Thursday, June 22, 2017

Ontario judge extends terminal definition for euthanasia to a woman with osteoarthritis.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On Tuesday I wrote about Canada's euthanasia law - one year later, showing how the euthanasia law is being extended in Canada at a record pace.

In June 2016, Canada's federal government legalized euthanasia (Bill C-14) with imprecise terminology

From my first reading of C-14, I was convinced that the government intentionally used imprecise language to enable the expansion of euthanasia, without facing political pressure from passing a wide-open euthanasia law.

For instance, the government claimed to be restricting euthanasia to terminally ill people. C-14 stated that a person's: "natural death must be reasonably foreseeable."

The Euthanasia Prevention Coalition urged politicians to amend this definition because it lacked meaning while the euthanasia lobby lobbied politicians to remove this definition because it was "too restrictive."

This week, Justice Paul Perrell approved death by lethal injection for a 77 year-old woman with osteoarthritis, (known as AB) since doctors had refused to kill her because she is not terminally ill.

Justice Paul Perrell
According to a Toronto Star article by Alyshah Hasham, Justice Perrell stated:

To be reasonably foreseeable, the person’s natural death doesn’t have be imminent or within a specific time frame or be the result of a terminal condition. 
“The legislation is intended to apply to a person who is “on a trajectory toward death because he or she a) has a serious and incurable illness, disease or disability; b) is in an advanced state of irreversible decline in capability; and c) is enduring physical or psychological suffering that is intolerable and that cannot be relieved under conditions that they consider acceptable,” 
AB’s case clearly qualifies as she is an “almost 80-year-old woman in an advanced stated of incurable, irreversible, worsening illness with excruciating pain and no quality of life,”
In other words, people who are not terminally ill are terminally ill.

The Toronto Star article stated that, according to Justice Perrell, there is no fear that the court will be over-run with death applications, because his case applies to every future case:

“All the court can do in the circumstances of the immediate case is to clarify what Parliament meant in (the legislation) so the Physician-1 and other physicians have no misunderstanding about how to comply with the legislation,” Perrell said “There is no floodgates concern because the court need do this only once for whatever benefit it may provide to AB and others.”
Meanwhile, two people in British Columbia are challenging the "terminal definition" in the law, two people in Montreal are challenging the "terminal definition" in the euthanasia law and Dr. Yves Robert, Secretary of the Collège des médecins du Québec, and a long-time supporter of euthanasia, is questioning the expansion of the law. 

According to legal experts, the Perrell decision only applies to Ontario.

Catherine Frazee: The Nazi Aktion T4 euthanasia program is part of my history as a disabled person.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Catherine Frazee
Recently the euthanasia lobby attacked Dr Harvey Schipper for comparing "assisted dying" to the Nazi T-4 euthanasia program. This would not have been a big deal other than that fact that Schipper had been appointed to chair a working group that was to examine Canada's euthanasia law and make recommendations concerning possible extensions to the law.

