Monday, February 24, 2020

Canadian Government MAiD bill may permit euthanasia of incompetent people.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Last week, Canada's federal government asked the Quebec court for a four month extension to amend the euthanasia law.

On February 24, Canada's federal government introduced Bill C-7, an act to amend the Criminal Code (medical assistance in dying). Bill C-7 is the federal government's response to the Quebec Court decision that struck down the section of Canada's euthanasia law that requiring that "natural death be reasonably foreseeable" before qualifying for death by euthanasia (lethal injection).

I reported that the Quebec court expanded Canada's euthanasia law by eliminating the requirement that only terminally ill people could be killed by lethal injection.

The court decision expanded euthanasia to people with psychological conditions. Canada's euthanasia law states that a person qualifies for euthanasia if:

the illness, disease or disability or that state of decline causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable
A person didn't qualify for euthanasia based on psychological reasons alone since the law required that a person's "natural death be reasonably foreseeable" but since the Quebec court struck down this requirement, the law now permits euthanasia for psychological reasons.

Bill C-7 pretends to prevent euthanasia for psychological suffering. Section (2.‍1) states: 

For the purposes of paragraph (2)‍(a), a mental illness is not considered to be an illness, disease or disability.
This paragraph does not prevent euthanasia for psychological reasons since the law states that the person must be experiencing physical or psychological suffering. 

Bill C-7 creates a two track law where a person who is not terminally ill has a 90 day waiting period while Bill C-7 waves the 10 day waiting period for people who are terminally ill. Therefore a person can request and then die by lethal injection on the same day.

The government is wrong to create a two tier euthanasia law. A future court decision will likely strike down the 90 day waiting period for people who are not terminally ill because this provision represents an inequality within the law.

Bill C-7 allows a person's healthcare provider or care provider to be one of the witnesses. This is a conflict of interest.

Finally, Bill C-7 allows doctors and nurse practitioners to lethally inject an incompetent person, (advanced request) so long as that person consented to death by lethal injection before becoming incompetent.

This amendment to the law contravenes the Carter decision which required that a person be capable of consenting to die.

The goal of the euthanasia lobby was to amend the law to allow "advanced consent" for euthanasia. Canada's Liberal government appears to be working closely with the euthanasia lobby.

By eliminating the 10 day waiting period, a terminally ill person can request euthanasia and die by euthanasia on the same day. Studies show that the Will to Live fluctuates over time.

The government should wait before amending the law. In June 2020, the government will begin its consultation on 5 years of euthanasia in Canada.

Assisted Suicide laws are lethal discrimination against old, ill and disabled people

This article was published on February 24 in connection with a poll on assisted suicide. The rift published a YES and NO assisted suicide article (Link) and then asks you to vote.

Diane Coleman wrote the No to assisted suicide article that I have re-published below.

By Diane Coleman
President of Not Dead Yet

Assisted suicide may understandably be viewed as an easy way to die, but a closer look reveals inherent dangers that should lead to second thoughts.

First, assisted suicide is not needed to ensure that we can die peacefully in our sleep, since we can already do so by receiving palliative care, up to and including full sedation.

So what do assisted suicide laws actually do? They grant civil and criminal immunity to healthcare providers and caregivers who may be involved.

The image of government approved, medically administered assisted suicide is that it only hastens the death of someone who is already dying and voluntarily takes lethal drugs, with “safeguards” preventing abuse. 

Under U.S. laws, an heir or abusive caregiver may suggest assisted suicide, witness the written request, and even give the drug without consent.

In contrast, in U.S. jurisdictions where assisted suicide is legal, Oregon being the national “model”, no authority verifies patients were eligible or procedures were followed. A short form filed by the prescribing doctor is accepted at face value. It’s the “honor” system.

The U.S. laws require a 6-month prognosis, yet Oregon data shows that people far outlived their prognosis. Hospice data shows that 12-15% outlive their predicted expiration date. Oregon also defines someone as “terminal” who simply cannot afford treatment.

Some countries have expanded assisted suicide eligibility to include people with ordinary non-terminal disabilities and even psychological suffering with no physical illness.

So the image that all eligible people are dying soon anyway is not valid. But isn’t it still voluntary?

