Friday, April 18, 2014

Susan Martinuk: Euthanasia debate is alive and well

This column was written by Susan Martinuk and published in the Calgary Herald - April 18.

Susan Martinuk
By Susan Martinuk

When you don’t have facts and/or good arguments, the only way to win a debate is to declare the discussion obsolete and anoint yourself the winner.

That’s what happened last week in the debate over euthanasia (where one individual deliberately kills another to “end their suffering”) and assisted suicide (where one individual provides the means, information or whatever is required for another to commit suicide so as to “end their suffering”).

An April 7 commentary in the Canadian Medical Association Journal arrogantly suggested that the “yes or no debate” is over, arguments about sanctity of life, personal autonomy and intolerable suffering may now be obsolete and it’s time for doctors to focus on establishing guidelines and policies (“we may need them very soon”) that would “suit the Canadian context.”

As the authors no doubt hoped, the editorial created substantial media buzz, and some headlines and news reports gave the public the incorrect perception that this was a dictate of the Canadian Medical Association or Canada’s palliative care physicians.

That it was printed in the Canadian Medical Association Journal in no way means that it is CMA policy. As in any truly free academic journal, editorial opinions and scientific interpretations are not censored. However, in this particular case, this commentary runs counter to CMA policies (reaffirmed as recently as 2013) that overwhelmingly oppose euthanasia and assisted suicide, calling it “unethical” and “in conflict with basic ethical principles of medical practice.”

In addition, the suggestion that the debate is over and doctors should practically prepare to deal with euthanasia does not have the support of Canada’s doctors or palliative care physicians.

A 2013 Canadian Medical Association poll showed that just 16 per cent of its members would be willing to participate in the taking of a life. A 2010 survey by the Canadian Society of Palliative Care Physicians found that 88 per cent of its members were opposed to euthanasia and 80 per cent were against legalization of assisted suicide.

The American Medical Association says euthanasia/assisted suicide is “fundamentally incompatible with the physician’s role” and the World Medical Association calls it “unethical” and asks all national medical associations and physicians to refrain from participating in it — even if laws allow it.

In other words, the vast majority of physicians oppose any legalization of the practice and the insistence on calling it an unethical practice reinforces the idea that even if these practices are legalized, they will still be anathema to a physicians’ role and responsibility to a patient.

Thursday, April 17, 2014

Harold Shipman: Euthanasia without request or consent?

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Harold Shipman was responsible
for at least 218 deaths.
The Associated Press reports that a recent documentary marking ten years since the death of Dr Harold Shipman, a doctor in the UK who was also a serial killer, refers to his actions as euthanasia.
The two-part documentary examines some of the deaths attributed to Dr Shipman and interviews some of the family members of his victims. The Associated Press article reports:
Jack Shelmerdine, whose father - also called Jack - died at the hands of the GP, said he and his family had a greater suspicion that there was a problem with hospital care than their doctor being at fault. 
The son of one of serial killer Harold Shipman's victims still maintains he was a "good doctor" and said he views the killing as "euthanasia". 
He had been present when Shipman delivered the lethal injection. Mr Shelmerdine recalled: " I was concerned that my father was still unconscious, still asleep as we were thinking, and I rang Dr Shipman and I remember his words were, 'Oh, he might well make it'. But those words, 'he might make it' seemed odd to me. 
"And I just wondered whether questions ought to be asked. I wasn't thinking in terms of Dr Shipman having done anything. We were more inclined to think that the hospital had done something wrong rather than Shipman.
Michael Swango was responsible
for approximately 60 deaths.
The difficulty with euthanasia is that the family members are often unaware of what is actually happening or that comments that result in death are often misconstrued. This explains why statistics from Belgium indicate that up to 32% of all assisted deaths are done without request.

The Associated Press article reports on the first part of the documentary. The article states:
In the first programme, Harold Shipman: Driven To Kill, a former colleague from his early years practising medicine at Pontefract General Infirmary, the then ward sister Margaret Sivorn, said he was a "brilliant doctor". 
"The consultants liked him. He got on well with his colleagues. The patients absolutely couldn't ever say a bad thing about him," she said. 
"They felt calm and comfortable with him and knew that he was looking after them properly. He was always professional, always, and you always felt at ease with him. He'd have a smile with them, a little joke with them, but professional to his fingertips."

Tuesday, April 15, 2014

Assisted suicide would bring a culture of death.

The following editorial was published on March 25, 2014 by The Telegraph UK. This editorial was published after UK Prime Minister David Cameron stated that he would be voting against the assisted suicide bill.

Legalisation leads to bureaucratisation, turning a matter of complex moral concern into one of legal box-ticking.