Schipper responded to the criticism by resigning as chair of the working group

Catherine Frazee, who is an Officer of the Order of Canada and professor emerita at the Ryerson University School of Disability Studies wrote an article titled: Look into the dark corners of history that was published in the Victoria Times Colonist on June 15. Frazee wrote:
History has a role in the national conversation about medically assisted death, despite protests to the contrary. 
A respected physician and scholar recently stepped down as chairman of the expert working group appointed to study the issue of advanced directives for medically assisted death. 
Named to this position only two weeks before by the Council of Canadian Academies, Dr. Harvey Schipper was judged harshly in some circles for having authored a commentary in 2014 in which, according to some reports, he had “compared arguments used to justify assisted dying with those advanced by Nazi Germany to justify the Holocaust.” 
Schipper was repeatedly characterized as “a strident opponent of assisted dying” for reasons having nothing to do with the tone or substance of his argument. What seemed to cause offence and give rise to a condemnation of “strident” opposition was Schipper’s reference to Nazi-era euthanasia.
Nazi T4 euthanasia program victims
Frazee continues by recounting the history of the Nazi euthanasia program:
None of Schipper’s critics disputed the facts upon which his reference was made, nor should they. As historians have chronicled, the Nazi euthanasia program originated when a father in Leipzig petitioned to end the life of his disabled daughter and Adolf Hitler dispatched his personal physician, Karl Brandt, to authorize her death as “an act of mercy.” 
According to historian Hugh Gallagher, “as the story of the little Leipzig girl became known in medical circles, other families sent similar appeals to the Führer.” It fell to Brandt to make determinations on each of these requests and ultimately to authorize the killing of at least 70,000 people with disabilities pursuant to what the American Holocaust Museum describes as “a medically administered program of ‘mercy death.’ ”
Frazee then challenges the attack on Schipper:
Schipper’s recusal as working group chairman will no doubt be applauded by advocates who seek to broaden the availability of assisted death in Canada. Others, such as myself, who know Schipper to be a man of considerable wisdom and integrity, are saddened that the 43-member panel — which includes expert advocates on both sides of this debate — failed to seize the opportunity to rise above the clamour and reject any suggestion that politics, rather than evidence, would govern their work. 
Had they spoken out together, and forcefully, in defence of their colleague, the outcome might have been different. 
This is not the first time that a measured and accurate reference to the historical facts of the Nazi euthanasia program has been condemned as strident, distasteful or offensive. It should be the last
Nothing about medically assisted death is ahistorical. As we review current law and practice, and consider potential expansion to the Criminal Code exemptions that permit Canadian doctors and nurse practitioners to end the lives of certain patients, surely we have the maturity to invite history into the conversation.
Frazee then outlines the reality that people with disabilities have historically faced:
Doctors, at times, have killed. This is fact. Often, when they have killed or harmed, they have not acted alone, but as agents of state authority. 
With all of their immense skill and influence, doctors have played indispensable roles in residential schools and asylums in Canada, comfort stations in Southeast Asia, enhanced interrogation facilities at Guantánamo Bay and extermination centres in Nazi Germany. 
People with disabilities have suffered violence and harm at the hands of doctors, parents and caregivers. Sometimes, as with Satoshi Uematsu in Sagamihara, Japan, the world has instantly recoiled in horror. Sometimes, as with parent Robert Latimer in Saskatchewan, a court of law might ultimately uphold conviction, but not before public opinion solidifies in support of the perpetrator. 
Sometimes, as with Brandt, a nation colludes. 
The Nazi Aktion T4 euthanasia program is part of my history as a disabled person. Importantly, it’s also part of Schipper’s history as a physician. Those who would forbid us to speak of this history, or police our speech as strident and unwelcome, can only fuel doubt about whether its lessons have been learned.
Frazee concludes by challenging the working groups to examine the extension of euthanasia through the lens of history:
If our federal government is to benefit from the comprehensive reviews it assigned to the Council of Canadian Academies, and if the council’s working groups are to gather the evidence Canadians require to guide policy decisions about providing medically assisted death to mature minors, to people with mental illness and to people no longer capable of expressing consent, then the history of euthanasia, and questions arising from the darkest corners of that history, must not be out of bounds. 
As Margaret MacMillan, the distinguished Canadian historian, has said: “We don’t always know best, and the past can remind us of that.”
Thank you to Catherine Frazee for setting the record straight.

Previous articles by Catherine Frazee:

Tuesday, June 20, 2017

Canada's Assisted Dying law - one year later.

Alex Schadenberg
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

One year after the legalization of euthanasia and assisted suicide, Canada has become the prime example of how legalizing assisted dying cannot be controlled and why these laws are naturally expansive. Society needs policies that encourage caring and not killing.

On June 17, 2016; Canada's Senate passed euthanasia bill (C-14) in time for their summer break. Even though some groups claimed victory based on the amendments to C-14, EPC was concerned by the fact that the most dangerous language in C-14 remained intact
Bill C-14 uses undefined language that (in my opinion) is designed to enable expansion of Canada's euthanasia law.

The Euthanasia Prevention Coalition continues to oppose euthanasia. 
  • EPC has successfully produced the Euthanasia Deception documentary focusing on personal stories by people with direct experience with euthanasia,
  • EPC has successfully distributed the Caring Not Killing pamphlet that explains why euthanasia and assisted suicide are not necessary and what you can do to make a difference,
  • EPC is working with the Compassionate Community Care service that offers advice and direction for family and friends of people who are considering dying by assisted death or people facing difficult end-of-life decisions. Contact CCC at: 1-855-675-8749. 
More people are dying by euthanasia than projected.

Even though we are well into 2017, the data from 2016 indicates that there were 970 reported assisted deaths in Canada

Other than Québec, where there were 463 deaths in the full year, these deaths occurred in 6.5 months (June 17 - Dec 31). The percentage of assisted deaths is highest in British Columbia, where there were 188 assisted deaths, where they have two euthanasia clinics, as compared to 189 assisted deaths in Ontario. The 970 reported assisted deaths represented 0.6% of all deaths in Canada. 

There may be more assisted deaths. 

According to the report, not every province has a legal requirement to report assisted deaths while Nunavut and the Yukon territories did not submit information based on privacy concerns and the small number of assisted deaths.

CBC news report (April 20) stated that there were more than 1324 assisted deaths since legalization.

The number of deaths is high in comparison to Belgium where there was 235 reported assisted deaths in its first full year (2003), 349 in its second full year and 393 in its third full year after legalization. Currently Belgium is approximately 1/3 of Canada's population.

In 2015, there were 2021 reported Belgian assisted deaths, up from 1924 reported assisted deaths in 2014. A study published in the New England Journal of Medicine (March 2015) found that more than 40% of the assisted deaths were not reported in 2013.