Unfortunately, under U.S. laws, an heir or abusive caregiver may suggest assisted suicide, witness the written request, and even give the drug without consent. No independent witness is required when the drugs are used, so who would know? Assisted suicide can also hide medical mistakes or malpractice.

Assisted suicide is being marketed as a new “civil right”

Finally, perhaps the greatest concern should be healthcare cost cutting pressures. As cofounder of the Hemlock Society Derek Humphry wrote, “…economics, not the quest for broadened individual liberties or increased autonomy, will drive assisted suicide to the plateau of acceptable practice.”

Assisted suicide is being marketed as a new “civil right,” but will we fall for it? Will we offer suicide prevention to most suicidal people, but carve out those who are old, ill and disabled? How long before a so-called option turns into an expectation, then a duty?

The real civil rights are nondiscrimination and equal protection of the laws. This is why every major national U.S. disability organization that has taken a position on assisted suicide laws opposes them.

Sunday, February 23, 2020

Portugal may soon legalize doctors lethally injecting their patients.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On February 20, the Portuguese Parliament voted on five different proposals to legalize euthanasia. All of the proposals passed, even though two years ago, similar proposals were defeated.

The Portuguese government will now propose a single bill for parliament.

A report by Barry Hutton for the Associated Press explains that Portuguese president, Marcelo Rebelo de Sousa opposes euthanasia and may veto the bill. Hutton wrote:
President Marcelo Rebelo de Sousa, who is known to be reluctant about euthanasia, could veto the new law, but parliament can override his veto by voting a second time for approval. The Portuguese president doesn’t have executive powers. 
The head of state also could ask the Constitutional Court to review the legislation; Portugal’s Constitution states that human life is “sacrosanct,” though abortion has been legal in the country since 2007.
Based on the recent vote, it is possible that the Portuguese parliament can over-ride a veto.

Groups that oppose euthanasia are gathering signatures to demand a referendum on the issue. During the parliamentary 
debate on euthanasia, there were hundreds of people protesting euthanasia. One One banner said: 
“Euthanasia doesn’t end suffering, it ends life.”
Recently the Spanish parliament also voted to continue to debate euthanasia

As bad as this is, the debate in Portugal is not over.

Wednesday, February 19, 2020

Canada's federal government asks Quebec court for 4 month extension to amend euthanasia law.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Canada's Justice Minister, the Hon. David Lametti and the Attorney General of Canada the Hon. Patty Hajdu have asked a Quebec Superior Court for a four month extension to amend Canada's euthanasia law.

A Quebec Superior Court decision, in September 2019, struck down the requirement in Canada's euthanasia law that a person's natural death must be reasonably foreseeable. The Quebec court decision gave the federal government six months to amend the euthanasia law in line with their decision. 
The federal government did not appeal the decision.

At that time, I reported that striking down the "terminal illness" requirement in the law opened the door to euthanasia for psychiatric conditions alone (Link).

In a press release from the Department of Justice, Ministers Lametti and Hajdu stated:

Hon Patty Hajdu
"Today, the Attorney General of Canada filed a motion to request a 4-month extension of the Superior Court of Québec's September 2019 Truchon ruling.

"Without this extension, the 'reasonable foreseeability of natural death' criterion from the federal law will no longer be applicable in the province of Quebec come March 12, but will remain in effect in other provinces and territories.

Hon David Lametti
"Following the successful completion of the Government's consultations on this important matter, we fully intend to introduce new medical assistance in dying legislation in the near future. An extension would give Parliament time to consider and enact proposed amendments. 
"We recognize that medical assistance in dying is a complex and deeply personal issue. The high level of engagement during the January 2020 online public consultations—which received nearly 300,000 responses—is a strong demonstration of the importance of this issue for Canadians. 
"We remain committed to responding to the Court's ruling as quickly as possible."The fact is that there is no rush to change Canada's euthanasia law. The Liberal government is talking about opening Canada's euthanasia law to people with mental illness and to people who are incompetent, but had made an advanced request to be killed.

The government announced, last year, that they would not amend the law until the five-year consultation on the law that was to begin in June 2020. 

The Euthanasia Prevention Coalition holds that the federal government should not amend the law until after they have completed the five-year consultation on Canada's euthanasia law.

