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Not Dead Yet UK intervenes in assisted suicide court case.

Thu, 2017-07-20 21:30
Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Disability rights group - Not Dead Yet UK is intervening at the UK High Court in the Conway case. The Conway case seeks to strike down Britain's law that protects people from assisted suicide in the UK.

In their press release, Not Dead Yet states that legalising assisted suicide by any means would put other disabled and terminally ill people at risk. The Not Dead Yet UK press release states:Not Dead Yet UK maintains any imposed safeguards will never be watertight enough to successfully protect all ill and disabled people from a change to the Suicide Act. The Act currently provides much needed protection to disabled and terminally ill people by prohibiting anyone from assisting another person to kill themselves. Even if only one person dies against their wishes as a result of a change to the law that is one death too many and completely unacceptable. We argue that disabled and terminally ill people are just as entitled to this protection as everyone else; to single out one group of society as different to the rest is a dangerous move and will be open to misinterpretation. Legalising Assisted Suicide for disabled and terminally ill people would again set us aside from the rest of society. We would effectively be second class citizens again, with suicide seen as a valid choice for us while non-disabled people would be encouraged to live. This issue was last considered by Parliament almost two years ago (September 2015) when Rob Marris MP’s “Assisted Dying Bill” was decisively defeated by 330 to 118 votes in the House of Commons. Mr Conway is now attempting to override Parliament’s decision by seeking a change in the law through the Courts.The Press release then quotes from a few of their notable leaders:Baroness Jane CampbellDisability campaigner Baroness Campbell of Surbiton, one of the founders of Not Dead Yet UK said, “We have successfully seen off attempts to change the law on Assisted Suicide in Parliament. Now we must change tactics to ensure the Courts continue to uphold our equal right to life. The law must not be weakened via the back door.” Speaking for Not Dead Yet UK, co-founder Phil Friend said, “A change in the law is a terrifying prospect to the vast majority of disabled and terminally ill people who work hard towards achieving equality for all. Until we have reached that objective Assisted Suicide will remain a dangerous and prejudiced option, likely to increase suffering and distress”. Liz CarrLiz Carr, star of BBC1 drama ‘Silent Witness’ states, “Disabled and terminally ill people want support to live – not to die. It is important that the Court hears from the people most at risk from any change to the current law. As a long standing supporter of Not Dead Yet UK I am keen to take an active role in making that happen”.Link to other articles concerning the disability rights group Not Dead Yet.
Categories: Discussion

Assisted Suicide – Is It All About The Money?

Thu, 2017-07-20 18:47
The following article was published by Hope Australia on July 20, 2017.
Paul RussellBy Paul Russell - the Director of Hope Australia
CEO of St Vincent’s Hospital network, Toby Hall must have been wondering at all the fuss over a simple observation in a recent article in The Australian about his network stating its blanket refusal to cooperate with assisted suicide should Victoria pass the Andrews’ Government mooted legislation.
I have written previously about the Greens’ Party spokesperson, Colleen Hartland calling for the government to review St Vincent’s funding as a response. A veiled threat if ever there was one. Surely the mantras of tolerance and diversity are broad enough to include a health service that has a conscientious objection? Maybe not.

But the most scathing criticism of Hall’s comments came from journalist Andrew Denton; also on the pages of The Australian. Denton was responding to the following statement in the original article:“St Vincent’s Health Australia chief executive Toby Hall said the Andrews government’s proposed “conservative” euthanasia model was flawed and vulnerable patients would be put at risk by the proposed legislative changes, which he described as a “cheap economic way out”. “He accused the government of taking the cheaper option to “give someone a drug and kill them” rather than providing sufficient palliative care for the majority of Victoria’s terminally ill.”But rather than providing any concrete evidence to support his criticism of Hall’s comments, Denton simply asserts that, “It is both incorrect and highly insensitive to the reality of how Victorians are dying” and then moves on. That is, except for this curious claim:But by palliative care’s own admission all the resources in the world aren’t going to help them deal with all pain and suffering. It is not medically possible. And until we find a cure for cancer, MND and other diseases, this is unlikely to change.The first statement seems to be a paraphrase that is, at the very least, debatable – depending on what one might take to be the precise meaning of each of its phrases. The second is redundant – if there were no difficult diseases there would clearly be little if any difficulty in managing symptoms.

But there’s a bigger picture here that Hall was alluding to, made abundantly clear by the call this week by Palliative Care Victoria for an additional $65M in funding in the state to help meet the need and to fill the service delivery and educational gaps. This follows closely upon the New South Wales Government recently committing $100M towards regional and rural palliative care services in that state.

The reality is that, in spite of Australia’s Palliative Care Services being ranked second in the world behind Britain, there are still service gaps and funding shortfalls. In that context and for some, the supposed ‘choice’ of assisted suicide is, in reality, no choice at all.

This is also true when you consider that in a landmark study by the Grattan Institute a few years ago confirmed that something like 70% of Australians expressed a deep desire to die at home when only 14% of people were actually able to exercise that choice.

So if you live in rural or remote parts of Australia not only will you likely not be able to die at home, but the services you receive could be well below Australian standards or you may need to choose between dying in a regional hospital that may not be able to meet your needs or being transferred to a big city hospital with all of the attendant dislocation. Perhaps assisted suicide becomes a more pressing option when other legitimate choices are limited. Hardly fair is it?

In spite of the need for increased funding for palliative care and end of life care being recognised in the Victorian Auditor General in 2015, the End of Life Choices Inquiry in 2016 and by the Productivity Commission this year, there was no additional funding for such services in the recent Victorian State Budget.

Yet, according to Palliative Care Victoria:"Currently 55% of Victorian palliative care services report that they are unable to meet the current demand for palliative care. At least 26% of Victorians who die are missing out on the benefits of palliative care, according to the international measures of population need for palliative care."They further note that there has been no nett increase in palliative care funding from the government since 2014.

Does this sound like a government that has a handle on its agenda? Surely, if they were serious about ‘choice’ as a value in promoting assisted suicide they would have increased funding in the last budget a few months ago; even if only to make the point that they take end of life care seriously.

No doubt they will point to the mooted lead in period until their assisted suicide regime becomes active. But Palliative Care Victoria’s plaintive cry for support won’t fix the gaps overnight. As Liz Carr told Victorian Parliamentarians a few months ago – fix the first 48 recommendations of the Parliamentary Inquiry Report before you tackle number 49 (the suicide recommendation).

Without such funding the CEO of St Vincent’s assertion of assisted suicide may be seen by bean counters as a ‘cheap way out’ has a ring of authenticity.

In Canada, less than a year after the Quebec and Ottawa government's legalised forms of euthanasia and assisted suicide, a research paper entitled: Cost analysis of medical assistance in dying in Canada appeared in the Canadian Medical Journal (CMAJ). It found that "Medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million." The bean counters must have been in seventh heaven.

The authors summarized: "Our analyses suggest that the savings will almost certainly exceed the costs associated with offering medical assistance in dying to patients across the country, and that the inclusion of medical assistance in dying in the services covered by universal health care will not increase health care spending, but rather will release funds to be reinvested elsewhere." Adding lamely: "We are not suggesting medical assistance in dying as a measure to cut costs." Really?

Daniel Fleming took up the 'economic argument' on the pages of the ABC's Religion and Ethics website, citing the Canadian study:"Soon after the legislation was introduced in Canada, the above mentioned study was undertaken which had the object of demonstrating the savings to Canadian tax-payers as a result of the legislation. At this point in time, such savings might be considered an ancillary purpose to the explicit purpose of providing PAS-E (Euthanasia and Physician Assisted Suicide). However, they reveal important facts: end-of-life care is expensive, and it is not impossible to imagine a government or healthcare organisation which needs to face this fact during a hard budget agreeing to focus more attention on the cheaper options of PAS-E than on other forms of end-of-life care, an approach which has already been suggested by one of the world's leading economists."Even the famous Dutch euthanasia enthusiast, Dr. Boudewijn Chabot recently lamented the effect of financial considerations in relation to euthanasia for psychiatric reasons in his own country:"Ever since budget cuts turned chronic psychiatry into a diagnosis-prescription business, good treatment has become scarce."Fleming warned in conclusion:"These are uncomfortable considerations, and they take the debate outside of its typical contours which consider the suffering of an individual and sometimes their family, and whether or not it is right for that person to end their own life with medical assistance. That debate still needs to be had. However we land there, it is crucial to remember that the debate takes place in an ideological context, and if or when the legislation is enacted it will be done in a way that takes it beyond the intent of those proposing it, and into the realm of the value set of capitalism. Any legislation or major social interventions has social consequences beyond its original purpose."There’s always the money question just as there will always be people who are at risk under any form of legislation. There are winners and losers in all of these debates.

Even Premier Andrews, now the prime mover in the assisted suicide agenda, once noted the money question, as Fairfax media reporter, Farah Tomazin noted last December:

Andrews' resistance was not based on faith, he explained, but from his stint as health minister under the Brumby government. It was during that time the Labor MP saw firsthand the incessant demand for hospital beds in an overstretched system and became increasingly concerned that "these laws might see a rationing of precious health dollars".