Conscience rights for medical professionals are not protected.

Bill C-14 did not protect conscience rights for medical professionals. The Coalition for HealthCare and Conscience launched a legal challenge to the Ontario College of Physicians policy that forces physicians, who oppose killing, to "effectively refer" their patients to a physician who will kill. Effective referral is defined as referral for the purpose of the act. The court case was heard (June 13 - 15) in an Ontario court. Some physicians will leave Ontario if they are forced to participate in euthanasia.

At the same time, the Québec government has pressured palliative care units to participate in euthanasia.

Conscience rights are recognized in Canada's Charter of Rights and Freedom but the euthanasia lobby claims that patients have a "right to access" euthanasia and thus claim that conscience rights must be limited.

Expansion of euthanasia law.

Before the ink was dry, the first court case was launched to expand Bill C-14. Recently two people from Montreal launched a similar court case to expand Canada's euthanasia law to people who are not terminally ill.

Canada's federal government did not waste time to announce that they were conducting research into expanding euthanasia to people with dementia, who stated in their advanced directive that they wanted to die by euthanasia, children, and people with psychological suffering alone.

Abuse of the law.

The law requires the physician, or nurse practitioner, who lethally injects their patient to self-report the act. Self-reporting systems enables those who lethally inject their patients in questionable circumstances to cover-up abuse of the law. 

In late September 2016, Dr Will Johnston reported on two British Columbia deaths that appear to abuse the euthanasia law. In November I was contacted by a man who stated that his Aunt, who died by euthanasia, may only have had a bladder infection.

Based on the Québec government euthanasia report 14% of the assisted deaths did not comply with the law.

Further to that, a Canadian bioethicist is already promoting euthanasia / organ donation, a study was published explaining that up to 138 million dollars can be saved by euthanasia.

Once society crosses the line and decides that it is acceptable to kill people, the only remaining question is who will be killed.

Meanwhile a Toronto study that was published in the New England Journal of Medicine found that requests for euthanasia were based on existential distress and not uncontrolled pain.

The euthanasia debate needs to go beyond theory and buzz words and become based on human reality. People usually ask for euthanasia when they are emotionally and/or psychologically distraught by their medical or personal situation. Therefore euthanasia becomes an abandonment of people at the most vulnerable time of their life.

The answer to euthanasia is to care for people and not to kill people.

Monday, June 19, 2017

We are a nation of laws and conscience

This article was published in The National Post online on June 15 2017

By: Dr. Ramona Coelho (London, ON), Dr. Lucas Vivas (Toronto, ON), Catherine Ferrier, MD (Montreal, QC), Ricardo Di Cecca (Burlington, ON)

Dr. Ramona Coelho
Re: When religion must yield to the law, Derek Smith, June 12. Derek Smith claims that rules are essential to prevent religious physicians from harming others. A physician not willing to arrange the killing (MAiD—Medical Assistance in Dying) of a patient is now seen by some as causing harm. While that is debatable in our pluralistic society, what is clear is that the protection of the patient’s life has always been the foundation for the trust in the patient-physician relationship.

Groups representing Jews, Muslims, Christians, Sikhs and secular humanists have all said that effective referral isn’t a workable solution for patient access. The College of Physicians and Surgeons of Ontario has helpfully suggested that physicians who cannot adopt their pro-MAiD ethical framework should leave or retrain. Is that a compassionate or creative response to this conundrum? We all are paying for our health system and therefore we all belong.

These doctors have been vocal about their willingness to give information and not obstruct patient wishes. Everywhere else has a more respectful system. Why would coercion be part of the equation here in Ontario?

Derek Smith mentions frail patients, unable to use a phone to self-refer. I am a doctor with years of home care experience of the most vulnerable. I have met new patients who were isolated, poor, malnourished, in pain, and some suicidal. One can imagine that helping that patient access MAiD would not be anyone’s priority nor would that patient be in a state to choose such a service.

For frail and vulnerable patients to live in the community, they need a full care team. Anyone on the care team could help make the phone call.

There are many ways to accommodate both physician and patient in these tricky situations. Coercion need not be one of them and is not a creative nor a Canadian solution. Derek Smith is concerned that religious physicians may impede access to assisted death in “frail patient(s) who cannot make a MAiD phone call.”

A patient so isolated that they cannot make a phone call is not in need of killing: they are in need of social supports and care so that they may not be alone in their final illness.

It is impossible that a patient in such isolation would really have received “adequate palliative care”, and facilitating their death will only result in less motivation to fund and provide the high-quality palliation that our most vulnerable so desperately need.

Rather than spending time and resources trying to compel good doctors to lose their integrity or leave the profession, the College of Physicians and Surgeons and the Ministry of Health should be focusing on providing better end-of-life care to all Ontarians. Derek Smith opposes the lawsuit against the College of Physicians and Surgeons of Ontario by doctors who are not willing to send patients to be euthanized. To support his arguments, he creates an imaginary world in which a medical need is being denied to frail people in emergency situations by religious zealots who refuse to do their duty.