More articles on this topic:
  • Competing reports on euthanasia for mental illness (Link).
  • Why legalizing MAiD for mental illness is misguided (Link).
  • Quebec backtracks to permit euthanasia for mental illness (Link).
  • Quebec government begins consultation to extend euthanasia for Alzheimer's (Link).

Marylanders need health care, not assisted suicide

This article was published by the Frederick News Post on February 17, 2020.

By Katie Collins-Ihrke is the executive director of Accessible Resources for Independence, the Center for Independent Living in Anne Arundel and Howard counties.

The Maryland Legislature is expected to again consider an “end-of-life option” bill in its new session. Once again, disability activists will be a prominent part of the coalition to oppose the bill as a discriminatory overlay to a beleaguered and inequitable health care system.

The bill, an assisted-suicide bill, authorizes health care providers to write lethal prescriptions for people who are considered terminally ill, and grants broad legal immunity to everyone involved in their deaths. It does not provide medical and palliative alternatives. The only course of action it facilitates is death.

People have every right to say no to treatment they don’t want. However, there is a sharp distinction between a patient deciding when not to have life-prolonging treatment and a doctor actively prescribing lethal drugs for the purpose of directly causing the patient’s death. As Dr. Joseph Marine, professor at Johns Hopkins University School of Medicine, has stated, assisted suicide:

“is not medical care. It has no basis in medical science or medical tradition ... the drug concoctions used to end patients’ lives … come from the euthanasia movement and not from the medical profession or medical research.”
Physician-assisted suicide is depicted by its supporters as a choice for patients who have tried everything; however, many Marylanders do not have access to “everything.” The medical system is focused on reducing costs as it remains profit-driven. Many people struggle to obtain basic care. Yet there still are “quality of life” prejudices against elders and people with disabilities, and people of color still cope with deadly health disparities. Survival rates for cystic fibrosis, for example, vary depending on the type of insurance a person has available. With the system so broken and no consensus about solutions either on the state or federal level, it is inherently dangerous to legalize assisted suicide for any class of patients.

Data from Oregon indicates that the leading reasons people request lethal prescriptions are unrelated to pain or unbearable suffering, but rather to factors such as perceived lessening of autonomy or dignity. These issues are difficult but they can be addressed by programs promoting greater access to consumer-directed home aide support and respite care, and a change in attitudes about human interdependence. The disability community has shown that severe physical limitations can be managed to maintain one’s enjoyment of life.

It is telling that supporters of last year’s assisted-suicide bill were critical to the point of abandoning the bill when quite minimal patient protections were added to it. Their concern seemed to be not in avoiding needless premature deaths, but in preventing delays and expenditure of resources. For example, a desire to die may be fueled by depression or other psychosocial factors causing suicidal ideation. But some proponents objected to a requirement that a person get a psychiatric evaluation before being given a lethal prescription because “There is a severe shortage of mental health professionals in Maryland,…[especially] in rural areas.” This seems like a tacit admission that Maryland residents may be underserved in their mental health needs at a time when they need services the most.

“End-of-life option” bills are consistently marketed to the public as applying only to people who are expected to die within six months, not to people with chronic illnesses or disabilities. But buyer, beware! Apart from the fact there is no way to prevent mistakes in diagnosis, even when more than one doctor is involved, the term “terminal illness” can be surprisingly elastic. An Oregon health official has written that conditions can be deemed terminal even if there is lifesaving treatment, but the person is uninsured or cannot afford it. This includes diabetes and other serious conditions which can be medically managed.

Curiously, last year’s proponents of the Maryland bill opposed an amendment to add terms like “irreversible” and “progressive” to the definition of terminal illness. Moreover, a recent medical commenter in the Baltimore Sun has urged that Maryland follow not Oregon, but Canada, which allows both assisted suicide and active euthanasia and which is dropping any requirement that death be “reasonably foreseeable,” thus offering assisted death to anyone with a significant health problem or permanent disability.

Disability advocacy organizations are against giving doctors the authority to write lethal prescriptions, regardless of how an assisted suicide bill is written. Catchphrases can’t change the fact that mistakes, coercion and abuses will occur. We aim for a more equitable and supportive health system which gives people true options so they can live as well as they can for as much time as they naturally have.

