Monday, July 24, 2017

The article on assisted suicide that Australian newspapers wouldn't publish

This article was published by HOPE Australia on July 22, 2017.

How Can The Public Make A Good Decision About Assisted Suicide When Reasoned Argument Is Verboten! 
Rachel Carling-Jenkins

Read Dr Carling-Jenkins Article And Judge For Yourself!

Guest Article by Dr Rachel Carling-Jenkins
Victorian State Parliamentary Leader, Australian Conservatives

Compassion for people at the end of life is a fundamental reflection of our humanity. We care. It’s what people do.

Australians are a compassionate people. We are known for it. Whether motivated to help our friends and family or to respond to natural disasters or even the plight of suffering people that play out with regularity in the euthanasia debates – we care. Our motivation drives us to action (intention): we act as we can, we offer support, and we donate to causes.

But our compassion should never drive us to support killing by euthanasia or to help someone to their suicide. That intention is always wrong. Our legal system and the vast majority of legal systems throughout the world have held to this principle since ever laws were written. We don’t see killing or supporting suicide as a valid option in response to difficult circumstances.

The Victorian Parliament has been talking about this issue for more than a year. The motivation – to care and to respond to suffering – is honourable; and the majority of the recommendations of the Parliamentary Report on end-of-life choices reflect that. Yet the question of whether there should be a law in Victoria that allows people to commit suicide with medical support or to die by euthanasia was never really dealt with by the committee in any detail. Certainly, the report itemised the case for and against, but it never discussed the pros and cons nor did it grapple with the inherent risks nor the moral and ethical concerns. (Think: if we need to talk about ‘safeguards’, then there’s something inherently ‘unsafe’ about the practice)

If this were an environmental impact statement for a large urban development no government would proceed based on such a flimsy and inconclusive presentation. Yet when talking about a literal ‘life and death’ issue, Premier Andrews and his Health Minister seem driven more by ideology than common sense. This is reckless, dangerous and ill-conceived.

My colleague, Daniel Mulino MLC tabled a dissenting report last year that looked at all of the literature and all of the practice of euthanasia and assisted suicide in the few jurisdictions where it is legal. His work raised significant doubts about the ability of any law to protect vulnerable people or to contain the target cohort. Even a cursory glance at Mulino’s work would cast serious doubt about the glib assertions of the likes of Andrew Denton.

Victorians are being sold a dud. The use of euphemisms such as ‘assisted dying’ to describe medical aid to suicide feeds on our sense of compassion but it leads us down a blind alley. It encourages us to accept that, because it sounds compassionate, it somehow follows that the intention is benign. We’re told that there are people driven to suicide by their medical conditions, but all the government is offering as an alternative is, well, suicide. How is that compassionate? Surely we can do better than that!

And above all of this we have behaviour by the likes of Denton and his cohort that reminds me more of the wild-west snake oil salesman than it does of anything else. Theirs is a simple proposition: create fear in people’s minds that some of us will die in significant pain and then offer them a deceptively simple solution – assisted suicide. The Report of the Victorian Parliamentary Inquiry took this bait all too easily, going so far as to wrongly cite a submission by Palliative Care Victoria (PCV) to make the false claim that “not all pain can be alleviated”. This is not the case, as the PCV submission made abundantly clear.

Using fear as a political tool may be effective, but it is bad public policy to undermine confidence in our palliative services.

Associate Professor Ian Haines, medical oncologist and palliative medicine specialist, told another newspaper last year that, as an oncologist with 35 years' full-time experience, “I have seen palliative care reach the point where the terminally ill can die with equal or more dignity than euthanasia will provide.”

If there are shortcomings in palliative medicine it is surely that not every Victorian, not every Australian, currently has access to quality services in their time of need. To remedy that situation the NSW government recently committed to $100M in funding for rural and remote services and Palliative Care Victoria has identified an immediate need of an additional $65M to the same end. It would be a cruel hoax played on the people of Victoria that some may feel forced to ‘choose’ assisted suicide because of a lack of effective services.

