Sunday, June 17, 2018

California appeals court re-instates assisted suicide law.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On Friday, June 15, the Fourth District Court of Appeals in Riverside County California, issued a stay of the assisted suicide law to once again permit doctors to prescribe lethal drugs in California.

Sign our petition: Saying NO to assisted suicide. (Link).

The Associated Press reported that the plaintiffs in the case have until July 2 to object to the decision of the court of appeals. 

On May 15, Judge Daniel Ottolia overturned the California assisted suicide law by ruling in Ahn vs. Hestrin that the legislature acted outside the scope of its authority when it enacted the End of Life Option Act in 2015.
California passed the state's assisted suicide law in a special health care funding session, in 2015, after the legislature failed to pass the assisted suicide bill in its regular session. Judge Ottolia, held that:
“the End of Life Option Act does not fall within the scope of access to healthcare services,” and that it “is not a matter of health care funding.”
On May 23, the Fourth District Court of Appeals upheld the decision by Judge Ottolia  ensuring that assisted suicide remained prohibited in California.
On May 30, Judge Ottolia refused to vacate the decision, that the California assisted suicide law was unconstitutionally enacted.

Bill McMorris reported in the Washington Free Beacon that:

...Riverside Superior Court Judge Daniel Ottolia rejected a motion to vacate his decision declaring the End of Life Options Act unconstitutional. Assisted suicide supporters Compassion & Choices filed the motion on behalf of two terminally ill patients, as well as a doctor who prescribes lethal medication.
Since the California's assisted suicide law was instituted in an unconstitutional manner, therefore the decision by the Fourth District Court of Appeals to stay the decision needs to be appealed immediately. 
California citizens deserve to have their lives protected from assisted suicide and they deserve to have the rule of law respected.

Québec physicians: Shortage of palliative care is pushing people to euthanasia

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

A group of Québec doctors held a press conference to explain that the lack of funding for palliative care in Québec is pushing people to seek death by euthanasia.

CTV news reported that the doctors stated that since MAiD was legalized access to palliative care has decreased. The doctors said that:
patients have told them that they’re choosing assisted dying because they can’t find adequate palliative care services.
Dr Paul Saba
Dr Paul Saba, was reported as saying that they want to provide the care and support that people need:

Dr. Paul Saba, a family physician who is leading the group said fewer doctors have entered the field of palliative care since the law came into effect and that patients are suffering as a result. 
“People really are feeling a burden, financial stress, psychological stress and lack of autonomy,” 
“So what we want do is we want to give people what they need, and they need care and support.”
Dr Laurence Normand-Rivest
Dr. Laurence Normand-Rivest, who specializes in  palliative care, told the press conference:

“We were promised that there would be a plan for the development of palliative care in Quebec and the [government] commission asked for five years to develop this plan,”

“We’re in 2018, and for now, there’s no plan.”
Dr Charles Bernard, the President of the Québec College of Physicians, told the Québec government at the end of May that more funding is needed for palliative care. CTV reported that Bernard wrote to the government stating:
“Patients, failing to benefit from such care, could have no other choice but to ask for medical aid in dying to end their days in dignity,” 
“Patients who ask for medical aid in dying are given priority access to available resources to the detriment of other patients at the end of their lives.”
The Canadian government will be receiving reports in December on the extension of euthanasia to children, people with psychiatric conditions and people who are incompetent.

Thursday, June 14, 2018

How crazy is it to encourage the mentally ill to kill themselves?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

In his article published today in the National Post, Charles Lewis makes the point  - It would be sick to give someone who is depressed and wants to end his or her life the encouragement to jump. But Canada may make such suicide legal.