Euthanasia: Canada, Conscience and Coercion.

This article was published by Nancy Valko on her blog on February 18, 2020

Nancy Valko
By Nancy Valko

A January 22, 2020 CNA article titled “Perform Euthanasia or Lose Government Funding”, Canadian Hospice Told” revealed that a secular Canadian hospice was at risk of losing its government funding over its refusal to euthanize patients who request an “assisted death.”

How could this happen?

First of all, Canadian health care (known to Canadians as “medicare”) is 69% publicly funded for “medically necessary” care administered by the 13 provinces and territories with different rules. 31% of Canadian health care costs are paid by the private sector for services not covered or only partially covered by medicare, such as prescription drugs, dentistry and optometry.

The problems started when the Canadian Supreme Court legalized MAiD (Medical Assitance in Dying” in 2015.

Soon after, the province of Quebec drew up guidelines for MAiD and made “euthanasia kits” for lethal injections available to every doctor in Quebec. Most MAiD deaths in Canada are done by lethal injection.

In September 2016, about three months after euthanasia became legal in Canada, British Columbia's Fraser Health introduced a new policy which required all hospices receiving more than 50% of provincial funding for their beds to offer euthanasia to their residents. However, the hospice, in question, is operated by the non-profit organization the Delta Hospice Society, which is opposed to Canada’s MAiD

One doctor said that there are “‘strong lobbies’ backing this new effort to expand MAiD into additional institutions which receive provincial funding, including faith-based hospitals or hospices.” (Emphasis added)

How One Catholic Health Care Facility Responded To MAiD

Unfortunately in 2018, the Catholic Covenant Health system in the province of Alberta, Canada released a revised MAID policy:

“after consultations with more than 100 individuals and groups including doctors, Catholic bishops, Alberta Health Services, the Alberta government, patient advisers, families, ethicists and community members. 
Under the policy, witnessing and signing of legal documents and assessments of eligibility can take place on Covenant Health sites. Patients deemed eligible for MAID would still be transferred to other facilities.” (Emphasis added)
A current check of the Covenant website on MAiD shows no change in policy.

The Canadian “Slippery Slope” Continues

In January, 2020 the Halifax Group, published “MAiD Legislation at a Crossroads: Persons with Mental Disorders as Their Sole Underlying Medical Condition” that supported MAiD not only for non-dying persons ” experiencing enduring, intolerable and irremediable suffering from physical conditions” but also for persons who have “a mental illness as their sole underlying medical condition.” (Emphasis added)

This month, The Expert Advisory Group responded to the Halifax group, warning that the Canadian medical suicide law is the “most permissive in the world”.

The Effect of MAiD on Doctors and Nurses

Last year, The Canadian Catholic Nurses joined the National Association of Catholic Nurses in opposing the American Nurses Association’s draft position for neutrality on physician-assisted suicide (unfortunately later approved) and gave a chilling look at what may be our future if legalized assisted suicide is not opposed:

“Our association formed in 2018 primarily in response to Canadian nurses’ moral distress regarding the nation-wide legalization of medically induced death.
Professional associations and licensing bodies across Canada endorsed the legal changes, requiring conscientious objectors to participate in “Medical Assistance in Dying” by “effective referral” to facilitate access at the patient’s request. Faith-based health care facilities are pressured to participate. Nurse practitioners are trained and qualified to prescribe and administer lethal doses of medication to patients that they or others deem eligible for euthanasia.”


The Canadian experience with assisted suicide and euthanasia provides evidence for your continued resistance to the practice.

Unlike Oregon, Canada has not experienced a growth in palliative care along with the rapid expansion of induced death. Instead, we experience ongoing demands for access to lethal injections for new categories of patients, including “mature minors;” those who write advanced directives; and those whose mental illness is the sole condition underlying their request.”