Andrews may have changed his mind to support assisted suicide, but his observations about the health system and the temptation to cut and/or limit budgets remains.
Categories: Discussion

Euthanasia, Conscience and Canadian doctors

Thu, 2017-07-20 17:29
This article was published by Physicians Alliance Against Euthanasia on July 16, 2017

In the year since euthanasia became legal, we have witnessed a powerful political push to normalize it as part of medicine in Canada. Yet many doctors remain opposed to the practice. Most would like to see it rigorously limited. And some, for reasons of personal and/or professional conscience, refuse categorically to be part of it.

Unfortunately, our politicians have made it perfectly clear that they intend to ignore the judgement of opposing doctors and to stifle their dissent. In fact, the worst of these politicians are to be found within our own profession.

Consider, as a case in point, the new (2015) College of Physicians and Surgeons of Ontario policy on doctors’ conscience rights.

This CPSO policy is identified as a mere “revised update”, but it actually bears little resemblance to the earlier version (2008).

And it is obvious why this is so: Without ever honestly mentioning euthanasia, assisted suicide, or even MAID, the new policy was designed from the start to facilitate a radical new Orwellian redefinition of “euthanasia”, from homicide to medical treatment. It effectively obliges all Ontario physicians and surgeons to participate in the euthanasia program.

In practical terms:
“Where physicians are unwilling to provide certain elements of care for reasons of conscience or religion, an effective referral to another health-care provider must be provided to the patient.”
This, of course, is the main sticking point for many doctors, who consider referring their patient to any agency of death to be an act just as abhorrent as performing the euthanasia themselves.

But “effective referral” is by no means all. There is also the “duty to inform”:
“Physicians must provide information about all clinical options that may be available or appropriate to meet patients’ clinical needs or concerns.”

“Physicians must not withhold information about the existence of any procedure or treatment because it conflicts with their conscience or religious beliefs.”
Please note the italics: The physician apparently has a duty to inform his patients of all options legally available even if they are inappropriate! And this obligation shall override any moral or professional convictions that physician might hold.

The violence of the obligation to “inform” goes even beyond that of “effective referral” itself. Every patient who fits the criteria for euthanasia must be subjected to the terrible stress and doubt of learning that he or she belongs to that select group of people for whom medically-inflicted death has become an option. And no objection of judgement or of conscience can free the doctor from delivering that terrible message and its implicit suggestion.

In Ontario, then, by proclamation of the CPSO, the doctor’s role is reduced to that of an automatic vending machine which simply displays state-mandated euthanasia options and passively offers corresponding buttons for the patient to push.

Obviously, the scope and impact of such a policy is astounding. Professional judgement is the bedrock of medical practice. Freedom of conscience is the underpinning for our entire system of secular democracy. Both are set aside. The scale of the emergency must be colossal to require such draconian measures!

But, of course, there is no such urgency.

Let us remember that the original euthanasia program was sold to us as an imperative response to a hypothetical terminally ill patient in unbearable and untreatable pain. Let us recall how that extreme, no, that virtually mythical case, was leveraged into all of the totally unrelated deaths that we now apprehend. Once again, a similar strategy is at work. This time, the absolute need for all doctors to promote euthanasia (all the time and to all of their most vulnerable patients), is presented as a required response to the hypothetical possibility of even one patient, desirous to die, but who is frustrated in her wish.

We are asked to believe that any real burden whatsoever, financial, professional, or moral, can be justified in the interest of allowing that one sacred voluntary death. It is a sort of grotesque inversion of the proposition that “no price is too high” provided that “only one child be saved…”. Which becomes in this case: “if only one person might die…”.

Other jurisdictions, no less respectable than Ontario have taken an opposite stance, and there is no evidence that anybody has suffered or will suffer.

Manitoba is in the process of explicitly recognizing the right of non-participation and non-referral of all health professionals and others working in health care. Major hospitals in Winnipeg have announced their refusal to euthanize patients.

In the State of Vermont a judicial battle over similar issues has resulted in an unambiguous victory for doctors’ rights.

And in Ontario, a group of dedicated and courageous doctors launched a court challenge in defense of doctors’ conscience, which was heard June 13-15, 2017.

That judgement will be rendered later this year. Let’s hope our courts get it right this time! But regardless of that outcome, regardless of the timeframe, and regardless of expense; regardless of the legislative efforts that may ultimately be required: This authoritarian policy of the College of Physicians and Surgeons of Ontario is neither necessary nor justified. It is not desirable. It is not even reasonably defensible. It is extreme. And it is irrational. Above all, it is profoundly harmful to individual doctors and patients and to the whole medical profession. It constitutes both an injustice and an embarrassment which cannot be allowed to stand.
Categories: Discussion

US House Appropriations Committee approves repeal of the DC assisted suicide Act

Fri, 2017-07-14 19:32
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Great News - Yesterday the US House of Representative Committee on Appropriations approved an amendment by Representative Andy Harris (Maryland), who is also a physician, that prohibits funds for assisted suicide in the District of Columbia, and repeals the DC Death with Dignity Act. The amendment was adopted on a vote of 28-24.

Information about the DC assisted suicide act.
Categories: Discussion

The law must protect, doctors must care, and euthanasia undermines both

Fri, 2017-07-14 18:56
The following article was published by Mercatornet on July 13, 2017

A British palliative care pioneer talks to MercatorNet about the campaign for assisted suicide.
By Carolyn Moynihan

Baroness Ilora Finlay
a palliative care pioneerThere is not much you could tell Professor, the Baroness Ilora Finlay about death and dying – outside of a war zone, perhaps. The Welsh doctor and Member of the British House of Lords (since 2001), was the first consultant in palliative medicine in Wales back in 1987 and set up the hospice system there. In 1989 she introduced the Diploma in Palliative Medicine at Cardiff University where she still teaches. She co-chairs Living and Dying Well, a think tank to examine the evidence around euthanasia and assisted suicide.

Over the decades Professor Finlay has cared for thousands of people at the end of their lives, and in opposition to the growing euthanasia movement has become an internationally recognised champion of the need for good palliative care for all those diagnosed with a terminal illness.

In 2005 she served on the House of Lords select committee on the Assisted Dying for the Terminally Ill Bill – an exhaustive inquiry into assisted suicide that resulted in the UK parliament rejected the bill. She was also a prominent opponent of a similar bill introduced in 2014 (that was also rejected).

Recently she visited New Zealand where a private member’s euthanasia bill (not the first of its kind here) is now before parliament. David Seymour’s End of Life Choice Bill would allow terminally ill people with six months to live, or people with a "grievous and irremediable" condition – that is, the chronically ill -- to ask a doctor to help end their lives.

Mental capacity and vulnerability

“It’s very similar to the law in the Netherlands,” she told me during an interview in Auckland. “It could even be wider in its effect.” For one thing the Seymour bill does not have an explicit requirement for mental capacity.

“It only states that the person concerned must ‘have the ability to understand’ the nature and consequences of assisted dying. There’s no requirement to ask whether a person at this moment is thinking straight, whether their judgement is unimpaired.

“This would make people with learning difficulties extremely vulnerable. A person with Down syndrome, for example, could ‘understand’ from what they hear and see around them what euthanasia ‘means’ and say yes to it when they have not really understood at all.”

The latest official reports from The Netherlands show that 1 in 26 of all deaths there come about through euthanasia or physician assisted suicide, with an increase of 15 percent year on year. In the words of one of the original promoters in The Netherlands, euthanasia is becoming “the default mode of dying” there.

The majority of doctors remain opposed

You would expect Britain, where Dame Cicely Saunders founded the hospice movement 50 years ago, to be good at looking after the dying. In The Economist’s Quality of Death Index 2015, the UK ranked first out of 80 countries for palliative care, followed by Australia and New Zealand.

But is the medical profession there standing firm in its opposition to euthanasia?

“All the professional colleges in the UK as well as in most places around the world remain opposed, as do the majority of doctors,” says Professor Finlay. “Even in Oregon, where they changed the law, two-thirds of the doctors don’t want to be involved. I met with the New Zealand Medical Association whose chairman is absolutely clear that this is not a role for doctors.

“And indeed it is not the place of doctors to sit in judgement on who is or is not eligible for assisted dying, and then be part of the process of bringing about the person’s death deliberately with lethal drugs, when what they should be doing is getting on with looking after patients and caring for them, helping them maintain their dignity and keeping them comfortable, irrespective of what has happened to them.”

Being in control is not most people’s priority

One of the cultural forces driving the euthanasia movement is the desire of some people in prosperous countries who have always had “choices” and been in control of their lives, to remain in control to the end.

How much do people who actually are terminally ill care about being in control of everything?