Lewis begins the article by considering the recent tragic celebrity suicide deaths:
Two celebrities take their lives, two people who appeared to have everything to live for. Though clearly, Anthony Bourdain, a globetrotting chef for CNN, and Kate Spade, the handbag maker who made millions ooh and ah, did not see it that way. 
The reaction in the media was predictable: sadness, regret and questions about why. On Sunday, The New York Times ran an information piece for readers who worry that someone close to them might be suicidal. It was called: “What to do When a Loved One is Severely Depressed.” 
Not one of the many suggestions mentioned helping the person commit suicide or putting them out of their misery in a humane way. 
The Times article was intended to prevent a needless death. That is as it should be. It would be sick to give someone who is depressed and wants to end his or her life the encouragement to jump. 
Imagine if the article said: “When confronted with someone suffering from mental illness, you might suggest they sit in their car, in the garage, and rev the engine till the gas puts them out of their misery.” 
But for how much longer will the idea of abetting a suicidal person like Bourdain or Spade be seen as sick and immoral — especially in Canada?
Lewis then examines the question of euthanasia for the mentally ill
In December 2016, Health Canada struck a committee of experts to look at extending our current laws on euthanasia to teens and the mentally ill. Currently, MAID — Medical Aid in Dying — is limited to those over the age of 18 whose physical health ailments mean that their natural death is “reasonably foreseeable.” The committee is supposed to report back at the end of this year. 
It is possible the experts will say no to both proposals. Or yes to both or one or the other. What should be concerning, however, is that this is even being considered. 
I am going to put aside the proposal on teens for now. That might be the one area where even those who are pro-euthanasia will balk. ...
But I am not so sure about the outcome for the mentally ill. 
Somewhere in 2016 a group of people in the government debated this and there were enough people in favour of extending euthanasia that they thought it was worth studying. That should be the first alarm. 
I think even 10 years ago these types of suggestions would have seemed insane. Even in 2016, the year euthanasia in this country became legal, anyone who worried about the law expanding would have been accused of fear mongering. There is no danger of a slippery slope, we were told.
Lewis then examines the debate concerning euthanasia based on mental illness in Canada.
I would have hoped that even today this type of suggestion would have seemed repugnant. But then last year, in The Globe and Mail, there was a column that made me realize nothing is off limits. 
In 2017, a 27-year-old man named Adam Maier-Clayton took his own life. He suffered from mental illness. The young man had written about wanting a legal way to end his suffering and his life in a Globe essay months before his death. 
André Picard, The Globe and Mail’s health reporter, wrote a column that urged lawmakers to heed to Maier-Clayton’s wish in honour of his tragic death. 
“Other Canadians who want to avail themselves of assisted death shouldn’t have to wait either for legislation to catch up with the court ruling and public sentiment. Most people accept that if someone’s dying anyhow, it’s OK to hasten their death, especially if they’re old,” Picard wrote. “But cases such as Mr. Maier-Clayton’s make us distinctly uncomfortable. He was young, healthy-looking and not suffering from any obvious physical illness. 
“We should not discriminate or deny people rights because it makes us queasy or because of our prejudices. This case reminds us just how severe mental illness can be.” 
The Netherlands and Belgium already dispatch the mentally ill, so Picard’s suggestion is not without precedent.
Lewis concludes his article as it began
In the first 12 months of legal euthanasia, from June 2016 to June 2017, 2,000 Canadian died via lethal injection. To me this is tragedy enough. But I would have thought that there were Canadians who, unlike me, are in favour of euthanasia, but who would balk at killing the mentally ill.
Depression and other mental illnesses should not be a death sentence. As time has gone on, with improvements in medicine, they have become easier to live with. Many people so afflicted can grow out of their illnesses. What it takes is for those of us who are around these people to offer whatever aid we can. We need to ensure they are seeing a doctor. We need to listen carefully to what they have to say, to look for hints that they might go the way of Spade and Bourdain. 
How crazy would it be if we were to encourage them to end their lives? 
How crazy would it be if our government decided that death is a medical option for those who suffer mentally? 
How crazy indeed.

Wednesday, June 13, 2018

Suicide epidemic exacerbated by cultural loneliness.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The suicide epidemic is once again in the news possibly due to the celebrity suicide deaths of Anthony Bourdain, Kate Spade, and others. There have been many articles published on what may be causing the significant increase in suicide deaths.