Medicine is an ancient and universal profession whose purpose is to diagnose, treat and prevent disease, and to relieve symptoms where cure is not possible.

Canada is one of a tiny minority of countries that permit doctors to kill patients, an act that remains anathema to the worldwide medical community. Even among supporters of euthanasia there are some who now question the role of medicine in its administration.

Consider his imaginary frail patient, wanting euthanasia (as a now-legal personal choice, not a medical need), but unable to use a telephone or a computer to access a centralized referral system.

Does that person exist? How does he get groceries or do his banking? If hospitalized, is she not surrounded by a host of other people to whom the request can be made? Is there anyone so isolated they cannot find one person to help them get what they want? What is Dying with Dignity for, if not for that?

What “emergency” need for death does he have in mind?

Oregon dehydration bill (SB 494) passes in Oregon Senate

* SB 494 died when the House Judiciary Committee closed for the legislative session.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Oregon Senate Bill 494 (SB 494) that amends the advanced directive legislation in Oregon passed on June 8 in the Oregon Senate and has now being debated in the Oregon House Judiciary Committee. SB 494 specifically permits the dehydration of people who are not otherwise dying.

Another Oregon Senate Bill (SB 893) that would have expanded Oregon's assisted suicide law to permit euthanasia (someone else completes the act) died in the Oregon Senate Health Committee.

SB 494 appears to simply replace the current advanced directives legislation, but in fact it encourages the withholding or withdrawal of nutrition and hydration (food and water) from people who are incompetent but not otherwise dying.

Since SB 893 would have expanded the Oregon assisted suicide act to permit euthanasia of incompetent persons, when the person stated in a valid advanced directive while competent, a wish to die by lethal drugs (completed by another person) and since SB 494 permits death by dehydration of incompetent persons who are not otherwise dying, it is my belief that SB 494 and SB 893 are companion legislation (incremental steps).

Since death by dehydration can be a horrific way to die, therefore if SB 494 passes in the Oregon House, it may lead to the approval of euthanasia for incompetent people, since lethal injection is a far less painful way to die than dehydration.

Read: Oregon bill would extend assisted suicide to euthanasia of incompetent people.

John Kelly examines legislators’ arguments led to victory in Maine

John Kelly testimony in Connecticut
This article was published by Not Dead Yet on June 16, 2017

Not Dead Yet testimony helped defeat of Maine assisted suicide bill

The situation was tense. The Maine State Senate had pulled off a stunner by passing assisted suicide bill LD 347 by a vote of 16-15. We were nervous because two years ago, it was the Senate that saved the day by stopping a bill passed by the House. Now we had to place our hopes in the House to prevent a huge win for assisted suicide proponents. Even though Gov. Paul LePage promised to veto any bill coming out of the legislature, assisted suicide proponents would be able to confidently claim victory in the wait for a supportive governor.

Rep Deborah Sanderson
The entire House took the bill up on May 23, and after a short debate, defeated LD 347 by a vote of 85-61. Relief! It was especially gratifying because a number of legislators used arguments from Not Dead Yet and Second Thoughts testimonies against assisted suicide to oppose the bill.

Rep Deborah Sanderson of Chelsea, Maine, used Not Dead Yet and Second Thoughts Massachusetts’ testimony in two separate short speeches, which we have now captioned and put up on YouTube. She stressed two things, the inevitability of misdiagnosis cutting short people’s lives (captioned video here) and the impossibility of knowing whether someone actually self-administered the drugs because no witness is required at the death (captioned video here).

Rep Stacey Guerin
Rep Sanderson referred to one of our best examples of how legalized assisted suicide puts people at risk who are not dying. Sanderson did not mention Jeanette Hall by name, but described the letter she wrote to the Boston Globe. Jeanette wrote that she voted for assisted suicide, and when she received her own terminal diagnosis, she asked her doctor for the lethal drugs. But her doctor persuaded her to try more treatment, and Jeanette learned that she wasn’t dying after all! Now more than a decade later, Jeanette urges people to reject assisted suicide.

Rep Stacey Guerin of Glenburn, Maine, made two strong arguments against the legalization of assisted suicide. First, it increases opportunities for and the likelihood of elder abuse. She refers directly to Not Dead Yet President and CEO Diane Coleman on the ease with which an abusive caregiver could engineer a suicide. She brought up the inevitability of suicide contagion, as adolescents compare their own troubles to the accepted suicides of older people. Her captioned video is here.