A 2018 study “Medical assistance in dying (MAiD): Canadian nurses’ experiences” stated that:

“It is vital to understand how MAiD is influencing nurses in the Canadian context to ensure a smooth transition of this end‐of‐life care option across settings and communities. ” (Emphasis added)
The study acknowledges some nurses’ “moral distress” but describes “how participating in, or declining to participate in MAiD is shaping the participants’ perceptions of nursing as a profession“. The authors suggest promoting concepts like “Providing holistic care without judgment, Advocating choice, Supporting a good death” to positively reinforce that MAiD was “not a significant departure from their professional goals”. (Emphasis added)

(Ironically, 77% doctors in Laval, Canada refused to provide MAiD 18 months after legalization with the most common reason that MAiD was “too much of an emotional burden to bear”.)


Last year it was reported that “More than one in every 100 deaths in Canada is administered by a doctor“ but that even this number is likely higher because parts of Canada currently do not report such deaths.

The numbers are also likely to get higher as the Canadian euthanasia laws expand the eligibility criteria and health care professionals worry about losing their jobs if they refuse to participate.

Unfortunately, most of the US mainstream media ignores the Canadian euthanasia experience while approvingly reporting on the increasing number of US states legalizing physician-assisted suicide.

What all of us need to understand is that the legalized killing of any patient ultimately leads to the destruction not only of the patient but also of a trustworthy health care system and a truly safe and civilized society.

Tuesday, February 18, 2020

Assisted suicide bills are not what they appear to be.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The assisted suicide lobby has introduced assisted suicide bills in at least 18 States in 2020. All of these bills include "safeguards" that appear to provide oversight of the law.

Recently I published an article explaining how the "safeguards" are
written with loosely defined language to permit the laws to be redefined over time. I also explained that the "safeguards" are designed to convince legislators to legalize assisted suicide, while the assisted suicide lobby intends to remove them overtime. 

For instance, the Hawaii legislature passed an assisted suicide bill in 2018 that came into effect on January 1, 2019. There were 27 assisted suicide deaths in 2019.

The assisted suicide lobby is proposing to expand the assisted suicide law after only one year. The Hawaii legislature is debating bills SB 2582 and HB 2451 to expand the assisted suicide law by:

  • permitting nurses to prescribe the lethal drugs,
  • shortening the waiting period in general, and 
  • waiving the waiting period when someone is "nearing death."
The Hawaii legislature also debated bill SB 3047 that would have allowed:
  • assisted suicide for incompetent people who requested death in an advanced directive,
  • physicians to waive the counseling requirement, 
  • assisted suicide to be approved by "telehealth" and 
  • require insurance companies to pay for assisted suicide.
Its hard to believe that the assisted suicide lobby wants death by "Telehealth."

The Washington State legislature is debating Bill 2419, a bill to study the "safeguards" in their assisted suicide law. One of the issues to be studied is allowing euthanasia (lethal injection) rather than limiting it to assisted suicide.

Last year the Oregon legislature expanded their assisted suicide law by waiving the 15 day waiting period.

Assisted suicide may not be a peaceful death.

The assisted suicide lobby has been using experimental lethal drug cocktails as they attempt to find a cheaper way to kill. The current assisted suicide drug cocktails have caused painful deaths that may take many hours to die. A recent article stated:
The (first drug mix) turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, used 67 times, has led to deaths that stretched out hours in some patients — and up to 31 hours in one case.
The assisted suicide lobby is working on their third experimental lethal cocktail. Assisted suicide is not guaranteed to cause a "peaceful or painless death."

Our greatest concern is the New York assisted suicide bill. Governor Cuomo stated that he will sign an assisted suicide bill into law.

New York Assembly Bill A2694 and Senate Bill S3947 where introduced as the Medical Aid in Dying Act.

As Margaret Dore, the President of Choice is an Illusion stated in her article: New York: Reject Medical Aid in Dying Act:

“Aid in Dying” is a euphemism for euthanasia.[3] The Act, however, purports to prohibit euthanasia. On close examination, this prohibition will be unenforceable.
If enacted, the Act will apply to people with years or decades to live. It will also facilitate financial exploitation, especially in the inheritance context. Don’t render yourself or someone you care about a sitting duck to heirs and other predators. I urge you to reject the proposed Act.
Assisted suicide is an act whereby one person (usually a physician) provides a prescription for a lethal drug cocktail knowing that the other person intends to use it for suicide.

Euthanasia is an act whereby one person (usually a physician) lethally injects another person, usually after a request.