The latest research from the Center for Disease Control indicates that between 1999 and 2016, the suicide rate in America increased in every state (except Nevada) and suicide deaths have increased by a staggering 30% in America where in 2016 alone 45,000 people died by suicide.

After reading many articles and studies on the scourge of suicide, I am further convinced that the causes of suicide are the same or similar reasons why people ask for assisted suicide. Based on their feelings of hopelessness and despair, they feel like they have no other choice.

An article by Ross Douthat in the New York Times Sunday Review (May 18, 2013) concerning loneliness and suicide states:
Right now, the pessimistic scenario seems more plausible. In an essay for The New Republic about the consequences of loneliness for public health, Judith Shulevitz reports that one in three Americans over 45 identifies as chronically lonely, up from just one in five a decade ago. “With baby boomers reaching retirement age at a rate of 10,000 a day,” she notes, “the number of lonely Americans will surely spike.”
The same concerns were expressed by Ben Domenech in an article published in the Federalist (June 11) in commenting about the tragic death of Anthony Bourdain. Domenech states:
The answer is almost assuredly loneliness and depression – both of which Bourdain has talked about in multiple interviews over the years, and since his divorce. Listening to his conversations over the weekend with Marc Maron and David Remnick, it’s barely under the surface of his conversations – and if you’re familiar with his shows, they seem less like advocacy for an approach to life, and more like arguments with himself about the inherent goodness and beauty we can find in the world. 
The disturbing truth we have to recognize is that Bourdain is not alone in his loneliness and depression. We are experiencing an incredible increase in suicide levels according to the latest research from the CDC. From 1999 to 2016, suicide increased in every U.S. state but one (and that one is Nevada, which remains in the top ten states for suicides). It is one of the top ten causes of death and one of only three such causes on the rise. The rise is seen in every age group and across all demographics, but particularly among people who look like Bourdain: 84 percent of suicide victims are white, and roughly 77 percent are men. 
Last month, a CIGNA survey found that loneliness is epidemic, and that the youngest Americans proclaim the highest levels. “One in four Americans (27 percent) rarely or never feel as though there are people who really understand them. Two in five Americans sometimes or always feel that their relationships are not meaningful (43 percent) and that they are isolated from others (43 percent). One in five people report they rarely or never feel close to people (20 percent) or feel like there are people they can talk to (18 percent).

The "experts" claim that suicide has nothing to do with assisted suicide. The American Association of Suicidology accepted the false position of long-time assisted suicide activist Margaret Battin who wrote that suicide and assisted suicide are different acts done for different reasons. Battin is known for producing ideological studies that are not factually based. The assisted suicide lobby knows that assisted suicide becomes socially accepted when it is differentiated from suicide.
With 20 years of experience with the issues of euthanasia and assisted suicide I contend that the reasons people die by suicide are the same or similar reasons why people ask for assisted suicide, even when the circumstances differ.

Most people who ask for assisted suicide feel that there life lacks purpose, meaning or hope, they feel that no one cares about them or that they are a burden on others. Physical suffering rarely causes someone to seek a hastened death but loneliness, depression or feelings of hopelessness are primary reasons.

There aren't easy answers, but I contend that a culture can reduce the scourge of suicide and the cultural abandonment associated with assisted suicide, by caring for and being with others at their time of need. It is essential that people who feel that their life lacks value or purpose, or feels that no one cares, is offered purpose, support and genuine hope from significant community.

The answer is not only talking about it (suicide), the answer is inclusion, caring and being with others as they journey through the difficult times of their lives.

California can right the wrong of assisted suicide

The following article was published as an opinion column by The Press Enterprise on June 12, 2018

By Marilyn Golden - Senior policy analyst, Disability Rights Education and Defense Fund.

Marilyn Golden
California made a mistake by legalizing assisted suicide, but now it has a chance to correct its error. California’s assisted suicide law was overturned by Judge Daniel Ottolia because the legislative process was not properly followed. If Judge Ottolia’s ruling stands, it will be a great protection for people with terminal illness, economic disadvantage, and especially people with disabilities.