Rep Beth Turner
Rep Beth Turner of Burlington, Maine, rejected proponents’ arguments that it is all about individual choice. She followed Not Dead Yet in declaring the obvious: 

“We don’t live in pure isolation. One person’s decision to end their​ life and one legislator’s decision to sanction it would surely impact all of us. It would also send a message that some people are less valued, less worthy. That some lives deserve suicide assistance rather than suicide prevention.” Her captioned video is here.
It’s now been 21 years since Not Dead Yet formed to fight Jack Kevorkian and the death machine he used on distraught disabled people, more than half of whom were not terminal in any way. We swarmed the trial that finally put him behind bars. We have gone from being ignored to being quoted during legislative debates. So please keep writing letters, op-ed’s, and testimony – our hard work is paying off!

Friday, June 16, 2017

Disabled 8 year-old's death by organ donation is being investigated.

This article was published by the disability rights group, Not Dead Yet on June 15, 2017

Stephen Drake
By Stephen Drake

The LA Times is reporting that the death of a disabled 8-year-old boy in 2013 is currently under investigation by Los Angeles police and the DA office.

Back in 2013, Cole Hartman’s father found his son with his head submerged in their washing machine. Cole went into cardiac arrest, but paramedics were able to resuscitate him.

From the story:
Physicians at UCLA’s pediatric intensive care unit told Cole’s family that the child was not brain-dead but “would never recover normal neuro function and … could never awaken,” according to an entry in his medical chart. 
The Hartmans decided to take Cole off life support and donate his organs. He was removed from the ventilator and, 23 minutes later with his family at his bedside, pronounced dead by an anesthesiologist.
Before getting into why there’s an investigation into Cole’s death – and why it’s happening four years after his death – here’s some info on Donation after Cardiac Death (DCD), and what we call “rush to judgment.”

First, there are long established protocols regarding waiting times for recovery in brain injury cases, as were shared in this blog post:
I recently attended a medical ethics seminar held at the Rehabilitation Institute of Chicago that reaffirmed medical practice guidelines about brain injury. Doctors continue to agree that it is necessary to wait before they can predict brain injury outcomes with reasonable, though they also admit not total, certainty. For traumatic brain injury (e.g. car accidents), the waiting period is one year. For anoxic brain injury (e.g. stroke or heart attack), it’s three months.
And, experts say that children are more likely to recover from brain injury than adults, as discussed by doctors regarding the “end of life” case of Haleigh Poutre. Here are excerpts from a story by Joe Shapiro after 11-year-old Haleigh Poutre’s brush with an “end of life” judgment:
Dr. JANE O’BRIEN (Chief Medical Director, Franciscan Hospital for Children): Children’s brains are amazing. They are very plastic. There is often a lot of potential to reach levels that nobody expects. 
SHAPIRO: There are 39 children living on the inpatient unit. They’re kids but with a difference. Most depend upon some piece of technology. 
Dr. O’BRIEN: Many of them would have tracheostomy tubes or tubes that they need in order to breath. They might be attached to ventilators. Many of them rely on feeding tubes into their stomachs in order to get the nutrition that they need. 
SHAPIRO: Typically, a child stays at the hospital for about three months. 
Dr. O’BRIEN: People hear about children when they have accidents at the time because that’s often the newsworthy story. But most of the children who come into our hospital, go back out into the community and most of them, they’re able to go to school. They have much more recovery, I think, than most people realize is possible.
Also this:
SHAPIRO: Bernat’s a neurologist at Dartmouth Hitchcock Medical Center. He’s not the girl’s doctor. But he says its unusual to give up so quickly on a child. 
Dr. BERNAT: In this case this girl has been in a vegetative state for somewhat under five months from trumatic brain injury. And we know that those can recover in up to a year. Or sometimes too, people will spontaneously recover awareness.
(note: the state actually sued for treatment removal ten days after Poutre’s injuries – the court fight over the removal of treatment took five months.)

Thursday, June 15, 2017

Elder abuse is a clear and present danger in the euthanasia debate.

This article was published by Mercatornet on June 15, 2017.

Paul Russell
By Paul Russell - the director of HOPE Australia

June 15 is World Elder Abuse Awareness Day. Timed to coincide with this international day, the Australian Law Reform Commission has released its final report into a long-running inquiry on Elder Abuse and the Law.

Running to 432 pages, the report takes a comprehensive look at the legal landscape across Australia and argues for a comprehensive nation-wide approach to tackling Elder Abuse. While looking mainly at the law, it also looks at abuse in Aged Care settings and argues for an overhaul of staffing, staff training, recruitment and mandatory reporting type structures to protect people.

The report also looks at training for lawyers and medical professionals.

What is elder abuse?

The World Health Organisation describes Elder Abuse as: ‘a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person’

It is recognized to 'take various forms, such as physical abuse, psychological or emotional abuse, financial abuse, sexual abuse, and neglect. The World Health Organization has estimated that the prevalence rate of elder abuse in high-or middle-income countries ranges from 2% to 14% of people usually defined as 'over the age of 60 or 65 years'.