“I’ve looked after thousands of dying people,” says Professor Finlay, “and what they want is to feel better than they do at the moment, to live better during whatever time they have left. It has often struck me that people who were adamant when they were well that they would want euthanasia or assisted suicide, when they are ill suddenly change their minds and are desperate to carry on living. When they face the reality of losing life they want everything done to help them live as fully as possible.

“The demand for euthanasia is coming, by and large, from those who are not in the last stage of illness, whereas those who are in the last stage are actually being looked after very well. People are frightened of things that, with good care, will probably not happen to them: that they might lose their mind, become breathless, that pain will become unbearable.”

The grey wave and the cost factor

There’s another kind of fear behind the “demand”, too – fear of the cost of caring for an ageing society. How are we going to care for all the people living longer lives but needing help?

“That’s a really interesting question. What the research shows is that if you look after people well, if you provide palliative care early, and you help them live as well as possible, their depression is lower, hopelessness is lower, the quality of life is higher – so paradoxically they live longer, but the costs are not higher. Because you are helping people maintain independent living and carrying on.

“If you look at the statistics for Oregon, for example, the peak age group for assisted suicide requests is 65-80, it’s not among the 80-plus year olds. And people in their 80s are generally much fitter today than they were.”

Are we up to this kind of care?

Can we, though, count on having enough professionals who want to do this kind of care, with its extra demand for empathy, understanding and personal skills? Are we cosseted Westerners up to it these days?

“Oh yes, we are completely up to it. There’s no problem about people wanting to go into specialist palliative care at all. It is one of the most competitive fields of medicine in the UK.

“I think, also, that there is an awareness that we need to be putting more into care, helping people make decisions, helping them understand that they can refuse treatment. Nobody is being forced to stay alive, nobody is being forced to suffer, as people campaigning for Euthanasia claim.

“However, there is always a power differential in the doctor-patient relationship, and we do need to train doctors to listen to what people need, to help them plan in advance and to modify their wishes as they go along.”

Fragile families and loneliness

Fear of death and requests for assisted suicide may be partly driven by changes in the family. Small families, distant families, broken families, families burdened by big mortgages so that both spouses have to work full time – these trends mean that someone who needs support because of old age or a degenerative disease will often not be able to find it in their family.

“Loneliness is a big killer. There certainly is evidence that it shortens your life expectancy, and both loneliness and the fear of it is a major problem in society today.”

Whatever the problem, the answer is not suicide, not killing. But how should opponents of euthanasia focus their case? Professor Finlay strongly emphasises the proper role of the law.

Prime focus: the law must protect the whole population

“First, you have to ask those wanting to change the law, does the law we have now not work? Laws have to protect the whole population, not just a few, so if we change the law, will more people be protected? Or will you be removing protection from people? All the evidence I have seen shows that these laws cannot protect everyone. The process becomes quite arbitrary: here is a suicide we will try to prevent; here is one we will assist. But why?

“You can’t be neutral. The law is written in a way that will involve you. People who think, ‘I’ll leave that to someone else to deal with,’ are deluding themselves. I think if you object to euthanasia and assisted suicide you have a duty to say so, to collect your thoughts and express them sensibly.

“This, by the way, has nothing to do with religion. It is not a question of what you believe -- people on both sides have their beliefs. Your arguments have to be based on evidence. Sometimes the evidence used is not very strong – you get stories going around that might or might not be true.

“But here is a story that comes straight from the most recent full report from Holland’s monitoring committees. There were three young women who were each severely psychologically disturbed. And in all three it could be traced back to abuse in childhood or early teens. Yet they were allowed to be euthanased because they were so disturbed.

“I have a real problem with a society that says, we will kill the victim with a lethal injection, but the perpetrator is out there, free.”

Carolyn Moynihan is deputy editor of MercatorNet.
Categories: Discussion

New York Times article promotes infanticide - killing (euthanasia) newborns with disabilities

Fri, 2017-07-14 04:54
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Several years ago, the Groningen Protocol was approved in the Netherlands to permit the killing, by lethal injection of newborns with disabilities. A few years ago a Canadian bioethicist wrote an article promoting infanticide, now the New York Times has published an article promoting infanticide of newborns with disabilities.

The article by Gary Comstock was published in the New York Times on July 12 tells the story of a newborn child with Trisomy 18, a condition that is claimed by many to be "incompatible with life."

Read: Trisomy 18 is not a dead sentence  - The story of Lilliana Dennis.

 Comstock writes about the birth of the child, the treatment of the child and the death of the child in a well written and matter of fact manner. The story, in fact, is moving and compelling.
The family decides to forgo treatment and let their child die a natural death by withdrawing the ventilator. The death is written in a traumatic manner. After the child dies Comstock writes:
You should not have let your baby die. You should have killed him.

This thought occurs to you years later, thinking about the gruesome struggle of his last 20 minutes. You are not sure whether it makes sense to talk about his life, because he never seemed to have the things that make a life: thoughts, wants, desires, interests, memories, a future. But supposing that he had thoughts, his strongest thought during those last minutes certainly appeared to be: “This hurts. Can’t someone help it stop?” He didn’t know your name, but if he had, he would have said: “Daddy? Please. Now.”

It seems the medical community has few options to offer parents of newborns likely to die. We can leave our babies on respirators and hope for the best. Or remove the hose and watch the child die a tortured death. Shouldn’t we have another choice? Shouldn’t we be allowed the swift humane option afforded the owners of dogs, a lethal dose of a painkiller?

For years you repress the thought. Then, early one morning, remembering again those last minutes, you realize that the repugnant has become reasonable. The unthinkable has become the right, the good. Painlessly. Quickly. With the assistance of a trained physician.

You should have killed your baby.I found this to be a heartless ending to the story. There are so many loving parents who cared for their child and hoped for the best and others who held and loved their child until the child died naturally. This story tells them that they should have killed their child.

The writer boldly states that it is better to kill a baby with disabilities and then lies by stating that there are only two options, kill the baby or let the baby die a tortured death. 

What about having hope? What about proper pain and symptom management to allow a peaceful natural death?

This story is a heartless, mean spirited and discriminatory. This article is designed to redefine love, from that of caring parents to that of parents and doctors who kill newborns with disabilities.

Categories: Discussion

Someone Else Is Allowed to Administer the Lethal Assisted Suicide Dose to the Patient

Tue, 2017-07-11 20:09
This article was published by Choice is an Illusion on July 10, 2017

Margaret DoreBy Margaret Dore, Esq., MBA

The South Dakota measure allows someone else, such as a doctor or family member, to administer the lethal dose to a patient. This is true for three reasons:

1. The Measure Merely Says That the Patient “May” Self-Administer the Lethal Dose

The measure says that a patient may self-administer the lethal dose.[1] There is no language that administration “must” be by self-administration.[2]

2. Generally Accepted Medical Practice Allows Someone Else to Administer Medication to a Patient

The measure describes the lethal dose as “medication.”[3] Generally accepted medical practice allows a doctor, or a person acting under the direction of a doctor, to administer medication/drugs to a patient.[4] Oregon doctor, Kenneth Stevens, states:
Common examples of persons acting under the direction of a doctor, include: [N]urses . . . who act under the direction of a doctor to administer drugs to a patient in a hospital setting; . . . and adult children who act under the direction of a doctor to administer drugs to their parents in a home setting. (Emphasis added).[5]
With self-administration not mandatory, generally accepted medical practice allows a doctor, or a person acting under the direction of a doctor, to administer the lethal dose (a “medication”) to the patient.

3. “Self-administer” Is Specially Defined to Allow Someone Else to Administer the Lethal Dose

The measure states:
Terms used in this Act mean:

(11) “Self-administer,” a qualified patient’s act of ingesting medication to end the patient’s life . . . (Emphasis added).[6]
The measure does not define “ingest.”[7] Dictionary definitions include:
[T]o take (food, drugs, etc.) into the body, as by swallowing, inhaling, or absorbing. (Emphasis added).[8]
With this situation, someone else placing a medication patch on the patient’s arm qualifies as self-administration because the patient will be “absorbing” the lethal dose, i.e., “ingesting” it. Gas administration qualifies because the patient will be “inhaling” the lethal dose, i.e., “ingesting” it. Putting the lethal dose into the patient’s mouth qualifies because the patient will be "swallowing" it, i.e., “ingesting” it. With self-administer defined as ingesting, someone else is allowed to administer the lethal dose to the patient.


[1] The Initiated Measure, § 1(6), states:
“Informed decision,” a decision by a qualified patient, to request and obtain a prescription for medication that the qualified patient may self-administer to end the patient’s life . . . (Emphasis added).
[2] See the measure in its entirety at this link:
[3] See § 1(6), which states:
“Informed decision,” a decision by a qualified patient, to request and obtain a prescription for medication that the qualified patient may self-administer to end the patient’s life . . . (Emphasis added).
[4] Declaration of Kenneth Stevens, MD, 01/06/16, ¶10,
[5] Id.
[6] Initiated measure, § 1(11).
[7] See the initiated measure in its entirety.
[8] Your (defining " ingest").
Categories: Discussion

Elderly man with dementia punched 11 times by personal care worker in Ottawa.