But California Attorney General Xavier Becerra is appealing Judge Ottolia’s ruling in an effort to once again make assisted suicide legal in California. It is disappointing to see the person responsible for upholding the rule of law and the state’s constitution, defending an illegally passed law. No matter the procedural problem this court decision is based upon, disability rights advocates are opposed to assisted suicide laws because they have harmful impacts on people with disabilities.

Sign our petition: Say NO to assisted suicide in California. (Link).

Contrary to much of the rhetoric surrounding this debate, pain is not the top reason cited in most cases of assisted suicide. The California law is virtually the same as Oregon’s, the first assisted suicide law in the U.S. According to a recent report by the Oregon Public Health Division, the top five reasons for requesting suicide drugs by the patients were:
  • “Losing autonomy” (89.5 percent)
  • “Less able to engage in activities making life enjoyable” (89.5 percent)
  • “Loss of dignity” (65.4 percent)
  • “Losing control of bodily functions” (36.8 percent)
  • “Burden on family, friends/caregivers” (48.9 percent)
Each of these concerns describe what people with disabilities experience on a daily basis. These numbers strongly suggest that it is disability, or fear of disability, behind most assisted suicides under Oregon’s so-called model law. Further, this speaks volumes about our society and how it is terrified of living with a disability or caring for someone who lives with a disability.

Also alarming is that people experiencing depression may not be protected from obtaining lethal drugs. This occurred, for example, to Oregonian Michael Freeland. He had a 43-year history of depression and suicide attempts. Yet when Freeland saw a doctor about arranging an assisted suicide, the physician said he didn’t think that a psychiatric consultation was “necessary.” But the law’s supporters frequently insist that as a key safeguard, depressed people are ineligible for assisted suicide. If Oregon’s safeguards are claimed to be so thorough, how did Michael Freeland receive lethal drugs?

Like in other states where assisted suicide is legal, the “safeguards” built into California’s law are hollow. If a person fails to qualify for assisted suicide by one doctor’s evaluation, that person or their family, as in the case of Portland, Oregon, resident Kate Cheney, can shop for a doctor who will give them the lethal dose, over and over again if necessary.

As a disability rights advocate, there is no doubt in my mind that assisted suicide will have a profound negative impact on public insurance coverage of expensive medical treatment. This has also happened in Oregon, including to cancer patient Barbara Wagner, whose insurer denied coverage for a particular prescribed chemotherapy regimen. However, she was instead offered drugs that would have killed her by assisted suicide. Do we really think insurance companies will do the right thing, or the cheap thing?

Judge Ottolia’s ruling has provided a golden opportunity for California to reassess its stance on assisted suicide and expand access to palliative care and in-home and community-based personal care services. Lack of access to services is a pervasive problem for the disability community. However, allowing assisted suicide to be reinstated in California would undermine efforts to fix this problem, by allowing the cheaper, easier option of hastening one’s death as the only alternative to which everyone has equal access.

Suicide is not medical care, and we should not treat it as such. We urge California to seize this opportunity to help people with terminal illness, with economic disadvantage, and with disabilities by accepting Judge Ottolia’s ruling and rejecting the assisted suicide law. California should provide vulnerable people with authentic help, not this dangerous so-called medical treatment.

Marilyn Golden is a senior policy analyst with the Disability Rights Education and Defense Fund.

Tuesday, June 12, 2018

Québec Physicians Denounce Lack of Free Informed Consent & Safeguards of Euthanasia and Assisted Suicide Laws

10 Quebec doctors denounce the fact that the health care system is forcing people to accept “medical aid in dying” rather “than medical aid in living” in Canada.
Dr Laurence Normand-Rivest
According to the doctors, patients end up wanting to die because they do not have access to proper medical care. Each physician demonstrated how the lack of access to proper care deprived patients of free and informed consent and adequate safeguards in the euthanasia and assisted suicide laws.