Several of the assisted suicide bills have language that can be interpreted to permit euthanasia.

Assisted suicide bills are usually designed as an application process for obtaining a lethal dose.

For instance the
Maryland assisted suicide bill HB 0643 may permit euthanasia (homicide) because it doesn't require the person to self-administer. The Maryland bill doesn't protect the conscience rights of medical professionals either.
The Massachusetts assisted suicide bill can also be interpreted to permit euthanasia.

The New Hampshire assisted suicide bill gives physicians the right to write a lethal prescription but the term self ingest is not found in the main text of the bill. Only within the life insurance section is there a statement that may be construed as limiting the act to assisted suicide where it states:

Neither shall a qualified patient’s act of ingesting medication to end such patient’s life in a humane and dignified manner have an effect upon a life, health, or accident insurance or annuity policy.
Even this statement does not refer to self-ingestion.

The New Hampshire bill permits euthanasia by giving a physician the right in law to write a lethal drug prescription, but it does not limit how the lethal drugs can be used.

New Hampshire assisted suicide bill will create a perfect crime (Link).
Assisted suicide bills are intentionally written in a deceptive manner, so that if legalized, the legislation can be interpreted in a wider manner. Further to that, the assisted suicide lobby has no intention of maintaining the "safeguards" in the bills. These "safeguards" are simply mean't to sell assisted suicide to the legislators.

Hawaii is debating the expansion of its assisted suicide law only one year after it came into effect, and Washington State is examining all of the safeguards, while Oregon expanded its assisted suicide law last year.

Clearly assisted suicide bills are not what they appear to be.

Monday, February 17, 2020

Competing reports on euthanasia for mental illness.

This article was published by BioEdge on February 16, 2020

Michael Cook
By Michael Cook

The Provincial and Federal governments in Canada need to amend their euthanasia laws quickly. They have to meet a March 2020 deadline set last year by Quebec Superior Court Justice Baudouin who ruled that it was unconstitutional to deny Canadians the right to die unless their deaths were “reasonably foreseeable”.

Amongst other issues, lawmakers need to determine whether people with mental illness will be able to access euthanasia, or Medical Assistance in Dying (MAiD), as it is called in Canada.

In every jurisdiction where euthanasia has been legalised, this is a fiercely debated topic. There is no doubt that mental illness causes great suffering. But even supporters of euthanasia are divided on whether it is unbearable and whether it is incurable.

It comes as no surprise, then, that Canadians have two acronym-rich reports to digest about euthanasia and mental illness. Or, for more precision, medical assistance in dying as it relates to cases where a mental disorder is the sole underlying medical condition -- MAiD for MD-SUMC.

The first was published by the Institute for Research on Public Policy (IRPP) and was written by “the Halifax Group”, eight academics on the Council of Canadian Academies (CCA) expert panel on MAiD. Its best-known member is Jocelyn Downie, a legal expert.

They contend that persons with MD-SUMC should not be excluded from accessing MAiD, provided that their decision is “well thought out and not impulsive”. They also insist that legislation should not require their decision to be “non-ambivalent”. In other words, even if people are torn between competing values (such as desiring death but not wanting to leave their children), they can still make a rational decision.

Admittedly, there is a danger of “over-inclusion” – allowing people to access MAiD whose suffering could be alleviated. But they feel that this risk can be minimized by providing better mental health services.

The second report argues that Canada is on the way to becoming “the most permissive jurisdiction in the world for MAiD, with the fewest safeguards against unwanted deaths”. It was written by the Expert Advisory Group (EAG) on MAiD, a group of Canadian and international experts, plus people with lived experience of mental illness.

The EAG’s core recommendation is that:

“determinations of irremediability and irreversible decline cannot be made for mental illnesses at this time, and therefore applications for MAiD for the sole underlying medical condition of a mental disorder cannot fulfill MAiD eligibility requirements”. 
“The risk of providing MAiD for mental illnesses, while being unable to predict irremediability of mental illnesses, is obvious,” they argue. “Non‐dying people who would have improved will be assisted to die prematurely.”
It also recommends two other conditions: non-ambivalence about a MAiD decision and “lack of a reasonable alternative”.