And yet, for all of the talk about pain and all of the hard cases that the pro-assisted suicide lobby delight to recall, the main reason people choose assisted suicide isn’t pain at all. It’s about fear of loss of autonomy and fear of being a burden. What kind of endorsement would we be giving to our elderly and ill if we passed into law the thought that, yes, indeed, you are a burden? As Dutch academic Henk Reitsema says: Before it becomes a legal option, caring for someone who needs care is just the human thing that you do. But once they have the option to 'choose' to let their lives be ended, their not doing so is to choose to burden their next of kin - and that's unfair!'

Saturday, July 22, 2017

Legalizing assisted suicide is dangerous - just look at Canada

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kevin Yuill
Professor and author, Kevin Yuill, has written another excellent article that Spike published on July 20, 2017 titled: Legalizing assisted suicide is dangerous - just look at Canada

Yuill, who was born in Canada, refers to the recent Canadian experience with assisted dying to urge British citizens to reject assisted suicide.

The British court is currently dealing with the Conway case, a case that seeks to strike down the laws protecting people from assisted suicide in the UK. With reference to the recent Canadian experience, Yuill writes:
The CBC reported recently that, by the end of 2016, there had been 1,324 cases of medical assistance in dying (MAiD) in Canada – that is, assisted suicide and euthanasia. This number is likely to increase. Before the ink was dry on C-14, the British Columbia Civil Liberties Association launched a court case to ‘strike down’ as unconstitutional the somewhat slippery provision that a person’s ‘natural death must be reasonably foreseeable’ to qualify for death by lethal injection. 
In the weeks that followed C-14’s passage into law, the Canadian federal government announced that it would conduct research into the possibility of extending the benefits of euthanasia to people with dementia, ‘mature children’, and those with solely psychological suffering. In the case of a 77-year-old woman suffering from non-terminal osteoarthritis, the judge chided doctors who had refused euthanasia on the grounds that her disease was not terminal. He granted the woman the right to die as she was ‘almost 80’ with ‘no quality of life’. And, of course, her death was judged to be ‘reasonably foreseeable’.
In the province of Ontario, the Ministry of Health and Long-Term Care announced that it would force doctors to either euthanise patients who wanted to die, or refer them to someone who would. Three years ago, it was a crime for doctors to kill their patients in Canada. Now, doctors could lose their licence for refusing to participate in killing their patients. 
Judges and juries are generally sympathetic in tragic cases like Conway’s. But there is no need to change the law. We should take the court case in Canada, which opened a Pandora’s box, as a warning about the dangers of legalising assisted suicide.
Previous articles by Kevin Yuill

Friday, July 21, 2017

Euthanasia doctors can kill but can't count.

Alex Schadenberg
This article was published by OneNewsNow on July 21, 2017

A study of euthanasia in one European country gives America a hint of what is to come in states if they legalize it.

Every five years the Netherlands conducts an independent study of euthanasia deaths, comparing figures released by the government with an anonymous study in which the results are expected to be more accurate.

While the government reports there were over 5,500 assisted suicide deaths, the study revealed more than 7,200.

Alex Schadenberg of the Euthanasia Prevention Coalition has reviewed the figures, which show 23 percent of euthanasia deaths weren't reported in 2015.

"It also showed there were 431 lethal injections, intentional killings, without request," he tells OneNewsNow.

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

Some instances, he said, involve patients with dementia who cannot consent to being injected and killed. Unreported deaths could be blamed on sloppy reporting by doctors but also by ones who lethally inject a patient in violation of the law.

According to Schadenberg, a similar problem exists in the U.S. states of Oregon and Washington state. Those states do not have blind, anonymous studies as the Netherlands does and even studies that are done by the states are not completed in a manner to uncover even deaths performed outside the state laws.

"So all we know from Oregon and Washington state," he says, "is what the doctors who deliver the death tell us.”

The system is designed to protect the doctors, he warns, so if laws are violated they have no fear of recrimination.