Lisa d’Amico lives in Montreal and is the President of the Medical Errors Victims Fund. She lives with cerebral palsy since birth. Lisa argues that euthanasia and assisted suicide laws are abusive and killing people against their will. According to Mme d’Amico: 

"the lack of medical care and therapeutic incidents or accidents lead to unwarranted deaths."
Dr. Colavincenzo described a patient with congestive heart failure with many quality years to live being euthanized without free and informed consent because of overly pessismistic predictions by the physician unduly influencing family members. According to Dr. Colavincenzo this clearly shows that the laws are not protecting patients.

Dr Ron Olivenstein, former Director of the Montreal Chest Hospital, described how patients with severe lung disease can have many years to live, but whose lives are short-circuited because of lack of availability to pulmonary rehabilitation services. Without optimal care, some of these patients will decide to end their lives. For Dr. Olivenstein this is another example of lack of free and informed consent and inadequate safeguards.

Dr. Kass who is former Director of Surgery at Lachine Hospital and operates on woman with breast cancer, states that woman over 70 are not encouraged to have routine mammograms which could result in missing some early cancers. Patients who do not undergo timely screening and treatment cannot give a free and informed consent because of inadequate safeguards.

Dr Laliberté, former Director of Family Medicine at Lachine, considers that some patients may ask for assisted death without a free and informed consent. Lack of accessibility to adequate palliative care is a major issue, as recently reported by the Quebec College of Physicians. Consequently patients, in distress will be forced to ask for physician assisted death. This is not to be taken lightly as the decision is serious and and has irretrievable consequences, namely death.

Dr. Thierry Toledano is an internal medicine specialist. He stated that it is impossibile to give patients clear informed consent as to whether they are at the end of life. What does end of life mean : a few days; several months; less than 6 months; less than a year? The Canadian law is even less clear than the Quebec law since a prognosis does not need to be given to the patient. What does dying in the foreseeable future mean if prognosis is not to be included in the assessment? Does this mean the patient doesn’t even have to be dying? Most chronic medical conditions that physicians treat (for example, diabetes, chronic heart and lung problems) are “incurable” and progressive. Which of these patients are eligible under the current law?

For Dr. Toledano, the consent cannot be free and informed if the eligibility conditions are vague.

Dr. Liette Pilon, a family physician,deplores the fact that access to important care like pain control is long and difficult. Access for mental health, geriatric,disability, home and palliative care is lacking. Some patients end up asking for death because of inadequate care. « How can a patient have a free and informed choice when a lethal injection is more readily available than real care? » asks Dr. Pilon.

Dr. Sylvia Baribeau, a family physician described the pressures placed on patients who want home care but do not have access and are afraid to go to the hospital where the care often is suboptimal for basic hygiene. They talk about ending their lives rather than facing undignified living conditions at the hospital or nursing homes.

Dr. Peter Blusanovics is an AIDS hospice, palliative and geriatric physician. He decries the lack of access ot quality health care, delays in diagnosis and treatment and lack of hygienic care in institutions which may cause patients to: 

"rush into a hasty decision to end their lives by assisted suicide or euthanasia because of the fear of not receiving adequate medical care and fear of being alone or a burden to others."
Dr Laurence Normand Rivest who works in palliative care described that many patients in Quebec do not have access to the quality home palliative care services they need. At the end of life the choice is either going to the hospital where they do not want to spend their last days or ending their life quickly by a lethal injection.

Recently, the Quebec College of Physicians which is mandated to ensure the quality of medical practice, issued a letter to the Quebec Government expressing their concerns that physician assisted death may be causing patients to turn to lethal injections because of the lack of palliative care.

Dr Paul Saba
In this letter, the President of the College of Physicians informed the Health Minister that there are "difficulties with the accessibility of palliative care for many end-of-life patients" denouncing that "in certain well-identified cases, patients, not benefiting from such care, could have had no choice but to request medical assistance in dying to end their days "in dignity;" The College of Physicians also advises that "end-of-life care can not be limited to access to medical assistance in dying."

Dr. Paul Saba reminded us that the Quebec Commission in 2016 and 2017 reported many deaths that did not respect the law. For Dr. Saba, these findings confirm that the law is not being respected, that patients are not being properly informed and that the safeguards are inadequate.