Mon, 2017-07-10 22:32
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Elder abuse is a growing scourge in Canadian society, a problem that is based on the dehumanization of the victim. Human society has always faced a level of abuse, but in a society that claims to be based on the equality of all human persons, it is horrific when we look into the mirror and recognize that in fact our society has denigrated certain human persons leading to abuse of those persons.

Someone recently asked me - how can we protect people in our culture - and I responded that you cannot leave them alone.

The abuse of George Karam (89) by Jie Xiao (44) his "care worker" that was caught on video at Garry J. Armstrong long-term care home in Ottawa emphasizes the brutality and dehumanization associated with elder abuse.

The Ottawa Citizen reported on the case and includes a video link with the story.
The video, which was provided to the Citizen by Karam’s family, shows the elderly man lying in bed as personal support worker Jie Xiao yanks him back and forth while removing his diaper. Karam suffers from Alzheimer’s and Parkinson’s disease and needs a wheelchair to move around. An agitated Karam took a pair of swipes with a crippled and shaking hand at Xiao during the diaper change. It was after a third swipe that came closer to Xiao’s face that the 44-year-old care worker unleashed a series of rapid punches with his gloved hand to the side of Karam’s face on March 8. Xiao frequently paused between the blows, delivering two or three punches at time with his left hand as his right hand took hold of Karam’s arm. The sound of the fist making contact with Karam’s face is clearly audible on the video.
In between the punches, Xiao frequently raised a closed fist next to Karam’s face. Before delivering the final punch, Xiao appears to be swearing at Karam. Karam then lets out a shout. The whole assault lasts about 28 seconds.Horrific incidences of elder abuse are not uncommon. In 2013 a similar story of elder abuse was caught on film in Peterborough.
On June 30 the Euthanasia Prevention Coalition reported on the recent data from a study examining how people die in the Netherlands. The study indicated that there were 431 hastened deaths without explicit request and 1693 unreported assisted deaths in 2015 in the Netherlands.
A similar study that examined how people died in the Flanders region of Belgium found that there were more than 1000 hastened deaths without explicit request and approximately 1380 unreported assisted deaths in 2013.
What is most disturbing that the Belgian data indicates that more than 80% of the hastened deaths without explicit request were people with dementia, Alzheimer's or coma, people who were incompetent to make decisions for themselves. I am convinced that the dehumanizing attitude that has led to the scourge of elder abuse in our culture has also led to de-stigmatizing the concept of doctors killing patients by euthanasia.
The concept that euthanasia or assisted suicide can be administered without abuse within a society that has dehumanized people living with certain conditions is naive at best.
Categories: Discussion

Irwin promotes assisted suicide by planning his suicide.

Mon, 2017-07-10 20:26
No assisted suicide.
No assisted elder abuse.Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Michael Irwin (86), an assisted suicide lobby activist and retired physician in the UK decided to end his life in order to promote the legalization of assisted suicide in the UK. 
As sad as it is that Irwin is promoting assisted suicide through his own death, the reality is that the attitude and language that Irwin uses concerning his own life mirrors the attitude of the assisted suicide lobby towards the lives of others.

Irwin refers to himself as "existing beyond my sell-by date" and that he doesn't want his friends or family to remember him as "an increasingly decrepit person."

Liz CarrLiz Carr, a disability rights activist and actress in the UK, last year stated in an interview why she opposes assisted suicide and why she produced a musical on the topic. Carr states:“Until we value ill, older and disabled people as equals; until there are no more hate crimes; until their deaths or murders are no longer portrayed or perceived as mercy killing, and until there’s real equality and validity for those groups of people, then maybe we can have that conversation.”Carr later states in the interview:“The problem with disability is social oppression, not disability. The solution to that is not to kill a person; it’s not to give them easy access to end their life. It’s to look at the reasons why that person wants to end their life. And are we doing everything we can? Irwin, who is a past-president of the World Federation of Right to Die Societies and has promoted old-age suicide since 2009, was "struck-off" the list of physicians in 2005 for breaking the code of ethics.

Irwin's personal campaign to legalize assisted suicide devalues the lives of people with disabilities and older people. Irwin is promoting his own death in a manner that devalues the lives of other people creating a new pressure to die.
Categories: Discussion

Charlie Gard situations have happened here too

Fri, 2017-07-07 19:20
This article was published by National Review online on July 4, 2017.

By Wesley Smith

Wesley SmithThere is a proper international uproar over U.K. doctors winning the right in court to unilaterally remove the infant Charlie Gard from life support. 
Some have commented on the case as if that is a product of the UK’s socialized medical system. It’s not. It is a product of utilitarian bioethics advocacy for the right to refuse wanted life-sustaining treatment — called “futile care” — based on the doctor’s or a hospital bioethics committee’s values on the moral worth of the ill patient’s life and/or the high cost of care. 

Whose baby is Charlie Gard anyway?
Similar authoritarian care withdrawals as has been imposed on Charlie Gard have happened here too — and to very ill patients of all ages. I get into a few of these cases involving infants today over at First Things. 
  • There was the Baby Ryan case in Seattle, in which a hospital actually reported a family for child abuse because they obtained an injunction against removing kidney dialysis. In the end, the doctors were wrong that death was imminent. The boy lived four years as a happy, if sickly child, who loved to give high-fives. 
  • The parents of Baby Terry in Michigan were stripped of their parental rights for refusing to consent to withdrawing life support. 
  • In Canada, doctors treating Baby Joseph insisted on the right to remove life support from a terminally ill baby and refused a tracheotomy that would have permitted the baby to go home to die with his family. Priests for Life eventually paid for the baby to be flown to the USA for the procedure, which was successful. Joseph died several months later in his parents arms. 
Charlie GardThe Charlie Gard case is unique in only one respect: It is the only futile care case I know of in which the hospital and the law is preventing discharge to another facility or allowing the patient to go home to die. From, “Whose Baby is Charlie Gard, Anyway?” The refusal to allow Charlie’s parents to remove their baby boy from the hospital is an act of bioethical aggression that will extend futile-care controversies, creating a duty to die at the time and place of doctors’ choosing.  And that raises a crucial liberty question: Whose baby is Charlie Gard? His parents’? Or are sick babies — and others facing futile-care impositions — ultimately owned by the hospital and the state? Again. This isn’t about socialism — although that issue is relevant. More, it is about cost containment — including in free-market systems — and the attempt by the bioethics movement and medical intelligentsia to replace the equality/sanctity of life ethic with a more utilitarian “quality of life” view.

For more on the danger posed by bioethics generally, hit this link.
Categories: Discussion

Canadian media campaigns for more euthanasia.

Fri, 2017-07-07 03:07
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Recently Canadians have, once again, experienced a plethora of articles concerning euthanasia. I am convinced that the media is pressuring physicians to join the "list" of those who are willing to kill their patients and the media is campaigning against the "safeguards" in the law to increase access to death by lethal injection.

Thank you Dr Ramona Coelho, Dr Mark D'Souza and the many caring physicians and nurse practitioners who continue to oppose killing patients or directly referring patients to death.
Dr Ramona Coelho
In an article published today by CBC London Dr Coelho says that being whe is pressured to be involved with euthanasia.
One year after medically assisted death was made law in Canada, a London physician is adamant the rules are putting undue pressure on physicians who don't want to refer patients for the procedure.A recent Globe and Mail article quotes Dr Mark D'Souza, who stopped his palliative care practice because the euthanasia law put him at direct risk of losing his medical license because he opposes euthanasia:
“If [patients] complain that I’m not the one picking up the phone [to do the referral], my licence would be in jeopardy,” he said. “That’s not a scenario I want to expose myself to, and that’s why I left palliative care.”The media is campaigning for more euthanasia.
The Globe and Mail published an article on July 3 about a doctor who has lethally injected 20 people in British Columbia who decided to stop doing euthanasia because the BC government isn't paying him enough money to kill.

An article published by CBC London, promotes Dr Scott Anderson, who is one of two doctors in London Ontario who is willing to kill patients. This article appears to encourage other physicians to participate in euthanasia and to inform local physicians to refer their patients for lethal injection to Dr Anderson.
Dr Anderson offers some interesting quotes in the article:
"When somebody is asking for your help to die, I don't see how the answer can be no." In another instance, the patient wanted a medically assisted death but his family was against it. With his main responsibility to the patient, Anderson performed the procedure while the family was away from the residence.If Dr Anderson is visiting your depressed family member or friend, don't leave them alone.