The EAG authors insist that their approach is evidence-based and that the Halifax Group’s report does not represent a consensus of medical opinion. In fact, they say that “surveys of mental health providers show that while most (72%) do support MAiD in general, most do not support MAiD for mental illnesses (only 29% in support)”. They also criticise the competing report for failing to include authors with lived experience of mental illness.

Michael Cook is editor of BioEdge

Saturday, February 15, 2020

Assisted suicide laws are the most egregious form of discrimination against disabled and "terminally ill" people.

Published in the New Hampshire Union Leader on February 14, 2020

By Mike Reynolds, Not Dead Yet

For over two decades the independent people of New Hampshire have been solidly against assisted suicide. Since 1996, the New Hampshire legislature has studied or voted down this proposed law so many times it takes two hands to count them all.

Assisted suicide laws are the most egregious form of discrimination against severely disabled and “terminally ill” people. How can we call suicide a public health crisis for most people while facilitating the suicides of older, ill and disabled people? Should we not be doing everything we can to support such persons in having the best possible health care and home care so they have quality of life for however long they have?

With the experience of the laws in Oregon as a guide, the question of assisted suicide becomes, quite frankly, incompatible with New Hampshire values. [The] state motto, “Live Free or Die,” means we reject government interference in our daily lives. Oregon state government’s promotion of an assisted suicide program administered by the health care system means pushing people towards assisted suicide through denials of coverage for treatment and in-home care, covering up abuses, and ignoring incorrect prognoses that lead people to think they are dying when they are not.

The numerous flaws in HB 1659, the “Death with Dignity Act,” are so obvious that New Hampshire should reject this absurd legislation again. With HB 1659, the government would be promoting suicide for what in the preamble it calls “mental anguish over the prospect of losing control and independence, and/or embarrassing indignities.” This is a direct attack on the thousands of disabled Granite Staters who maintain their independence and dignity by directing aides to perform their care.

While assisted suicide proponents depict assisted suicide as only a last resort for people with advanced cancer, Oregon’s doctors have written lethal prescriptions for individuals whose qualifying medical diagnosis for assisted suicide was reported as chronic conditions like diabetes, gastrointestinal disease, arthritis, arteritis, sclerosis, stenosis, kidney failure, and musculoskeletal systems disorders.

As in Oregon, under bill HB1659 a person can be considered “terminal” and therefore eligible for assisted suicide simply by refusing medication they need. By that definition, people who have epilepsy, ongoing infections and other illnesses that can be managed with medication can qualify. This legislation is not limited in scope and is actually far more dangerous than the proponents want to admit.

A report released in May 2018 by the Centers for Disease Control and Prevention reveals that from 1999-2010, suicide among those aged 35-64 increased 49% in Oregon as compared to a 28% increase nationally. In Oregon, the rate of suicide is 21 percent above the national average and their rates of teen suicide have even been higher. There is a clear problem of suicide contagion.

While the bill proponents claim there are safeguards, there is absolutely no oversight once the medication is picked up from the pharmacy. Under the Oregon law and the proposed legislation, a “friend” can encourage an elder to make the assisted suicide request (“just in case”), sign the forms as a witness, pick up the prescription, and even administer the drug (since no independent witness is required). To be perfectly clear, the current bill being debated only discusses “self-administration” of the lethal drugs in the bill’s preamble; nowhere in the substantive provisions is the word mentioned.

This law is also vague about who can access it, but it would be far easier for an eighteen year old with a serious medical condition that could be controlled with medication to access this law than it would for the same eighteen-year-old to access cigarettes or alcohol.

There is nothing compassionate or caring in this bill. Instead it could serve as a template to encourage and even pressure the most vulnerable in our society, our older and critically ill populations, to hasten their deaths. And by giving legal immunity to everyone involved, it creates a legal framework where elder abuse (up to and including homicide), which nationally impacts about 10% of elders, gets a free pass. Please contact your legislators and have them oppose this very dangerous legislation.

Mike Reynolds is a member of Not Dead Yet, a disability rights group opposed to assisted suicide.