The WHO also noted that research in other predominantly high-income countries has found ‘wide variation in rates of abuse in the preceding 12 months among adults aged over 60 years, ranging from 0.8% in Spain and 2.6% in the United Kingdom to upwards of 18% in Israel, 23.8% in Austria and 32% in Belgium’.

Whether there is a connection between the extremely high rate of Elder Abuse in Belgium and the existence of their euthanasia regime can only be guessed at, though intuitively one could easily develop a 'best guess' argument based on culture alone.

The report notes that 'vulnerability' to such abuse is not necessarily related to the age of the person. However, the effects of aging, broadly understood, can make our elders vulnerable to such abuse. There is also a connection to disability as noted in the report:
"While older people should not be considered vulnerable merely because of their age, some factors commonly associated with age can make certain older people more vulnerable to abuse. Disability, for example, is more common among older people. More than 80% of people aged 85 years or over have some disability. While fewer than one in 20 Australians under 55 years have ‘severe or profound core activity limitations’, almost one-third of people aged 75 years or over have such limitations." The authors go on to add: "Vulnerability does not only stem from intrinsic factors such as health, but also from social or structural factors, like isolation and community attitudes such as ageism. All of these factors contribute to elder abuse."
We have discussed ageism before in terms of the dominant meme that elderly people are 'burdens'. Similar observations can be made in respect to 'ableism' and disability.

By way of explanation - a simple anecdote:

Dr. Kevin Fitzpatrick OBE and I shared a podium in Ireland a few years ago. Kevin became a paraplegic after an incident 40 years previous. He asked the audience to imagine that he and I separately visit our doctor; both of us displaying suicidal tendencies. Kevin observed that, in my case, I would be offered all sorts of support and interventions under suicide prevention strategies. In his case (as had been his experience) he said that the doctor would say that they understood why he wanted to kill himself because he had such a difficult life.

As Liz Carr recently observed, treating each of us differently based on disability is scary in terms of assisted suicide and euthanasia and is one of the reasons why many people living with disability do not want such laws. They already experience discrimination in medical care and recognise the potential that such discrimination will also be present in discussions on this subject.

Wednesday, June 14, 2017

Swiss assisted suicide clinic dumped human remains in Lake Zurich

Lake Zurich
Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

In April 2010, Dignitas founder, Ludwig Minelli, was implicated in the discovery of cremation urns that were dumped in Lake Zurich. 

In June 2010, the Telegraph published an interview with former Dignitas employee, Soraya Wernli, who stated that Minelli was dumping cremation urns and Dignitas was based on Minelli's personal financial gain. reported that the Swiss high court upheld the requirement that Dignitas dispose all remains in cemeteries after Dignitas lost the court case. reported:
Urns removed from Lake Zurich
The grisly find in 2010 prompted the local authorities to draft new regulations five years later that outlawed the professional disposal of human remains in the canton. Dignitas fought the order, arguing that it represented an unfair restriction of trade. But both the Administrative Court and now the Supreme Court have sided with the canton. 
The discovery of 67 urns in Lake Zurich, near to a Dignitas clinic, made international headlines seven years ago. The human remains were found by divers from the lake rescue service who were looking for a missing sunshade.  
A former Dignitas employee told the media that it was common to dump urns in the lake and estimated there to be around 300 in the watery grave. Dignitas denied the claims and Zurich prosecutors dropped a criminal probe after being unable to prove who had put the urns in the lake.
Dignitas is known for pushing the boundaries of assisted suicide in Switzerland. 

Delaware Assisted Suicide Euthanasia Bill: Proposed Oversight is a Sham

This article was published by Choice Is An Illusion on June 12, 2017.

To view a pdf version, click these links to view the indexmemo and appendix.

Delaware Legislative Building

HB 160 legalizes assisted suicide and euthanasia as those terms are traditionally defined. The bill is based on a similar law in Oregon, which has a near complete lack of transparency.

If Delaware enacts HB 160 and follows Oregon practice, there will be a similar lack of transparency. The safety and welfare of individuals will be unverifiable from state sources.


A.  If Delaware Follows Oregon’s Interpretation of “Not a Public Record,” the Bill Will Create a Government Entity Insulated from Review, Even by Law Enforcement 

The bill charges an unnamed “Department” with issuing an annual statistical report based on data collected pursuant to the bill.[1] The bill also states:

Except as otherwise required by law, the information collected is not a public record and may not be made available for inspection by the public. (Emphasis added).[2]
Oregon’s law has a nearly identical provision, as follows:
Except as otherwise required by law, the information collected shall not be a public record and may not be made available for inspection by the public. (Emphasis added).[3]
In Oregon, this nearly identical provision is interpreted to bar release of information about individual cases. Oregon’s website states:
[T]he Act specifically states that information collected is not a public record and is not available for inspection by the public (ORS 127.865 (2)). The protection of confidentiality conferred by the Death with Dignity Act precludes the Oregon Health Authority [which oversees Oregon’s Department of Health]  from releasing information that identifies patients or participants, to the public, media, researchers, students, advocates, or other interested parties .... (Emphasis added).[4]
Consider also this e-mail from Alicia Parkman, Mortality Research Analyst for the Oregon Health Authority, clarifying that even law enforcement is barred from obtaining individual identities. She states:
We have been contacted by law enforcement . . . in the past, but have not provided identifying information of any type. (Emphasis added).[5] 
If Delaware enacts HB 160 and follows Oregon’s interpretation of “not a public record,” there will be a similar lack of transparency in which even law enforcement will have no access to information about individual cases. The bill will create a government entity above the law.