The Globe and Mail published an article on July 5 which also appears to be campaigning for more physicians to kill and for more resources for euthanasia. The article claims that there are only a few doctors who are willing to kill people in Ontario.
Only 74 doctors and nurse practitioners have signed up for the new care co-ordination service, down from 181 when the Ontario Ministry of Health and Long-Term Care shut down its old confidential referral list of medical-aid-in-dying (MAID) providers on May 31.The also publishes a quote from Chantal Perrot, a doctor who has participated in 20 euthanasia deaths but who is not on the referral list.
The Globe and Mail article concludes by stating that there have been 548 euthanasia deaths in Ontario since June 17, 2016 when euthanasia became legal in Canada. A CBC article published in April stated that on March 31, there had been 365 euthanasia deaths in Ontario. Therefore there has been 183 euthanasia deaths in the last two months in Ontario. 
There are not too few euthanasia deaths, but rather too many. 
Sadly, the number of euthanasia deaths in Canada far exceeds the original predictions. Canada is becoming the example to America of why euthanasia should never be legalized.

Categories: Discussion

America: Let Canada be your example and warning of why you must not legalize assisted suicide.

Thu, 2017-07-06 03:27
This article was published by OneNewsNow on July 5, 2017
Alex Schadenberg
An opponent of euthanasia believes Canada's statistics on the subject should send a strong message to the United States.

Canada's Supreme Court forced euthanasia on the country, and Parliament enacted a law to implement it. Alex Schadenberg of the Euthanasia Prevention Coalition says the law used imprecise language, so vague it could have varied interpretations. And the country is seeing that now.
"We've already seen the extension of what was deemed to be the spirit of the law, so we have already had a case here in Ontario where somebody who was not terminally ill has been permitted to have euthanasia," Schadenberg reports. "We've then seen also the pressure on Quebec, where Quebec came out with a report showing that 21 of their euthanasia deaths in their first year were outside of the law."There was also under-reporting of euthanasia in the Netherlands in the last couple of years. The Coalition executive director has previously pointed to how when euthanasia was legalized in Europe, abuses began to occur, including the killings of people – because of mental problems, not terminal illnesses -- who did not request euthanasia. Some were killed just because they were lonely or depressed.
"We're seeing all this data out of Canada where, in fact, we're heading down the exact same direction," Schadenberg warns. "Expansion of euthanasia to children is the next pressure, psychological suffering alone -- these are all the pressure points going on in Canada for extending euthanasia, and yet we're only one year in."The door is opening wider and wider as each week passes.
"For everybody in America, Canada has become the example of why you cannot legalize euthanasia or assisted suicide," The euthanasia prevention advocate concludes.
Categories: Discussion

Euthanasia: The price on a life in Canada.

Tue, 2017-07-04 20:40
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Globe and Mail reported that at least one doctor in British Columbia (BC) stopped lethally injecting people because the Provincial Ministry of Health is not paying enough money to kill (MAID).

The article by Kelly Grant, in the Globe and Mail, appears to pressure the BC government to pay more for euthanasia. Grant writes:Dr. Pewarchuk, an internal medicine specialist in Victoria who has presided over 20 assisted deaths, took his name off the list of willing physicians last month after the body that sets doctors’ pay in British Columbia approved new fees that he and some of his fellow providers say are so low they could chase away even the most committed physician supporters of assisted dying.The article outlines the BC government fee schedule that is paid to doctors for euthanasia:Under the new fee schedule, B.C. physicians will now be paid $40 for every 15 minutes, up to a maximum of 90 minutes, to conduct the first of two eligibility assessments required by law. Each of the assessments has to be provided by a different clinician. That works out to $240, a significant increase from the $100.25 interim assessment fee that has been in place in B.C. since shortly after assisted death became legal. For second assessments, the time is capped at 75 minutes. In the case of providing an assisted death, the province has set a flat fee of $200, plus a home-visit fee of $113.15.The price on a life in British Columbia is up to $240 + $313.15 or $553.15.
The article then compares the BC payment for killing to several other Provinces:By comparison, if a doctor spent three hours start to finish on an assisted death – excluding the formal eligibility assessment – he or she could bill $621.60 in Alberta, $600 in New Brunswick, $499.80 in Quebec, $480 in Manitoba and $465.60 in Saskatchewan. If doctors in those same five provinces billed for two hours, they could still earn more than B.C.’s $313.15 in every province but Saskatchewan, though not by much.In January the Journal of the Canadian Medical Association published an article indicating that the Canadian healthcare system could save  up to138 Million dollars now that euthanasia is legal.
Categories: Discussion

Euthanasia: when safeguards become barriers to access.

Tue, 2017-07-04 16:43
This article was published by Mercatornet on July 4, 2017
BAubert Martiny Aubert Martin, Executive Director of Vivre dans la Dignité (Living with Dignity) Quebec
A month after the publication of a letter by the secretary of the College of Physicians of Quebec – in which he expressed his concern about a growing “pressure, demanding a form of death à la carte” and in which he denounced those who interpret refusals of euthanasia as a form of exclusion – lawyer Jean-Pierre Ménard is challenging before the courts the cases of two people living with disabilities who were refused the assistance of a physician to kill themselves.

The plaintiffs requested the removal of the “reasonably foreseeable death” clause of the federal law as well as the “end of life” requirement in the Quebec law.

More voices were added to the chorus of “rebels” decrying the cruelty of all criteria that dare make reference to the proximity of death.

Yet not so long ago, the elected Members of the National Assembly in Quebec (MNAs) were congratulating themselves on the wisdom of their law that made reference to… the end of life. This is another reversal of logic in the long list of changes of rhetoric we have already witnessed.

Indeed, at the time of the adoption of the Quebec bill, words like “safeguard” and “strict conditions” peppered the speech of those seeking to calm the fears of people wary of allowing homicide under certain circumstances.

Today, potential extensions of the law are justified by referring to “consensus” and “the will of the people,” while the “safeguards” have turned into “barriers to access”.

Meanwhile, the same promoters of euthanasia who claimed that it was only a matter of “exceptional requests for exceptional cases” have updated their rhetoric to justify the explosion of euthanasia requests: it has become “a response to a need.”

Yet, before the legalization of euthanasia and assisted suicide in Quebec and in Canada, warnings of the slippery slope were met with mockery and contempt from those who embraced medical suicide with open arms.

At best, this cautious warning, based on the experience of countries that legalized euthanasia before us, was treated as a scarecrow brandished by alarmists. “The slippery slope doesn’t exist!” responded those anti-skeptics and other merchants of death.

Today, slightly more than a year after the Quebec bill 52 that legalized euthanasia came into force, we see the first obvious signs of the slippery slope: we have gone from exception to promotion. Already the “end of life” criterion is presented as discrimination which prevents people with disabilities from committing suicide, implying that their living conditions justify their desire to die.

Secondly, the argument that euthanasia is about “capable and consenting people” is giving way to the idea of killing an incapable person (with Alzheimer’s or dementia) regardless of the person’s consent at the time of death.

Finally, according to a Canadian study published in May, the proverbial patient writhing in pain on his deathbed has morphed into a person in existential crisis over his loss of autonomy (read: disability).

So we won’t be surprised if tomorrow we are presented with other ludicrous propositions, such as the one currently gaining popularity in the Netherlands: opening “medical aid in dying” to elderly people who feel they have accomplished their lives.

A society does not accept overnight the idea that the state should endorse the suicide of an elderly and healthy person simply because she is tired of living. It must first live through the deep malaise that accompanies every new expansion of euthanasia access that is sold to us as progress.

In fact, when we think about it, the only thing that is “reasonably foreseeable” is the extension of medically assisted suicide to more and more groups of people. If death is sold as a solution to suffering, and if suicide is viewed favourably when a doctor is involved, the real question is not why some are opposed to it, but rather “why say yes to one and no to others?”

Aubert Martin is the Executive Director of Vivre dans la Dignité (Living with Dignity), a Quebec-based organisation.
Categories: Discussion

Whose baby is Charlie Gard, anyway?

Tue, 2017-07-04 16:24
This article was written by Wesley Smith and published by the National Review online July 4, 2017
Wesley SmithBy Wesley Smith
The time has come for your baby to die,” a doctor told the grieving parents of a catastrophically ill baby. No, this wasn’t the ongoing Charlie Gard case—so prominent in the news today—in which United Kingdom doctors and judges have told Charlie’s parents that their son’s life support will be removed, no matter what they want. (Charlie has a rare terminal mitochondrial disorder.) Rather, that blunt declaration was uttered in 1994 in Spokane, by a doctor to the parents of Ryan Nguyen, who—born at just twenty-three-weeks gestation—was on kidney dialysis and struggling for his life.

Then as now, doctors declared that further life-sustaining treatment of the child was “futile” and would only prolong his suffering. Then as now, desperate parents sought court relief against their son’s being pushed into the grave sooner rather than later. But then, unlike now, a court in Ryan’s case temporarily blocked the removal of treatment, pending trial.

The court never decided who had ultimate say over Ryan’s care, his parents or medical professionals, because his treatment was transferred to a different doctor who did not view his case as futile. Ryan was soon weaned off dialysis and survived for more than four years, a time in which he was a generally happy, if sickly, child who liked to give “high fives.” Had his original doctors successfully imposed their futile-care philosophy on their patient and his parents, Ryan would have died before he’d truly had a chance to live.

