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BELGIUM SET TO EXTEND RIGHT-TO-DIE LAW TO CHILDREN

Wednesday, 12 February 2014 07:15 Published in Health & Fitness

BRUSSELS (AP) -- Belgium, one of the very few countries where euthanasia is legal, is expected to take the unprecedented step this week of abolishing age restrictions on who can ask to be put to death - extending the right to children.

The legislation appears to have wide support in the largely liberal country. But it has also aroused intense opposition from foes - including a list of pediatricians - and everyday people who have staged noisy street protests, fearing that vulnerable children will be talked into making a final, irreversible choice.

Backers like Dr. Gerland van Berlaer, a prominent Brussels pediatrician, believe it is the merciful thing to do. The law will be specific enough that it will only apply to the handful of teenage boys and girls who are in advanced stages of cancer or other terminal illnesses and suffering unbearable pain, he said.

Under current law, they must let nature take its course or wait until they turn 18 and can ask to be euthanized.

"We are talking about children that are really at the end of their life. It's not that they have months or years to go. Their life will end anyway," said Van Berlaer, chief of clinic in the pediatric critical care unit of University Hospital Brussels. "The question they ask us is: `Don't make me go in a terrible, horrifying way, let me go now while I am still a human being and while I still have my dignity.'"

The Netherlands already allows euthanasia for children as young as 12, providing their families agree.

The Belgian Senate voted 50-17 on Dec. 12 to amend the country's 2002 law on euthanasia so that it would apply to minors, but only under certain additional conditions. Those include parental consent and a requirement that any minor desiring euthanasia demonstrate a "capacity for discernment" to a psychiatrist and psychologist.

The House of Representatives, the other chamber of Parliament, is scheduled to debate on Wednesday whether to agree to the changes, and vote on them Thursday. Passage is widely expected.

King Philippe, Belgium's constitutional head of state, must sign the legislation for it to go into effect. So far, the 53-year-old monarch and father of four has not taken a public position, but spokesman Pierre De Bauw said that is not unusual. "We never give any comment on any piece of legislation being discussed in Parliament," De Bauw said Tuesday.

Though one opinion poll found 75 percent of Belgians in favor, there has been a vocal opposition.

"We are opening a door that nobody will be able to close," Andre Leonard, the archbishop of Mechelen-Brussels and chairman of the Episcopal Conference of Belgium, told The Associated Press. "There is a risk of very serious consequences in the long term for society and the meaning we give to life, death and the freedom of human beings."

Etienne Dujardin, 29, a notary employee and father, has been among those staging protests as the debate in the House of Representatives nears. He doesn't believe safeguards proposed under the new law are watertight enough to protect youngsters who may be incapacitated by disease.

"If you take three psychiatrists, one of them will end up approving (euthanasia)," Dujardin said. "In the name of promoting freedom for children, we're letting someone else decide."

This week, an "open letter" carrying the names of 160 Belgian pediatricians was issued to argue against the new law, claiming there is no urgent need for it and that modern medicine is capable of soothing the pain of even the sickest children.

The doctors also said there was no objective way of providing that children possess the "discernment" to know what euthanasia means.

Van Berlaer, 45, was not one of the signatories. Very sick children who are surrounded by other ill and dying people are not like other youngsters, and mature quickly-too quickly, he said. They may look on as friends or neighbors in their ward die because they can no longer breathe or swallow, and come to realize what lies ahead for them.

In such cases, Van Berlaer said, a child may want to say goodbye to classmates and family, and ask if he or she can stop living.

"The thing is that it is an ultimate act of humanity and even love for the patients, minors in this case, that we at least listen to this question and think about why they would ask such a difficult thing," Van Berlaer said. "And it will never be easy, even if the law changes now, things won't be easier."

By his estimate, only a handful of Belgian children, all in the teenage years, would be able each year to make use of the lifting of age restrictions. "If there is still a possible medical treatment, they will not be allowed to ask for euthanasia," the Brussels pediatrician said.

The discernment clause, he said, should bar the law from applying to young children.

Dr. Marc Van Hoey, a general practitioner who is president of the Right to Die Association in the region of Flanders, also is in favor of the legislation. Euthanasia, he said, sometimes becomes the kindest and most caring option.

"I've seen quite a lot of persons dying in - how do you say in proper English - agony?" said Van Hoey. "If you see somebody who died in pain, you see his face completely with a kind of expression where you see the pain on the face.

"I never saw that when I gave someone euthanasia he or she asked for," the doctor said.

Besides Belgium, the only other countries to have legalized euthanasia are two of its neighbors, the Netherlands and Luxembourg, said Kenneth Chambaere, a sociologist and member of the End-of-Life Care research group at the Free University Brussels and University of Ghent.