B.  If Delaware Follows Oregon’s Data Collection Protocol, Patient Identities Will Not Be Recorded in Any Manner, Source Documentation Will Be Destroyed

Oregon’s website describes the data collection protocol for its annual reports, as follows:

The identity of participating physicians is coded, but the identity of individual patients is not recorded in any manner. Approximately one year from the publication of the Annual Report, all source documentation is destroyed. (Emphasis added).[6]
Alicia Parkman, Mortality Research Analyst for the Oregon Health Authority, makes a similar representation as follows:
To ensure confidentiality, our office does not maintain source information on participants. (Emphasis added).[7]
The significance is that Oregon’s annual reports cannot be verified to source documentation.  If Delaware follows Oregon, Delaware’s reports will also be unverifiable.

C.  If Delaware Follows the Oregon Experience, a Non-Governmental Entity Will Displace the State to Become the Defacto “Agency” Overseeing HB 160

Passage of Oregon’s law was spearheaded by the suicide promotion group, Compassion & Choices.  In Oregon, this organization has used Oregon’s law to disable and displace the Department of Health as the entity overseeing that law.  Consider this example.

In 2010, I had client who wanted to know if his father had died under Oregon’s law. I referred him to an Oregon attorney, who asked the police to investigate. The attorney’s declaration states:

The officer’s report describes how he determined that the death was under Oregon’s assisted suicide law due to records other than from the State of Oregon. The officer’s report also describes that he was unable to get this information from the Oregon Health Authority, which was not willing to confirm or deny whether the deceased had used the act . . . . (Emphasis added).[9]
I also read the officer’s report. Per the report, Compassion & Choices provided the records necessary for the officer to determine that the decedent had, in fact, died under Oregon’s law. In Oregon, Compassion & Choices, a non-governmental entity, has displaced the Department of Health as the “agency” overseeing Oregon’s law.


The proposed Oregon-style “oversight” is a sham and will create the opportunity for a non-governmental entity to displace  government oversight. The safely and welfare of individuals will be unverifiable from state sources. I urge you to vote “No” on HB 160.

Respectfully submitted this 11th day of June 2017

Margaret Dore, Esq., MBA
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion, a nonprofit corporation
1001 4th Avenue, Suite 4400
Seattle, WA 98154
206 697 1217


[1]  HB 160, § 2514B (d), states: “The Department shall generate and make available to the public an annual statistical report of information collected under of this section.” (Attached in the appendix at A-1, lines 159-160).
[2]  Id. at lines 157 to 158.
[3]  ORS 127.865 s.3.11(2), attached in the appendix at A-2.
[4]  Release of Information Regarding the Death with Dignity Act, in the appendix at A-3.
[5]  E-mail from Alicia Parkman to me, 01/04/12, in the appendix at A-4.

[6]  Oregon Health Authority, Frequently Asked Questions, in the appendix at A-5.
[7]  E-mail from Parkman to Dore, 01/04/12, supra, in the appendix at A-4.
[8]  Compassion & Choices is a successor organization to the Hemlock Society, founded by suicide promoter, Derek Humphry.  See newsletter in the appendix at A-6.
[9]  Isaac Jackson, Declaration of Testimony, 09/18/12, in the appendix at A-8, ¶ 8.  The entire declaration can be viewed at A-7 through A-12.

Two people in Montreal demand expansion of euthanasia law.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

A few days ago Dr. Yves Robert, Secretary of the Collège des médecins du Québec, questioned the direction of the euthanasia law. Robert asked the question:
“If the goal is euthanasia on demand based on a “right”, are we still talking about Medical Aid in Dying? Or simply Aid in Dying? And what, then, would the medical profession have to do with it?”
Today, two Montreal people with chronic conditions challenged Canada's euthanasia law claiming that the "terminal definition" - natural death must be reasonably foreseeable - is too restrictive. 

The "terminal requirement" was designed to limit euthanasia to people who are actually dying and not to allow euthanasia based on disability or psychological conditions alone.

