services Inc., Toronto, Ontario, August 26, 2018, www.accordconsulting.com

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Saturday, August 11, 2018

Oh the Web We’ve Spun When It Comes to Euthanasia

Assisted Death: Legal, Social and Ethical Issues after Carter

General Editor: Derek B.M. Ross, LL.B. LL.M. of the Ontario Bar
Publisher:LexisNexis Group, Toronto, ON, 2018


Oh the Web We’ve Spun When It Comes to Euthanasia 
The Supreme Court of Canada in 2015 made medical assistance in dying (MAiD) or euthanasia or physician assisted suicide (PAS) legal under certain conditions. Canada responded with basically supportive legislation in the form of Bill C-14 in 2016. This publication of Assisted Death: Legal, Social and Ethical Issues after Carterbrings together several prominent legal experts on what that means and how it impacts Canada and Canadians, not to mention the rest of the world with regard to where we go from here.
It is a large volume (541 pages) but one learns a lot. Given the profession of the writers one needs to read it patiently and with a highlighter. The rewards for a layman are significant. I learned about the doctrine of stare decisis-- when courts should, and should not, follow precedent -- and all the implications of the Carter case for and with respect to that doctrine. One learns about the importance of objectives of a law; whether rights limitations (a big deal here as MAiD is only extended to some individuals) are in accordance with the fundamental principles of justice; how freedom of conscience and religion, and the right to religious equality, for health care professionals and institutionsneed to be reconciled with patients’ interests; overbroad laws; the law’s conception of personal autonomy[and the difference between ‘Deliberative Autonomy’ and ‘Social Autonomy’];charter dialogue; the three sources of vulnerabilityand how they impact this issue; and much more.
Of course, there are social and ethical issues that must also be considered as a result of Carter and the consequences (positive and negative) that result from its application. These include:
·      the need “to affirm the inherent and equal value of every person’s life and to avoid encouraging negative perceptions of the quality of life of persons who are elderly, ill or disabled”
·      that “suicide is a significant public health issue that can have lasting and harmful effects on individuals, families and communities”
·      the “‘irrevocable nature of ending a life’ and the need for ‘robust safeguards. . . to prevent errors and abuse in the provision of MAiD’”
·      and “the interests of vulnerable persons in need of protection and those of society.”
There is way too much that one can highlight about this book. It is better in this case to simply state that it is very wisely divided by Derek Ross, the general editor, into four major parts, and to list those parts and their contents, as follows: 
I.        Carter’s Impact on Canadian Legal Doctrine – with chapters on:
a.     Carter: A Stain on Canadian Jurisprudence, by Dr. John Keown
b.     Carterand the Unsettling of Stare Decisis, by Dwight Newman
c.     The “Basic Bedford Rule” and Substantive Review of Criminal Law Prohibitions Under Section 7 of the Charter, by John Sikkema

II.        Charter Implications for Health Care Professionals and Institutions
a.     Conscientious Objections to Medical Aid in Dying: Considering How to Manage Claims of Conscience in a Pluralistic Society, by Mary Anne Waldron, Q.C.
b.     The Call in Carterto Interpret Freedom of Conscience, by Brian Bird
c.     Complicity, Autonomy, and Conscience: Charter Implications of the ‘Duty to Refer’ for Physician-Assisted Suicide, by Derek B.M. Ross
d.     The Right of Religious Hospitals to Refuse Physician-Assisted Suicide, by Barry W. Bussey

III.        The Future of Palliative Care in Canada and Safeguards Moving Forward
a.     Endgame: Philosophical, Clinical and Legal Distinctions between Palliative Care and Termination of Life, by Mary J. Shariff and Mark Gingerich
b.     Establishing the Right to Palliative Care in Canada, by David Baker and Geoff Cross
c.     The Way Forward for Medical Aid in Dying: Protecting Deliberative Autonomy is Not Enough, by Jonas-Sébastian Beaudry

IV.        Charter Dialogue and the Constitutionality of Canada’s MAiD Legislation
a.     Dialogue on Death: Parliament and the Courts on Medically-Assisted Dying, by Thomas M.J. Bateman and Matthew LeBlanc
b.     Constitutional Aspects of Canada’s New Medically-Assisted Dying Law, by Hamish Stewart
c.     Charter Scrutiny of Canada’s Medical Assistance in Dying Law and the Shifting Landscape of Belgian and Dutch Euthanasia Practice, by Trudo Lemmens
What I gleaned from the volume is that the Carterdecision has several flaws that should have been challenged with greater assertiveness.  They still can be when challenges to Canada’s legislation stemming from the Carterdecision arise, and they will – when a broader group of people want access to MAiD or when others want access for them – which is more alarming.
I was surprised by a number of facts including that the “trial judge in Carterdecided that there is no ethical distinction between intentionally and directly causing a person’s death and withdrawing life-sustaining treatment.” I was also surprised by the Court refusing “to confirm that the (Carter) decision would not compel physicians and other health care workers to provide medical aid in dying”, but rather simply stated that “nothing in the declaration. . . would compel physicians” to do so, but that “What follows is in the hands of the physicians’ colleges, Parliament, and the provincial legislatures.”  Ontario, of course, has decided its College of Physicians and Surgeons has the power (which it has used) to compel doctors to as a minimum make a bona fide referral to a doctor who will provide MAiD. In short, a cop-out by the Court. The matter is being appealed.  Also surprising was a Divisional Court’s contention that there “is no constitutionally protected right to practice medicine”, a position which is not in keeping with earlier decisions of the Supreme Court with respect to work.
The sections on religion, its legal definition, and its relationship to conscienceis fascinating both for the believer and the unbeliever. I was also intrigued by the position presented that ‘something being legal’ is not equivalent to ‘something being a right’. I learned about the so-called “Procedural Safeguards” that a professional must consider before a patient is granted MAiD – there are eight of them, many with their shortcomings. Alarming are the predictions of what lies ahead, some based on solid reasoning, and many based on observations of what has, and is, transpiring in Belgium and the Netherlands who have had MAiD for some time.
Some of my favorite quotes from the book include:
·     That the Court found the complete ban (on MAiD)to be overbroad, however, did not transform assisted suicide from a crime in 2015 to a Charter right in 2016. The repeal of crime does not automatically create a correlating constitutional right. To permit an act is not to mandatethat others perform it. (p. 170)
·     There is no right to termination of life, only a right to request it. The health care provider makes the determination regarding whether a request can be legally granted and whether or not to participate. (p. 289)
·     Parliament also declined to establish a right to PC (palliative care)when legalizing MAiD, contrary to both Belgium and Quebec which did establish a corollary right to PC. (p. 323)
·     The proportion of people who receive euthanasia and who are not terminally ill has also greatly increased in Belgium and The Netherlands. (p. 497)
·     Once end-of-life is abandoned as an access criterion, setting limits becomes very difficult if not impossible. . .. [A]significant majority of geriatricians in the Netherlands (62 per cent) felt pressured by family members to make a decision to euthanize. (p. 499)
This is a must read for anyone who has a loved one that is terminally ill or has the desire to ‘call it a day’ or just wants to “go home!” Certainly, doctors should read it, politicians should read it, clergy should read it. Highly recommended. It allows one to catch up on what has happened so far and alerts and prepares one for what is about to happen – both legally and socially. MAiD is one of the human issues that not only changes death, but impacts life.

n Ken B. Godevenos, President, Accord Resolutions Services Inc., Toronto, Ontario, August 11, 2018, www.accordconsulting.com

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