Paul J Saba
Coalition of Physicians for Social Justice
email us here

‘Flawless’ Fatal Flaws Film Reviews from Around the World

Fatal Flaws Ad in Guernsey
As screenings of Fatal Flaws continue throughout the world, we’ve been overwhelmed by positive responses from high-profile individuals from both medical and legal professions internationally.

For instance the screening in Guernsey helped defeat a euthanasia proposal.
As you consider a screening in your area, we invite you to read what others are saying about the film:
“Slippery slope arguments have often been criticized as philosophically weak. There could be no stronger evidence for the reality the slippery slope than Fatal Flaws. As both a psychiatrist and a palliative care physician, I cannot overemphasize the importance of this film as a spiritual call, a moral message, a social statement and a clinical intervention. Kevin Dunn is a modern day Cassandra who has produced a film that describes what would be terrifying science fiction, were it not already social fact: the legalization of the termination of the lives of the vulnerable, isolated, marginalized, and anguished in state after state and country after country. Even more disturbing those deaths come at the hands of physicians whom for millennia have sworn to heal and not to harm. Through interviews with patients, families and experts, Dunn gives a neglected and urgently needed critique of the euphemistic masking of suicide as compassion and in so doing exposed the dark side of the gilded claim that the relief of suffering lies in the affirmation of hopelessness, the embrace of futility, and the betrayal of the historic goals of medicine.”
- Cynthia Geppert MD, MA, MPH, MSB, DPS, MSJ, DFAPA, FCLP, Professor of Internal Medicine and Psychiatry, Director of Ethics Education ,University of New Mexico School of Medicine, Adjunct Professor of Bioethics Albany Medical College, USA
“Fatal Flaws is more than just a great documentary film. It is a clarion call to restore decency to the House of Medicine. For every doctor or patient who wants to understand the difference between medical killing and medically-responsible caring, this humane and sensitive film is a must-see.”
- Ronald W. Pies, MD, Professor Emeritus of Psychiatry, and Lecturer on Bioethics, SUNY Upstate Medical University; Clinical Professor of Psychiatry, Tufts U. School of Medicine; Editor-in-Chief Emeritus, Psychiatric Times, USA.
"This is a brilliant film that should be compulsory viewing for busy legislators who haven’t time to do their own research into how euthanasia is changing death and dying in countries such as Canada and the Netherlands. Kevin Dunn interviews supporters and opponents of euthanasia and physician assisted suicide in a non-judgemental way and the responses he gets are extraordinary."

- Professor the Baroness Sheila Hollins, House of Lords, Past President of the Royal College of Psychiatrists, UK
“Compelling, timely and moving. Physicians must see this film, especially those in training as the euthanasia movement is trying to redefine the ethics of medicine. ”
- Steven S. Sharfstein, M.D., Former President The American Psychiatric Association, USA
“Fatal Flaws should be necessary watching for anyone considering the legalisation of medical assistance in dying.” 
- David Albert Jones, Director of the Anscombe Bioethics Centre, Oxford, UK
“Sobering and contemplative, Fatal Flaws is a must-see, regardless of one’s personal views about the rightness or wrongness of medical assisted death. The film challenges us to think critically about our individual and social responses to vulnerability and suffering, and, in particular, the re-shaping of the ‘house of medicine’ through the logic of law.” 
- Mary J Shariff, Faculty of Law, University of Manitoba, Canada
“There are three words that should never have come together: “Physician Assisted Suicide”. This important film shines a critical light on the perverse reality that we are now training our medical students how to kill some of their patients. The medical arts of comfort and palliation are being supplanted by the seduction of euthanasia and the murky language of rights. We should all see this film and carefully weigh whether we really want our society to slide into a mire that extols medical murder.” 
- John Maher MD FRCPC, Editor-in-Chief, Journal of Ethics in Mental Health, President, Ontario Association for ACT & FACT, Canada

A hearty thanks to the above contributors for their positive and passionate reviews. 