Euthanasia in the Netherlands, the doctor will kill you now.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On July 20, the Wall Street Journal published an article by Kees van der Straaij, who is a member of the Netherlands parliament. The following is the Wall Street Journal article - In the Netherlands, the doctor will kill you now

Kees van der Straaij MP (Netherlands).
In 2002 the Netherlands became the first country to legalize euthanasia and physician-assisted suicide for those suffering deadly diseases or in the last stages of life. Not long after the legislation was enacted, eligibility was expanded to include those experiencing psychological suffering or dementia. Today pressure is mounting for the Dutch government to legalize a “euthanasia pill” for those who are not ill, but simply consider their lives to be “full.” 
Proponents of assisted suicide continue to claim that safeguards already built into Dutch law are sufficient to reduce the risk of abuse. They point out that medical professionals are required to assess whether a person’s suffering is indeed unbearable and hopeless. 
These safeguards do exist. In practice, however, they are hard to enforce. A poignant illustration was recently aired on Dutch television. An older woman stricken with semantic dementia had lost her ability to use words to convey meaning. “Upsy-daisy, let’s go,” she said. Both her husband and her physician at the end-of-life clinic interpreted her words to mean, “I want to die.” A review committee judged her euthanasia was in accordance both with the law and her earlier written instructions, an outcome very few would have imagined possible as recently as 10 years ago.  
Such episodes have many Dutch people worried about the erosion of protections for the socially vulnerable and medically fragile. A broad and heated public debate recently flared about whether doctors may administer fatal drugs to those with severe dementia based on a previously signed “advance directive.” In several controversial cases, assisted suicide was not directly discussed with patients who were incapable of reaffirming earlier written death wishes. In one case, a doctor slipped a dementia patient a sleeping pill in some apple sauce so that he could be easily taken home and given a deadly injection. 
Hundreds of Dutch physicians signed a declaration outlining their moral objection to these increasingly common practices. Nonetheless, the Dutch government stands by its claim that the law permits doctors to end such patients’ lives. Meanwhile, the Dutch Right to Die Society, a national euthanasia lobby, keeps pressing to take further steps, arguing that individuals should have the option to “step out of life.” 
But is this argument really convincing? Those seeking death because their lives are “full” are often haunted by loneliness and despair. Some elderly people fear bothering their children with their social and medical needs. They don’t want to be perceived as burdensome. 
Legalizing the euthanasia pill could put even more pressure on the vulnerable, disabled and elderly. More than 60% of geriatric-care specialists already say they have felt pressure from patients’ family members to euthanize elderly relatives. Will the day come when society considers it entirely normal—even “natural”—for people who grow old or become sick simply to pop the pill and disappear? If so, those who desire to continue living in spite of society’s expectations will have some serious explaining to do. 
All of this clearly shows the slippery slope of the euthanasia path. Contrary to the emphatic advice of a special advisory committee chaired by a prominent member of a liberal-democratic party, the outgoing Dutch government wishes to expand and extend the euthanasia law to those who consider their lives to be full. The pressing question is where the slope ends and the abyss begins. Will those with intellectual disabilities or physical defects also be “empowered” to step out of life? Will those battling thoughts of suicide be encouraged to opt for a “dignified death” in place of excellent psychiatric care? 
The government’s most fundamental task is to protect its citizens. The Dutch government, to its credit, often speaks out when fundamental human rights are under threat around the world. Now that the fundamental right to life is under threat in the Netherlands, it’s time for others to speak out about the Dutch culture of euthanasia.
Links to other articles concerning euthanasia in the Netherlands.

Thursday, July 20, 2017

Not Dead Yet UK intervenes in assisted suicide court case.

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 Campbell
Disability 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 Carr
Liz 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.

Assisted Suicide – Is It All About The Money?

The following article was published by Hope Australia on July 20, 2017.

Paul Russell
By 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.

Euthanasia, Conscience and Canadian doctors

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.

Friday, July 14, 2017

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

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.

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

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
There 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.

Thursday, July 13, 2017

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

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

In 2004, the Groningen Protocol was approved in the Netherlands which permitted the killing, by lethal injection of newborns with disabilities. In 2014 a Canadian bioethicist wrote an article titled: Physicians can justifiably euthanize certain severely impaired neonates. 

This week the New York Times has published an article by philospher Gary Comstock promoting infanticide of newborns with disabilities.

Comstock tells the story of Sam, his son 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.

The story of Sam's brief life, his birth, his treatment and his death is moving and compelling.

The narrative explains the decision to withdraw the baby's ventilator. The child did not die a beautiful death. Comstock writes about the baby waking and grasping silently for breath. 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.
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.

Comstock 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 article is designed to redefine love, from that of caring parents who live through the death of their child to that of parents and doctors who kill newborns with disabilities.