Before Baby Ryan’s ordeal, the parents of “Baby Terry”—also born after twenty-three weeks gestation—faced a similar ordeal. The ethics committee at the Hurley Medical Center in Flint, Michigan weighed in on August 9, 1993, opining that to honor the parents’ desire to continue Baby Terry’s treatment “would be contrary to medical judgment and to moral and ethical beliefs of physicians caring for the patient” (my emphasis). In other words, when it came to choosing between the values of the parents—based in large part on their religious faith—and the values of doctors and hospital bioethicists, the state argued that only the latter matters.

Joseph Maraachli with his mother, Sana.On that basis alone, a judge found Terry’s parents unfit to make health-care decisions for Terry and stripped them of their parental rights. He awarded temporary custody to the maternal great-aunt, who had previously stated her willingness to obey the doctors. Before that could happen, the infant died in his mother’s arms, aged two-and-a-half months.

In 2011, a similar struggle hit the headlines. Ten-month-old Joseph Maraachli was diagnosed with a terminal and progressively debilitating neurological disease. He was being cared for in a London, Ontario ICU when doctors told his parents, Moe Marraachli and Sana Nader, that they were going to withdraw all life-sustaining care.

Moe and Sana vehemently disagreed, and a bitter dispute erupted between them and the hospital’s doctors and administrators over continuing Joseph’s care. There were two areas of disagreement. First, there was the hospital’s stated intention to end all life-sustaining treatment. Second, when Moe and Sana asked doctors to perform a tracheotomy so that Joseph could be taken home, the doctors refused, claiming such a procedure was medically and ethically unwarranted.

Litigation ensued. The bitter impasse was broken when the American nonprofit organization Priests for Life paid to transfer Joseph to a hospital in St. Louis that was willing to perform the surgery. The operation was a success, and Joseph was brought home, where he died peacefully in his sleep five months later.

Charlie with his parentsThese, Charlie’s, and many other similar cases I could recite, involving profoundly ill people of all ages, are examples of what is known in the bioethics trade as “futile care” or “medical futility”—or, as I call it, futile-care theory. FCT authorizes doctors to refuse or withdraw wanted life-sustaining medical treatment over the objections of family and patients when the doctors and/or a bioethics committee believe that the patient’s quality of life makes that life not worth living—or, lurking in the subtext, not worth the resources required to sustain it.

A couple of important points need to be made: We are not talking about an intervention without a potential physiological benefit to the patient—a medical determination. Rather, FCT constitutes a value judgment. As bioethicist Dr. Stuart Youngner once put it, “futility determinations will inevitably involve value judgments about: 1) whether low probability chances are worth taking; and 2) whether certain lives are of a quality worth living.”

Worse, FCT empowers strangers to make medicine’s most important and intimate health-care decisions. Deciding whether to accept or reject life-sustaining care is one of the most difficult medical choices. Under FCT, a patient’s decision—whether it be the desire of an infant patient’s guardians or written in an adult patient’s advance directive—matters less than institutional and professional opinions.

Given all that, Charlie Gard’s heartbreaking situation is not surprising. However, until Charlie’s case, the patient or family has always had the option of finding alternative care. The hospital refusing Ryan’s dialysis did not seek to prevent his transfer. Neither did the hospital in the Baby Joseph controversy.

This is where Charlie Gard’s case is breaking new and even more authoritarian ground. Not only are doctors and judges forcing Charlie off life-support; they are also declaring that their ethics rule over Charlie’s life, even if the parents—Chris and Connie Gard—find alternative care. As far as I know, this is unprecedented in futile-care controversies.

Chris and Connie have raised more than $1 million through crowdfunding to pay for Charlie to be flown to the United States for an experimental treatment that has shown some potential in other mitochondrial conditions. If that course proves impossible, they just want to take their baby home so he can die there instead of in a pediatric ICU. But the hospital administration refuses to permit Charlie to be discharged! And the courts have agreed, based on a determination of what doctors and lawyers believe to be Charlie’s “best interests.”

The only silver lining in this tragedy is that a very sick baby’s life still has the power to move hearts. Not only have Chris and Connie received tremendous popular support internationally, but they are also being backed by two of the most visible leaders in the world: Pope Francis and Donald Trump.

The refusal to allow Charlie’s parents to remove their baby boy from the hospital is an act of bioethical aggression that will extend futile-care controversies, creating a duty to die at the time and place of doctors’ choosing. And that raises a crucial liberty question: Whose baby is Charlie Gard? His parents’? Or are sick babies—and others facing futile-care impositions—ultimately owned by the hospital and the state?

Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism and a consultant to the Patients Rights Council. His most recent book is Culture of Death: The Age of “Do Harm” Medicine.
Categories: Discussion

111 reported assisted suicide deaths in California in 2016.

Mon, 2017-07-03 18:42
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The recent assisted suicide report from the California Department of Public Health indicates that there were 111 reported assisted suicide deaths in 2016. Assisted suicide was officially legalized in California on June 9, 2016.

Another recent report, from the assisted suicide lobby, indicated that they facilitated at least 504 lethal prescriptions in the first year of the act. Dr Jacqueline Abernathy, in her article - One Year of Legalized Assisted Suicide in California, Countless Unanswered Questions stated:
Although premature and lacking in reliable data, Compassion & Choices (C & C, formerly the Hemlock Society) is already declaring the law is “working very well” in a recent press release - stating also: “Personal Stories, Statistics Show Law is Working as Lawmakers Intended.” However this report is full of dubious statistics that begs more questions than it feigns to answer. The report lists the number of facilities, doctors, insurance companies and hospice locations that support assisted suicide - yet supporting a dangerous law does not equate to proving it safe. If you recall, California legislators had soundly rejected assisted suicide in the previous session based upon a host of concerns about the safety of not just assisted suicide, but a bill that makes evaluation of the use of this form of euthanasia virtually impossible---since the law mandates that death certificates falsify the actual cause of death. The law states that death certificates from assisted suicide have their cause of death listed not as the lethal overdose that caused it- but their underlying prognosis.
The information provided in the 2016 California assisted suicide report is lacking in comparison to the yearly official reports from Oregon and Washington state. and nothing in the report assures compliance with the law.

Since the California law requires the doctor who prescribes the lethal drugs to also be the doctor who submits the report to the government, therefore we do not know if the law is being followed. Self-reporting systems do not assure compliance with the law. People who act outside of the law will rarely self-report their act.
It is concerning that the assisted suicide lobby admits to facilitating 504 lethal prescriptions in the first year of the law. It should also concern people that the number of assisted suicide prescriptions increased incrementally in the second six months of the law.

The official California report indicates that there 191 lethal prescriptions prescribed between June 9 - December 31 and the assisted suicide lobby claims to have facilitated 504 lethal prescriptions from June 9, 2016 to May 31, 2017. Therefore, not including assisted suicide prescriptions not prescribed by the assisted suicide lobby, at least 313 people were prescribed assisted suicide between January 1, 2017 and May 31, 2017. 
The California assisted suicide has been designed to provide physicians the right to assist suicides without fear of being prosecuted for acts that are done outside of the law.

As I asked on June 2 - Who is running the California assisted suicide law?

Categories: Discussion

Netherlands study: 431 people were killed without explicit request in 2015

Sat, 2017-07-01 04:48
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Every five years the Netherlands conducts a study to determine how people die in the Netherlands and whether or not there are concerns with the euthanasia law.

The data from the 2015 study concerning ending-of-life decisions in the Netherlands was recently published. In 2015 there were 7254 assisted deaths (6672 euthanasia deaths, 150 assisted suicide deaths, 431 termination of life without request) and 18,213 deaths whereby the medical decisions that were intended to bring about the death.

The 2010 Netherlands study of the euthanasia law was published in the Lancet July 11, 2012.