Prime Minister Cameron
David Cameron is right to warn of the dangers of legalising assisted suicide. Under the 1961 Suicide Act it is technically a criminal offence to help someone to die, but the Director of Public Prosecutions already issued guidelines four years ago to indicate that anyone who acted “out of compassion” would be unlikely to face charges. And yet Lord Falconer’s Bill to legalise assisted dying is before the Lords and the Government has indicated that it would permit a free vote on a measure that does not reflect a genuine need. Unless defeated, it could be the first uncertain step on a very slippery slope.

For a sense of what lies at the bottom of that slope, consider the Netherlands and Belgium. The Dutch liberalised euthanasia in 2001 and it was supposed to be limited to those with “unbearable and hopeless suffering” whose mental faculties were acute and who had no hope of relief. Since legalisation, the number of people dying through medical euthanasia has doubled – thanks in part to the operation of mobile euthanasia units that allow people to take their own life even if family doctors have refused to offer help. Among those who have died have been those with chronic depression and those in the early stages of dementia. In Belgium, meanwhile, euthanasia is now the cause of one in 50 deaths. A recent, high-profile example was that of 44-year-old Nathan Verhelst, who was helped to die when a botched sex-change operation left him with “unbearable psychological suffering”. Belgium has just become the first country in the world to permit euthanasia for chronically ill children.

Life can be full of pain and every sympathy should be extended to those who wish to die in dignity and peace. But legalisation leads to bureaucratisation, turning a matter of complex moral concern into one of legal box-ticking. Worse still, as we are seeing in the Benelux countries, it has the potential to become “normal”. Not only would this encourage ruthless relatives to persuade relatives to choose death, but it may also add to the wider societal pressure for the aged or the ill to see themselves as a “burden” on everybody else. We are already being bombarded with messages that our population is growing unmanageably old, fostering a culture of death. That is a culture that does not instinctively cherish all lives equally but rather directs attention and resources away from the infirm and towards the young and healthy.

One of the most important principles of medicine is “non-maleficence”, the ancient pledge to do no harm. The emphasis of health care must be to treasure life and safeguard it. The push for assisted suicide is a troubling challenge to that fine tradition.

People with disabilities don't want your pity and we don't want your death.

The following letter was published by the Hamilton Spectator on April 15, 2014.

Sign the Declaration of Hope to oppose euthanasia and assisted suicide.

Steve Passmore protesting
euthanasia bill in 2009.
By Steve Passmore

I was born with cerebral palsy and I have lived all of my life with pain. I now have scoliosis which affects my mobility and gives me further pain. My prognosis is living with a wheelchair.

Steven Fletcher MP has introduced euthanasia bills with language that specifically focuses on people with disabilities because his bills are about him dying by euthanasia.

Fletcher is saying that he does not value his life, but I value my life and the lives of others with disabilities. His “right to die” ends at the point where it affects other people. Don’t take me down with your death wish.

As a member of parliament, Fletcher has the opportunity to make a difference in the lives of people with disabilities, to work towards improving social supports and living opportunities, but his euthanasia bills say that our lives are not worth living.

People with disabilities are at risk from euthanasia because they are often dependent on others who legally have the right to make decisions for them. Any legislation that lessens protections in law for people with disabilities is very concerning.

I have overcome many physical and social barriers in my life, I am busy wanting to live, but Fletcher’s bill directly affects my right to live.

People with disabilities, who live with a positive mind-set, show society how to overcome challenges. We see these challenges as opportunities for personal growth.

Fletcher wants your pity. People with disabilities don’t want your pity and we don’t want your death.

The concept of euthanasia creates great fear for me. Legalizing euthanasia or assisted suicide abandons me as a person. That society would rather help me die with dignity, than help me live with dignity.

We will fight for the right of people with disabilities to live with equality, value and acceptance.

Steven Passmore
Hamilton Ontario

Links to similar articles:
People with disabilities are not disposable.
People with disabilities protest Bill C 384.

Monday, April 14, 2014

Registered Nurses' Association of Ontario will vote on a Pro-Euthanasia Resolution at May 1 - 3 AGM

All RNAO members need to attend this historic RNAO AGM to oppose this resolution.  
Register for the RNAO Conference/AGM

RNAO members can vote against this resolution online between April 15 - 30.

Non-members can voice their opposition to this resolution (contact link).

RN Voice in National Discussion Regarding End-of-Life Care

Submitted by: RNAO Board of Directors

Whereas a national discussion is underway regarding end-of-life care with specific emphasis on ‘dying with dignity’ which involves a review of assisted suicide and/or euthanasia; and

Whereas the final decision on permitting assisted suicide and/or euthanasia rests with the public; and

Whereas there is support from all three provincial political parties to engage in a discussion regarding end-of-life care; and

Whereas RNAO is being asked by stakeholders and media to comment on this issue;

Therefore Be It Resolved That RNAO urge the provincial and federal governments to engage in formal public dialogue on end of life issues and dying with dignity, including discussions, related to assisted suicide and/or euthanasia; and