CTV news reported that Jean Truchon and Nicole Gladu held a press conference in Montreal:

At a news conference alongside their lawyer, Jean-Pierre Menard, they explained they suffer from degenerative diseases but are not eligible for medical aid in dying because their deaths are not reasonably foreseeable and they are not at the end of their lives. 
They are asking the court to allow doctors to provide them with medical aid in dying and to invalidate the articles of the laws setting the criteria.

We also argued that based on "equality" that the Carter decision was irresponsible and dangerous and that the language of the decision would make it difficult to limit euthanasia to specific conditions.

The terminal definition "natural death must be reasonably foreseeable" lacks clear meaning. One of the reasons that the euthanasia lobby is wanting to eliminate this restriction is because it is a nebulous definition. Sadly, the language of Bill 14 had other problems that may become a significant problem in the near future.

Once you cross the clear line and permit doctors and nurse practitioners to kill their patients, then the only remaining debate is for what reason.

The Netherlands is currently debating extending euthanasia to people who claim to have a "completed life." There is no floor to euthanasia.

If Canada strikes down the minor restrictions that exist within its euthanasia law, then euthanasia will become the answer to any or no medical or psychological condition.

Every human person goes through highs and lows in life. 

Killing people is abandonment, not freedom.

Monday, June 12, 2017

Dr Yves Robert concerned about evolving euthanasia laws in Québec.

This article was published by the Physicians Alliance Against Euthanasia on June 12, 2017.

Dr Yves Robert Secretary of the
Collège des Médecins du Québec
On May 10, 2017, Dr. Yves Robert, Secretary of the Collège des médecins du Québec, asked the following question in a thoughtful article published on the CMQ website:
“If the goal is euthanasia on demand based on a “right”, are we still talking about Medical Aid in Dying? Or simply Aid in Dying? And what, then, would the medical profession have to do with it?”
Considering the past positions espoused by the College and by Dr. Robert personally – “The debate is only beginning…” (words of Dr. Robert at 18 minutes 24), such a quote is reminiscent of the classic novel Frankenstein, where that high-minded scientific genius, having created a humanoid monster threatening to the human race, is forced to confront the reality of his acts and of his responsibility for them. Tragically, but also heroically, he feels obligated, in the end, to hunt and destroy that creature – loved by him as a son – which his imprudent skill had set loose upon the world.

This reading of the text may be well beyond the Secretary’s intention. However, he has raised a clear statement of principle: if there are no criteria for euthanasia other than client demand, then medical wisdom, medical art and medical science have no role to play.

Once we allow any person to choose state-assisted suicide, and any doctor to perform it, we are legitimizing a purely subjective choice of death. There remains no logical reason why the right to exercise such choices should be restricted to this or that medical condition, or to medical conditions at all. Whatever limits are set, someone will feel constrained by them; and the state will continually be called upon to justify a discriminatory regime (where group “a” is allowed subjective decision, but group “b” is not).

Dr Robert apparently believes (or at least did believe) that protection of the common good can perform a limited retreat before the pressure of unfettered individual liberty, and that stable compromise can be established between these two visions. But the legal and moral change, from euthanasia-as-criminal-homicide to “medical aid in dying”, is not a difference in degree; it is a difference in kind. No compromise is possible. There is only a clearly perceptible earth-moving shift towards a radically different medical paradigm based, solely, upon personal subjective choice – a shift which the Physicians’ Alliance, palliative care providers and many others have opposed from the beginning.

The politicians who promoted Bill 52 insisted it was “an evolution, not a revolution”. But, as we observe the public opinion shift that alarms Dr. Robert – “the paradoxical discourse that calls for safeguards to avoid abuse, while asking the doctor to act as if there were none” – it becomes obvious that it is indeed a revolution, planned as such by its authors, wilfully ignoring the opposition of those who care for the dying. The ink is barely dry on Bill 52 and euthanasia enthusiasts are already demanding further concessions. The interim demands were never an acceptable final destination, only legal waystations on the path to complete liberty of personal choice. As Dr. Robert calls it, death à la carte.

And so it is, that even Dr. Robert has begun to speculate publicly upon the medical significance of such an extreme outcome. And these are the logical implications which he has now had the honesty and rigour to bring forward: The medical profession has no duty (or competence) to define, staff or take any responsibility for a public regime of death on demand. Whatever form such fundamental social change might take, it is NOT a medical problem. And (we would add) the sooner we realise this fact, and act upon its wisdom, the better things will be for all concerned.

Indeed, simple prudence would suggest that we show restraint right now in the administrative implementation of the euthanasia regime. Decontamination is always easier in proportion as the contaminated area is smaller. Hubris-driven attempts to impose MAID upon all corners of the health care system should be abandoned. Refusal of individuals and institutions to collaborate in this practice should be scrupulously respected.

Dr. Robert ends his article with a simple and sober admonition:

“Let us take the time to reflect carefully before going any further… Death is not that urgent.”
It is a sentiment with which we entirely agree.

Translated from the original article in French by the Physicians’ Alliance against Euthanasia.