Clear abuse of the euthanasia law.
According to the Netherlands 2015 official euthanasia report there were 5561 reported assisted deaths in 2015 and yet the data from the study indicates that there were 7254 assisted deaths in 2015. Therefore, there were 1693 unreported assisted deaths (approximately 23%) in 2015
The 431 terminations of life without explicit request, was up from 310 in 2010.
Let me make this clear. In almost every country, terminations of life without explicit request are considered homicide. Recently an Ontario nurse was sentenced to 25 years in prison for killing 8 nursing home residents in Southern Ontario.
Euthanasia deaths continue to increase.
Based on the five year interval reports:
  • In 2005 there were 2425 assisted deaths (20% were not reported and 550 deaths were without explicit request).
  • In 2010 there were 4050 assisted deaths (23% were not reported and 310 deaths were without explicit request).
  • In 2015 there were 7254 assisted deaths (23% were not reported and 431 deaths were without explicit request).
Recent Netherlands euthanasia stories:
In January 2016, euthanasia was extended to people with severe dementia in the Netherlands.
A study published in the Journal of Psychiatry (Feb 10, 2016) concerning euthanasia for psychiatric reasons in the Netherlands uncovered significant concerns. According to researcher Scott Kim: one EAS case, a woman who died by euthanasia was in her 70s without health problems had decided, with her husband, that they would not live without each other. After her husband died, she lived a life described as a "living hell" that was "meaningless." A consultant reported that this woman "did not feel depressed at all. She ate, drank and slept well. She followed the news and undertook activities."In May, the Netherlands euthanasia clinic lethally injected an otherwise healthy woman who was sexually abused as a child.
In October, the Netherlands government stated that it was planning to extend euthanasia to people who are not sick or dying but claim to have lived a "completed life."
In November, a Dutch journalist reported that he was writing a book about his brother who died by euthanasia based on chronic alcoholism.
In January 2017, a Regional euthanasia Review Committee decided that a forced euthanasia on a woman with dementia, where the doctor sedated the woman by putting the drugs in her coffee and then having the family hold her down for the lethal injection, found that the rules were not followed but the euthanasia was done in "good faith."
It must be noted that a group of Dutch physicians oppose euthanasia for dementia and the Dutch Medical Association oppose changing the law to permit euthanasia for "completed life."
Purchase the Euthanasia Deception documentary and show it in your community.
The euthanasia lobby argue that euthanasia should legalized to regulate and control a practice that happens already. They also claim that euthanasia can be controlled and there is no proof that a slippery slope or incremental extensions will occur.
The latest data from the Netherlands proves that, after legalization, covert euthanasia continues to occur, that regulations, such as the requirement to report all assisted deaths, will be ignored and euthanasia will continue to increase and extend to more human conditions. 
A practical slippery slope exists and the Netherlands experience with euthanasia clearly proves it.
Categories: Discussion

Euthanasia pioneer provides new information concerning euthanasia in the Netherlands.

Thu, 2017-06-29 22:06
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Recently, several articles have been published quoting Dutch psychiatrist and euthanasia pioneer, Dr Boudewijn Chabot commenting on the recent developments concerning euthanasia in his country. Articles such as "A Dutch euthanasia pioneer surveys the wreckage and despair" make it sound like Chabot is now critical of euthanasia, but is he?

This is not the first time that Chabot appears to be challenging the Dutch euthanasia practice. In January 2014 he stated that the Dutch euthanasia law has derailed.

We must remember that Chabot was the psychiatrist who opened the door to euthanasia for psychiatric reasons and he is currently involved with a suicide promotion service. When reading his recent commentary it appears that he is saying that euthanasia should not be extended to "completed life" (whatever that means), I suggest that he is actually saying that it is not necessary to extend euthanasia to include "completed life" because these people can avail themselves of his suicide service.

After re-reading the text of the Chabot commentary it is my conclusion that his writing is most important because of the new information he provides concerning the practice of euthanasia in the Netherlands.

What do I mean by "new information?"
The Netherlands euthanasia law has a reporting mechanism that requires the doctor who does the euthanasia death to also be the person to report the euthanasia death. In other words, the euthanasia law requires self-reporting. For this reason we don't actually know what is happening int the Netherlands because people don't self-report acts that are possibly outside of the law or that may cause them problems.
Further to that, unless you are a member of a regional euthanasia review committee, such as Professor Theo Boer, or you are given the reports from the euthanasia clinic, you will only have the basic information that is published in the Netherlands annual euthanasia report. Sadly, Canada and Belgium use similar "self-reporting" systems.
What information does Chabot provide?
First of all he clearly outlines the growth of euthanasia in the Netherlands. Chabot states:In the last ten years, the number of euthanasia reports has increased from two thousand to six thousand per year. People ask for it more often, doctors are more often willing to provide it, and consultants who assist the doctors give more often the green light. In 2016 the review committee found that only 10 of the 6,091 (0.16 percent) cases was done without due care.Chabot then states, In and of itself, this increase does not disturb me – even if the number exceeds ten thousand in a few years, but he continues:What does worry me is the increase in the number of times euthanasia was performed on dementia patients, from 12 in 2009 to 141 in 2016, and on chronic psychiatric patients, from 0 to 60. That number is small, one might object. But note the rapid increase of brain diseases such as dementia and chronic psychiatric diseases. More than one hundred thousand patients suffer from these diseases, and their disease can almost never be cured. Particularly in these groups, the financial dismantling of care has affected patients’ quality of life. One can easily predict that all of this could cause a skyrocketing increase in the number of euthanasia cases.Chabot continues by explaining that nearly all of these controversial euthanasia deaths are done by the euthanasia clinic:Strikingly, doctors from the End of Life Clinic Foundation* are often euthanizing these patients, while as a matter of principle they never treat patients for their illness. By 2015, a quarter of euthanasia cases on demented patients were performed by these doctors; in 2016 it had risen to one third. By 2015, doctors of the End of Life Clinic performed 60 percent of euthanasia cases in chronic psychiatric patients, by 2016 that had increased to 75 percent (46 out of 60 people).Since more than 75% of the psychiatric euthanasia deaths are done at the euthanasia clinic, therefore very few lethal injections for psychiatric reasons are being done by anyone else. Chabot comments on the fact that this information is not published in the annual report:For sure, the fact that in 2016 euthanasia has been granted to a total of sixty psychiatric patients is included in the annual report of the review committee. But nowhere in the report is it mentioned that in 46 of these cases, it was a physician at the End of Life Clinic who granted the request. That number you have to dig up from the annual report of the End of Life Clinic. Is this fog purely coincidental?Chabot then comments on how the 2012 review of the law muddied the definition of “unbearable suffering without prospect of improvement.” Chabot states that the review committee stated:The committee members found this difficult to evaluate, as was already apparent from the previous review of the law: “If the notifying physician and the consultant found the suffering to be unbearable, who are we to say something more about it here?”Chabot then recounts the case of the woman with dementia who died by lethal injection even though she was saying NOIn 2016, the committee found in only one of the 201 cases of euthanasia in dementia and psychiatry that the evaluation had been careless [not in line with due care] because the requirement of “unbearable suffering” had not been met. What problem is this evaluation structure, which costs about four million euros annually, really solving? The researchers fail to answer this question.In that case, a Netherlands Regional Euthanasia Review Committee decided that the forced euthanasia done on a woman with dementia, where the doctor sedated the woman by secretly putting the drugs in her coffee, was done in "good faith."
I thank Dr Chabot for sharing new information. Chabot, in his commentary, is saying that euthanasia for "completed life" is not necessary while promoting his suicide service, nonetheless, after reading his commentary, it is impossible to suggest that euthanasia has not been extended in the Netherlands, and in fact euthanasia is out-of-control.
Categories: Discussion

What Boudewijn Chabot teaches us about euthanasia.

Wed, 2017-06-28 18:53
This article was published by HOPE Australia on June 26, 2017

Paul RussellBy Paul Russell, the director of HOPE Australia

Dr. Boudewijn Chabot is a retired Dutch psychiatrist and psychotherapist. In 1993 he was charged with having assisted in the suicide of a healthy 50-year-old Dutch woman, Hilly Bosscher, in 1991. Bosscher had lost two sons in the previous five years; six months apart. One had committed suicide; the other had died of cancer. Both were in their early twenties. Her grief did not abate; she wanted to die and to 'to lie in between the graves of her two sons'.

The Independent reported at the time that:
"Dr Chabot, now 53, originally trained as a GP before specialising in psychiatry. It was not until he had spent more than 12 years in psychiatric practice that he decided to see patients who had contacted the Dutch Society for Voluntary Euthanasia (NVVE), desperately wanting to die. He has said that he got in touch with the NVVE in order to 'offer my services in difficult cases'. It had been reported that the organisation was unable to find psychiatrists who did not utterly oppose the patient's wish to die."At that time acts of euthanasia and assisted suicide were not legal but allowed under certain circumstances via court precedents stretching back to 1973 and the Postma case. The "Termination of Life on Request and Assisted Suicide (Review Procedures) Act" would not become law until 2002.

Chabot was tried and acquitted in a lower court. The prosecution appealed to the Supreme Court where a guilty verdict was returned but no punishment was applied. Up until this time euthanasia and assisted suicide cases were not considered lawful without the presence of 'unacceptable suffering' that was defined as physical. The standard defence of necessity or 'force majeure' did not apply to Chabot.

As Wesley Smith reported, this was a 'show trial' and there was never any intention to punish Chabot but, rather allow the case to set a new legal precedent.

Following the Supreme Court decision in November 1993 the Royal Dutch Medical Association (KNMG) amended its 1984 guidelines to include the possibility that there may be cases where 'it is merciful, such as if a patient has serious psychiatric problems and has no prospect of improvement'.

From The Independent:
"Chabot was put in contact with his patient through the NVVE in the summer of 1991. Two months of intensive consultations followed, during which he tried to find a way into her 'closed world of suicide'. She had planned to take her own life since the death of her second son earlier that year and had bought a plot of four graves, two for her sons, one for herself and another for her estranged husband. A suicide attempt the night of her second son's death failed."Chabot also consulted with other psychiatric professionals; though none reportedly examined the woman. According to Chabot, he suggested that she try anti-depressants, but she refused both the medication and an entrance into a therapeutic community.