Kevin Dunn, Director - Fatal Flaws

Disability Advocates Concerned as AMA Refers Assisted Suicide Policy for More Study

For Immediate Release: June 11, 2018

Diane Coleman 708-420-0539
Marilyn Golden 510-549-9339

Disability rights advocates led by Not Dead Yet are concerned with the American Medical Association’s decision today to continue studying the issue of physician assisted suicide. While the AMA’s longstanding policy against assisted suicide still stands, a simple affirmation of the policy was defeated in a 46-53% vote.

The current AMA policy states, in essential part:

“[P]ermitting physicians to engage in assisted suicide would ultimately cause more harm than good.

“Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”
Two years ago, some AMA members raised the possibility of taking a neutral stance on the issue, and the matter was referred to the AMA’s Council on Ethical and Judicial Affairs. After two years of study, the Council recommended that the AMA maintain its policy opposing assisted suicide, but this recommendation was not accepted and the matter was referred back for further study.
“We had hoped that the AMA would follow the Council’s lead and affirm current policy once and for all,” said Diane Coleman, president and CEO of Not Dead Yet, a national disability organization. “Assisted suicide proponents have repeatedly tried to make this a culture war issue, ignoring the strong opposition of the AMA and other medical organizations, as well as numerous national disability organizations. But we’ll keep fighting for this critical protection for patients.”
The top three concerns raised by disability advocates in opposing assisted suicide bills have been:
  • If insurers deny, or even merely delay, expensive live-saving treatment, the person will be steered toward assisted suicide. Will insurers do the right thing, or the cheap thing? 
  • Elder abuse, and abuse of people with disabilities, are a rising problem. Where assisted suicide is legal, an heir (someone who stands to inherit from the patient) or abusive caregiver may steer someone towards assisted suicide, witness the request, pick up the lethal dose, and even give the drug — no witnesses are required at the death, so who would know? 
  • Diagnoses of terminal illness are often wrong, leading people to give up on treatment and lose good years of their lives, and endangering people with disabilities, people with chronic illness, and other people misdiagnosed as terminally ill.
Coleman has analyzed the Oregon state assisted suicide data and found that it substantiates a number of their concerns. This information was included in Not Dead Yet’s second of two formal submissions to the AMA Council on Ethical and Judicial Affairs.
“If assisted suicide is legal, some people’s lives will be ended without their consent, through mistakes, coercion and abuse,” said Marilyn Golden, senior policy analyst with the Disability Rights Education and Defense Fund. “No safeguards have ever been enacted or even proposed, that can prevent this outcome, which can never be undone.”

Monday, June 11, 2018

AMA to continue to review its position on assisted suicide (language).

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The American Medical Association (AMA) at their annual convention in Chicago, decided not accept the assisted suicide report of the AMA Council on Ethical and Judicial Affairs (CEJA) and sent the question back to CEJA for further study. 

This means that the AMA will likely vote on the issue of assisted suicide at next year's Convention.

Two years ago, the AMA asked CEJA to study and make recommendations on the issue of assisted suicide. In early May, CEJA re-affirmed the AMA's long standing position opposing assisted suicide. The CEJA report concluded:

After careful consideration, CEJA concludes that in its current form the Code offers guidance to support physicians and the patients they serve in making well-considered, mutually respectful decisions about legally available options for care at the end of life in the intimacy of a patient-physician relationship. The Council on Ethical and Judicial Affairs therefore recommends that the Code of Medical Ethics not be amended.

According to Jane Recker reporting for the Chicago Sun Times, a key point of division in the AMA assisted suicide debate was language. The article by Recker reported:
After debating the American Medical Association Council on Ethical and Judicial Affair’s report that argued the AMA should continue to use the wording “physician-assisted suicide” instead of “aid in dying,” 56 percent of the AMA House of Delegates voted that the study be referred back to the Council to review their previous stance on what language should be used. 
This vote doesn’t mark any binding change in the AMA’s stance on physician-assisted suicide. However, it opens the door to permanent change when the amended report is presented at next year’s conference.
Recker reports that many physicians supported the CEJA report:
However, not all who attended the debate Monday were in agreement with the majority stance. Dr. Diane Gowski, a representative from the Society for Critical Care Medicine, argued that it was irresponsible for the AMA to call physician-assisted suicide anything else, especially in light of the recent suicide contagion effect sweeping the country. 
“Let’s be clear, (physician-assisted suicide) is suicide,” she said. “None of us would hand our patient a gun, so let us not hand them any means to end their life.”
Today's vote at the AMA convention did not change the position on assisted suicide. I commend CEJA for clearly stating why assisted suicide is unethical and I urge physicians to become more involved in the AMA. 