In the Netherlands, children between 12 and 15 may be euthanized with parents' permission, while those who are 16 or 17 must notify their parents beforehand. Luxembourg limits the practice to legal adults 18 and older.

© 2014 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

HEALTH CARE TWEAK: BIG COMPANIES GET WIGGLE ROOM

Wednesday, 12 February 2014 07:14 Published in Health & Fitness

WASHINGTON (AP) -- Big retail stores, hotels, restaurants and other companies with lots of low-wage and part-time workers are among the main beneficiaries of the Obama administration's latest tweak to health care rules.

Companies with 100 or more workers will be able to avoid the biggest of two potential employer penalties in the Affordable Care Act by offering coverage to 70 percent of their full-timers.

That target is considerably easier to hit than the administration's previous requirement of 95 percent, but the wiggle room is only good for next year.

"It will be very helpful to employers," said Bill O'Malley, a tax expert with McGladrey, a consulting firm focused on medium-size businesses. "This gives them a bit of a transition period to begin expanding coverage on a gradual basis. There would be some cost savings to employers who otherwise were nowhere near meeting the standard for 2015."

It means that big companies, not only medium-sized firms, can benefit from the new employer coverage rules that the Treasury Department announced Monday. Under those rules, companies with 50 to 99 workers were given an extra year, until 2016, to comply with the health care law's requirement to offer coverage.

"I think it's pretty significant because the vast majority of the workforce is in large firms," said Larry Levitt, a health insurance expert with the nonpartisan Kaiser Family Foundation. "It affects a much bigger swath of the economy."

President Barack Obama's health care law requires companies with 50 or more employees working 30 or more hours a week to offer them suitable coverage or pay fines.

The so-called employer mandate was written into the law as a guardrail to discourage employers from shifting workers into taxpayer-subsidized coverage. Small businesses with fewer than 50 workers are exempt. And more than 90 percent of the larger firms already offer health care.

But even if it directly impacts a relatively small share of companies, the mandate still represents a major new government requirement on businesses. At a time when the economy remains weak, implementation has been fraught with political overtones. The requirement was originally supposed to take effect in 2014, but last summer the White House delayed it for a year. Then came this week's additional delay for medium-size companies.

Treasury officials say the lower coverage standard for bigger companies should help employers struggling with the health care law's definition of a full-time worker as someone who averages 30 hours a week. Many firms have traditionally set a 35-hour week as the threshold for offering health care benefits.

To determine if an employer is subject to the mandate, the government doesn't actually count full-time workers. It uses a complicated formula that also averages part-timers' hours and converts them to the equivalent of full-time workers.

The next step is to determine how many workers averaging 30 or more weekly hours are being offered coverage.

Say a franchise owner with two dozen fast-food restaurants in a state is already providing coverage to 50 percent of its workers averaging 30 hours. A 70 percent threshold would be less onerous than expanding the offer to 95 percent of employees.

The Treasury Department says it works out to an easier path for companies already on the way.

Mark Holloway, a benefits expert with the Lockton consulting company, says that will help some companies avoid what he calls the law's "nuclear penalty," a $2,000-per-employee fine levied across a company's entire workforce, after adjustments.

But it would still leave in place a second, lesser penalty if workers at the company obtain subsidized insurance under the law.

"I would say it's good news, but it's not a panacea for companies," said Holloway.

"I think people have realized the law is here to stay and we are going to have to live with it," he added. "This is fairly good transition relief that pushed some things off, but employers are still going to have to figure out how to navigate this stuff."

© 2014 THE ASSOCIATED PRESS. ALL RIGHTS RESERVED. THIS MATERIAL MAY NOT BE PUBLISHED, BROADCAST, REWRITTEN OR REDISTRIBUTED. Learn more about our PRIVACY POLICY and TERMS OF USE.

 

 

Applications for heating help decline in Missouri

Tuesday, 11 February 2014 10:43 Published in Local News
COLUMBIA, Mo. (AP) - Despite a winter with periods of bitter cold and heavy snow, the use of a federal program that helps pay utility bills has declined in Missouri.
State officials say applications for the Low Income Home Energy Assistance Program, or LIHEAP, are down 5 percent statewide from last winter.
The program provides up to $800 in emergencies to avoid utility shutoffs and general energy assistance. The grants are based on household size, household income and the type of fuel used.
The Department of Social Services says 138,260 people have applied for the assistance this year. Last year, 145,605 households applied.
 A Columbia nonprofit that uses the program told The Columbia Daily Tribune the drop off could be attributed to weatherization programs, and to economic recovery.
 

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