The Chabot case opened the door to euthanasia and assisted suicide for psychiatric reasons. This is a classic case of 'bracket creep' or incremental extension. The recent interim report of the Victorian Ministerial Advisory Panel notes well that in their consultations there are those who have argued for a different 'starting point' that is much broader in application that parameters suggested by the earlier Parliamentary Committee report.

One way or another, such extension is inevitable.

But Chabot offers us another consideration both in the 1993 case and his recent lament about the application of the Dutch law published in NRC Handelsblad on June 16, 2017.

Chabot is severe in his criticisms of the developments in the application of the Dutch law in recent years. He's not at all concerned about the skyrocketing numbers of deaths ("In the last ten years, the number of euthanasia reports has increased from two thousand to six thousand per year.") but rather the changes that have seen the 'due care criteria' morph in ways that suggest that euthanasia and assisted suicide 'on demand' is now the prevailing paradigm.
"To understand what has gone wrong, the reader must know the three most important “due care criteria” of the law. There must be: 1) a voluntary and deliberate request; 2. unbearable suffering without prospect of improvement; 3. No reasonable alternative to euthanasia. "The second and third requirements are closely linked because if another solution, such as specialist palliative care, is indicated, the suffering is not without prospect of improvement. If the patient refuses that option, the physician will not be convinced of the “unbearable” nature of the suffering and will not provide euthanasia. "At least as important is what is not in the law. There is no requirement that the disease has to be physical, and the doctor need not have a treatment relationship with the patient."Chabot's concerns are well founded. They relate to the subjective nature of 'unbearable suffering' and the reality that the term 'no reasonable alternative' has also become entirely subjective. He does not note the irony that this was precisely the situation with Hilly Bosscher more than 30 years ago: there were alternative treatments available that she refused and her suffering was clearly unbearable to her.

The Victorian Parliamentary Committee suggested a framework for assisted suicide and euthanasia with certain qualifying criteria. They included:
– is at the end of their life (final weeks or months of life)– is suffering from a serious and incurable condition that is causing enduring and unbearable suffering that cannot be relieved in a manner the person deems tolerable (so similar to the Dutch Due Care criteria #2 & #3)The Interim Report of the Victorian Ministerial Advisory Panel suggested the possibility that 'final weeks or months of life' could be determined formally as a prognosis of either 6 or 12 months to live. At no time has there been any suggestion that a person who 'qualifies' need to have first exhausted any reasonable treatment options. That stands to reason in as much as no-one can be forced to accept any treatment offered. But I wonder if the public sees it that way.

Chabot laments:
"Once upon a time, moving to a nursing home or receiving treatment with some medication was still considered a “reasonable alternative” for euthanasia. At least it had to be tried. Many doctors now accept that a patient can refuse a reasonable alternative and that this does not create a barrier for euthanasia. That brake has now also disappeared."That description would seem to be the starting point in the proposed Victorian regime. Any thought in the mind of the public that a death by assisted suicide or euthanasia would be a 'last resort' option only, cannot be sustained.

The same applies to the role of the psychiatrist. Chabot is concerned that in a majority of the notified cases of euthanasia for psychiatric reasons were 'executed' by the Dutch End-of-Life Clinic:
"What happens to doctors for whom a deadly injection becomes a monthly routine? They are surely well-intended, but do they also realize how they are fanning a smoldering fire that can become a blaze because they fuel the death wish of vulnerable people who are still trying to live with their disabilities? "The End of Life Clinic is now actively recruiting psychiatrists. It justifies this by pointing to the long waiting list. Their task: relieving the unbearable and unrelievable suffering from psychiatric patients through euthanasia. Every time the Clinic is in the news, a wave of depressed patients whose treatments are allegedly exhausted but many of whom have never been properly treated report to the Clinic. Ever since budget cuts turned chronic psychiatry into a diagnosis-prescription business, good treatment has become scarce. "The newly recruited psychiatrists won’t need to enter into a treatment relation with the patient. The evaluation committee has accepted that in the case of severe physical illnesses. Now it has also applied this to incurable brain diseases—without discussing it with members of the psychiatric profession by the way."Will the same be said of the Victorian regime? Will the role of psychiatry be reduced to a 'diagnosis-prescription' type business where the therapeutic role of the profession is ignored or, at least, only given lip service?

That was precisely what occurred during the time that euthanasia was legal in the Northern Territory in the mid-1990s. The Lancet report on the four deaths that occurred under the short-lived regime showed scant regard for the law and the role of the psychiatrist was seen as just another hoop to jump through or tick on a list of checkboxes.

The Victoria Branch of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) noted similar concerns in their submission to the Victorian Ministerial Advisory Panel:
"The VIC Branch also notes that, due to the often rapidly changing manifestations of mental illness, proper assessments are best undertaken by clinicians with the benefit of extended interactions over a significant period of time with the individual in question. As such, the views of psychiatrists and/or other mental health professionals with established therapeutic relationships with individuals seeking voluntary assisted dying (sic) should be sought wherever possible."Yet the thrust in terms of the law proposed for Victoria seems likely to only require a psychiatric evaluation for the sake of concerns about capacity and not necessarily about suicidal ideation or the presence of psychiatric illness (though that may be implied). Moreover, as the RANZCP report also notes, there remains a significant risk that the treating doctor and the second confirming doctor may miss signs of psychiatric concern:
"In situations where a patient has a terminal condition causing enduring and unbearable suffering, there is a risk that symptoms of mental ill health may be mistaken by a doctor not trained in psychiatry for an 'understandable' reaction to their condition. Furthermore, traumatic brain injury, addiction issues, dementia and delirium may all confound assessments of capacity and non-psychiatrically trained doctors 'are not well placed to recognise the presence of these conditions in the medically ill population'."This raises serious questions about the mechanism that supposedly 'protects' people who are vulnerable. If neither of the two assessing doctors suspect a psychiatric issue, nothing more is done.

Will the final recommendation due to be made to Premier Daniel Andrews at the end of July include a requirement that a psychiatric evaluation takes place in a therapeutic context? This would imply a relationship over time that seeks a remedy to the presenting psychiatric issues. But time may well be short. Or will this all fall back on self-determination, as it did in the Chabot case, and an acceptance that, even though the patient may have therapeutic options available - both psychiatric and medical - that refusal of any or all treatment is a fast track to suicide?
"In psychiatry, an essential limitation disappeared when the existence of a treatment relationship was no longer required." Chabot.The outcome is grave and irreversible. The Andrews government has been talking into an echo chamber, yet most Victorians will likely be unaware of the proposal and even less aware of how any proposed law might operate. The idea that assisted suicide and euthanasia are a 'last-resort-only' option; that people would need to at least try 'reasonable' options, has never really been the case yet is likely to be the general public view.

With thanks to Professor Trudo Lemmens for the English translation of the recent Chabot article.
Categories: Discussion

Judge: Nurse who killed 8, broke her trust by terminating life. What about euthanasia?

Mon, 2017-06-26 20:57
Alex SchadenbergExecutive Director - Euthanasia Prevention Coalition
Elizabeth WettlauferElizabeth Wettlaufer, the nurse who confessed to killing 8 people in Woodstock and London Ontario was sentenced to 25 years without eligibility for parole today.

According to Yahoo news, Justice Thomas stated during sentencing that:"It is a complete betrayal of trust when a caregiver does not prolong life, but terminates it,"  "She was the shadow of death that passed over them on the night shift where she supervised."I agree with Justice Thomas, but I wonder how Canadians are expected to interpret this statement now that Canada has legalized "MAID" euthanasia?

Considering the fact that Wettlaufer was not caught until she told a counselor what she had done. The oversight was so lax that she was able to kill 8 people without being caught. 

Canada's euthanasia law requires the doctor or the nurse practitioner who causes death by euthanasia send a report to the applicable authorities concerning the act. Since Canada is using a self-reporting system, is it not possible that doctors or nurse practitioners will either not report all of the deaths or hide the fact that some of the deaths were outside of the law?
NEJM study on the practice of euthanasia in the Flanders region of Belgium found that in 2013 1.7% of all deaths (more than 1000 deaths) were assisted deaths without explicit request.

A Lancet study analyzing the Netherlands euthanasia experience found that there were 310 hastened deaths without explicit consent in 2010 in the Netherlands.
It is not safe to give physicians, or others, the right in law to cause the death of their patients.
When a nation legalizes euthanasia, it gives medical professionals, who were already willing to kill their patients the legal right to proceed.

1. Every Canadian Province must do an in-depth investigation into suspicious deaths at hospitals and care institutions or we will never know how many medical killings have happened in Canada.
2. Canadians must go past their fear of dying a bad death and realize that Canada's euthanasia law is fatally flawed. There is no effective oversight of the law while giving physicians and nurse practitioners the right in law to kill you.
Categories: Discussion