Center of expertiseīesides our mental health services, 113 acts as a change agent and centre of expertise: it leads the National Suicide Prevention Agenda (Landelijke Agenda Suïcide Preventie) and establishes Suicide Prevention Action NETworks (SUPRANET Care, SUPRAnEt Community). In our gatekeepers' training programme our clients learn how to identify signs of suicidal thoughts, to address those and how to refer to professional help. In addition, we support clients with our training services aimed at both professionals working in mental health care (GGZ professionals) and people who are facing suicide in their professional practice or personal environment. Consultation by telephone for other professionals, next of kin or friends about somebody in need (the opportunity to pose a brief question to a professional in a session lasting a maximum of ten minutes).Self-tests (questionnaires to fill in and to offer an indication of the severity of your troubles and symptoms (an anxiety and depression test and a test that measures suicidal tendencies).Self-help course (an independent online course aimed at reducing suicidal tendencies).Chat therapy (a maximum of 8 online chat dialogues with a professional).Crisis telephone (a direct opportunity to talk to a trained volunteer by phone and, if necessary, to a professional).Crisis chat (a direct opportunity to talk online to a trained volunteer).We are available 24 hours a day, 7 days a week across the Netherlands for crisis dialogues. ![]() 113 works in close cooperation with the mental health institutes' crisis centres. We employ mental health professionals, therapists, psychologists and a large group of fully trained volunteers who allow us to provide round-the-clock confidential support through chats, phone calls, and online therapy sessions. Our organization has been active as an independent care provider since September 2009. Who we areġ13 Suicide Prevention is the national Dutch suicide prevention centre, financed mainly by the Dutch Ministry of Health, Welfare and Sport (Ministerie van VWS). If you are not currently in the Netherlands, but you need help, you can reach us through chat ( You can also visit this website or this website. In end of life care double effect is a myth leading a double life.For technical reasons, unfortunately our crisis telephone numbers (1 - 0113) is only accessible for people calling from within the Netherlands. Whenever there is a demand to use morphine to render a patient unconscious, this should be refused, not just because of the law but because this approach is ineffective and risks causing more distress. Using double effect as a justification for patient assisted suicide and euthanasia on the grounds that it is already being done under the rubric of double effect is not tenable in evidence based medicine. Doctors who act precipitously with high, often intravenous, doses of opioids may do so out of compassionate panic, but they are being misled into bad practice by the continuing promotion of double effect as a real and essential phenomenon in end of life care. Palliative care specialists are not faced with the dilemma of controlling severe pain at the risk of killing the patient: they manage pain with drugs and doses adjusted to each patient, while at the same time helping fear, depression, and spiritual distress. The Dutch know this and hardly ever use morphine for euthanasia. ![]() 2 Its sedative effects wear off quickly (making it useless if you want to stay unconscious), toxic doses can cause distressing agitation (which is why such doses are never used in palliative care), and it has a wide therapeutic range (making death unlikely). 1Įvidence over the past 20 years has repeatedly shown that, used correctly, morphine is well tolerated and does not shorten life or hasten death. ![]() ![]() Kelly Taylor's request to use morphine “to make her unconscious” under the principle of double effect is a puzzling choice.
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