Therefore Be It Further Resolved That the following principles be considered when discussing assisted suicide and/or euthanasia:
● Personal autonomy and justice are fundamental principles
● Ensuring timely access to evidence-based palliative care must remain a top priority
● The government must reject calls for involuntary euthanasia
● Assisted suicide and/or euthanasia must never be considered within the context of cost-savings
● Procedural safeguards must be enacted, including:
○ Restricting assisted suicide and/or euthanasia to competent adults with terminal illness;
○ Requiring that requests for assisted suicide and/or euthanasia be initiated by the person seeking the service and would be subject to a thorough review process that includes: independent confirmation on terminal illness; determination of capacity by a mental health-care professional (with appeal to the Consent and Capacity Board); providing access to all reasonable alternatives and establishing a waiting period.
● The practice of assisted suicide and/or voluntary active euthanasia must be restricted to professionals who have sought designated education and training.
● No health professional or organization should be required to participate in assisted suicide and/or voluntary active euthanasia.
● A provincial monitoring and reporting system must be developed, including a process for responding to complaints.
This resolution on End-of-Life Care contradicts the RNAO policy concerning Patient Safety.

Links to articles related to nursing and euthanasia:
● Legalizing euthanasia and assisted suicide is not safe. Patient safety must come first.
American nursing association opposes assisted suicide.
● Nursing ethics and euthanasia.
● Quebec nurses and palliative care leaders so no to euthanasia.
Belgium nurses are involved with euthanasia without request - nearly half of the time.
Research article confirms that Belgian euthanasia law is abused.

Alex Schadenberg receives rave reviews for his presentations

The following is a review based on the feedback forms concerning my presentation at a conference on euthanasia in Des Moines Iowa on March 29, 2014.
Debating in Brussels Belgium
AlexSchadenberg, Executive Director and International Chair of the Euthanasia Prevention Coalition, is an expert on assisted suicide and euthanasia around the globe.  
On feedback forms, attendees expressed amazement at Alex’ vast knowledge and described him as an “excellent presenter,” “so passionate,” “humorous,” and “super informative.” One wrote, “Loved his stories,” referring to the poignant real-life stories with which Alex peppers his talks.
You can book Alex as a speaker for your conference at:

The next major conference that Alex is presenting at is the First National Symposium on Euthanasia and Assisted Suicide, May 2 - 3, 2014 at the Ramada Plaza Hotel in Minneapolis Minnesota. Register today.

Sunday, April 13, 2014

Woman needed help not assisted suicide.

The following article was written by Richard and Judy and published in the Daily Express on April 12, 2014.

By Richard and Judy, Express - April 12, 2014.

Richard and Judy

In a week of disturbing stories right across the news gauntlet – Peaches, Pistorius, the political car-crash of Maria Miller – one dark and troubling tale went almost unnoticed: The death of a retired art teacher, only identified as Anne, by assisted suicide at the infamous Dignitas clinic in Switzerland. 

The truly disturbing nature of Anne’s story is this: she was not suffering from any form of terminal disease. True, at 89, she had had her health problems – diseases of the lung and heart, requiring spells in hospital (which she hated). But she wasn’t dying of cancer, or one of the nasties such as Huntington’s Chorea, or multiple organ failure.

Anne simply felt alienated from the modern world. Speaking days before she died – from a lethal dose of drugs provided by the clinic – she said she felt she faced a choice either to “adapt or die”, and announced she was not prepared to adapt to a world in which technology took precedence over humanity. She added that she had become frustrated with the trappings of modern life, such as fast-food, consumerism, and the amount of time people spend watching television.
“They say ‘adapt or die,’” she said, having already made the decision to take the latter option by drinking a deadly dose of barbiturates. “I find myself swimming against the current, and you can’t do that. If you can’t join them, get off... all the old fashioned ways of doing things have gone.”
Now you may or may not agree with Anne’s world view, but judging by her comments (and there were more in the same vein) it sounds very much to me as if the poor woman was suffering from a classic case of clinical depression – feelings of hopelessness, alienation, despair and suicidal thoughts.

Is that a condition Dignitas should be giving itself permission to treat with a lethal cocktail of drugs? I don’t think so. Its own rules state that it will only provide help in cases of “illness which will lead inevitably to death, unendurable pain or an unendurable disability”.

Anne’s niece, Linda, 54, accompanied her aunt to Zurich and was by her side when she died. She has said she “cannot think of a better death”.

Hmm. I don’t doubt her personal belief in that statement and I am sure she genuinely believes she did the right thing by her aunt. But Anne’s death raises disturbing questions. What if she’d been 10 years younger, say, 79, but held exactly the same bleak view of the world? Would she still have been offered assisted suicide?

Or what about 69? Or 59? At exactly what point does the combination of (undiagnosed) depression plus advancing years get the thumbs-up from the Dignitas doctors?

Personally I have always supported the principle of assisted suicide but Anne’s exit from this world has made me seriously wonder if it can ever be properly controlled.

This disturbing story could be the thin end of a very unpleasant wedge.