Assisted suicide is never ethical and it is not healthcare.

Bioethicists to the people: ‘Obey Us!’

This article was published by National Review online on June 11, 2018

Wesley Smith
By Wesley Smith

Well, this is rich. Udo Schuklenk, the co-editor-in-chief of the journal Bioethics, insists that people obey bioethicists and doctors when it comes to decisions about ending life-sustaining treatment even when the patient or family wants to fight on — an authoritarian bioethics meme known as “futile care.”

Schuklenk is furious at the public backlash against the forced removal of life support from Alfie Evans in the U.K. — who had an undiagnosed degenerating brain condition — and the hospital and court’s barring his parents from taking Alfie to an Italian hospital willing to continue treatment. From, “Bioethics Culture Wars — 2018 Edition: Alfie Evans”:
Udo Schuklenk
There is invariably much talk about disrespect of the disabled, as if there is no difference between a disabled child living a life worth living and a child whose brain has been irreversibly catastrophically damaged. Add to that a liberal amount of second guessing and questioning of the clinical judgement made by clinicians involved first-hand in the care of the toddler by academics, activists and religious lobbyists with no clinical qualifications and no first-hand knowledge of the facts of the matter… 
A predictable consequence of the flurry of activism across the globe was that a sufficiently large number of activists was motivated to try to storm the hospital where the boy was cared for. Yes, they tried to storm the hospital! They even, for a brief period, managed to block an ambulance from entering the hospital. Without any sense of proportion, they call(ed) themselves Alfie’s Army. No, I ’m not kidding, army! 
Not terribly surprising: if you genuinely think that you are fighting a crime akin to the holocaust you will think about it in fairly militant terms. Agitation and propaganda have consequences.
So does presuming the right and power to impose your value judgments upon patients by forcing them off wanted life support, particularly since the reason for pulling the plug is that the care is succeeding in keeping the patient alive. In other words, futile-care impositions actually declare the patient to be “futile,” not the treatment.

A few emotional commentators in the Alfie Evans case made unfortunate comparisons to Nazism — never a good idea — and some protesters engaged in objectionable pushy tactics.

But make no mistake: The actual aggressors in this “culture war” are Schuklenk and other bioethicists of his ilk when they arrogantly grant to themselves the final say about when a life is worth living and maintaining — and then insist that all bow and acquiesce. No!

Now, let’s add in Schuklenk’s blatant hypocrisy to the mix. On several occasions he has written that doctors should be forced to take human life in abortion, lethal-injection euthanasia, and assisted suicide if the patient demands it — and that their conscience or religious objections to killing are irrelevant. Either do these immoral deeds (from the doctors’ perspective), Schuklenk believes, procure a doctor who will, or get out of medicine!

How do we square these two conflicting positions? Utilitarian bioethics increasingly isn’t about autonomy — once the movement’s most prominent advocacy thrust — but in justifying why certain patients should become dead.

If “choice” achieves that outcome, great. Such decisions are sacrosanct. But if patients make the “wrong” decision from bioethics’ utilitarian perspectives and choose to fight on, well, autonomy has its limits.

No one died and made bioethicists kings and queens. Their value judgments are not inherently superior to those of families and patients because bioethicists have a Ph.D. in philosophy. It is not our duty to meekly obey.

That so many people fought to save a little profoundly disabled and sick boy named Alfie Evans — and Charlie Gard before him — is to be celebrated, not decried.

Presumptuous bioethicists such as Udo Schuklenk corrode the people’s trust in the medical system, but ultimately, they will only have power if we cede it to them. Just say no to the technocracy.