Friday, February 14, 2020

Spain debates bill to legalize euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Reuters reported that the Spanish parliament voted 203 to 140 (2 abstained) to continue debating a bill to legalize euthanasia in Spain. Reuters stated:
“We’re talking about clearly debilitating diseases without a cure, without a solution and which cause significant suffering,” government spokeswoman Maria Jesus Montero said, adding that doctors who object to the practice will be able to opt out.
Montero is suggesting that the legislation will only allow euthanasia for extreme cases, but the reality is that once it is legal the law must be equally applied or it will be considered discriminatory.

The Quebec Minister of Health, in 2014, suggested that there would only be 100 euthanasia deaths per year. In 2019, approximately 5000 people died by euthanasia in Canada.

Euthanasia requires the direct action of a doctor to approve and carry-out a death by lethal injection.

The bill will now go to the Parliamentary Health Committee for discussion and then to the Senate before it can return to the lower house for a final vote.

Canadian euthanasia study offers more questions than answers.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A study examining MAID data from Ontario, the largest province in Canada, reports confirms much of what we knew already about euthanasia/assisted suicide deaths worldwide, but the data actually opens questions about the use/misuse of euthanasia in Canada.
Article: Euthanasia deaths rise quickly in Ontario. Nearly 1800 reported assisted deaths in 2019 (Link).
The data indicates that many of those who died by euthanasia were not terminally ill and had decided to die by lethal injection rather than live in a nursing home / institutional setting.

The lead study author, Dr James Downar, is a founder of the Dying with Dignity physicians advisory council and a long-time euthanasia promoter. 

This study will be used to assure politicians that Canada's euthanasia law can be expanded without fear of negative effects to vulnerable groups. It will also be used to undermine the resistance of palliative care doctors to euthanasia.

The data in this study was obtained from the euthanasia reports submitted to the Chief Coroner of Ontario. The reports are submitted by the doctors or nurse practitioners who lethally injected the person. This data was submitted, in a self-reporting system, to justify the act of euthanasia.

Since doctors don't self-report controversial decisions, it is unlikely that comments from these reports will uncover abuse.

Kelly Grant, writing for the Globe and Mail newspaper reported:

Patients who choose medically assisted death are wealthier, younger, more likely to be married and less likely to live in long-term care than those who die naturally, according to a major study of assisted dying in Canada’s most populous province.
The media suggests that this study proves that euthanasia does not negatively effect people who are poor or vulnerable, but in fact this study simply confirms what we have always known that people who are white, wealthy and worried are more likely to die an assisted death.

The study examined the data from 2241 reports from the euthanasia deaths in Ontario between June 17, 2016 and October 31, 2018.

Grant reports on the data in the study:

Patients who received an assisted death were more likely to be wealthy, with 24.9 per cent of MAID recipients earning enough to be in the highest of five income brackets. By contrast, 15.6 per cent of patients who died naturally were in the top income bracket. 
The study found that Ontario MAID recipients were, on average, two-and-a-half years younger when they died, and less likely to have been living in an institution, usually a nursing home, before they died. 
Of those who died naturally, 28 per cent lived in institutional settings, while only 6.3 per cent of MAID recipients did. 
The data in the study indicates that those who died by euthanasia died at age 74.4 (average) whereas those who died a natural death died at age 77 (average). 

Why are people dying by euthanasia 2.6 years younger than those who die a natural death? 

Why are people who die by euthanasia less likely to live in an institution (nursing home etc).

The data suggests that many of those who died by euthanasia were not terminally ill and decided to die by lethal injection rather than live in a nursing home / institutional setting.

Canada's euthanasia law stated that: natural death is reasonably foreseeable, but the law did not define this. It appears that most doctors had a wide interpretation of natural death being reasonably foreseeable.

Those who died by euthanasia stated that they were experiencing physical suffering (99.5%) of the time and psychological suffering (96.4%) of the time. The Canadian law states that physical or psychological suffering "is intolerable to them and that cannot be relieved under conditions that they consider acceptable." which is completely subjective.

The study states that:

Psychiatric consultations were performed in 6.2% of cases. In 4.3% of cases, the MAiD recipient had been found ineligible for MAiD on a previous request.
Considering the conditions that people may experience as they approach death, it is surprising that only 6.2% of the MAID deaths had a psychiatric consultation.

The data indicates that people who died by euthanasia had access to palliative care (74.4%) of the time suggesting that people are not asking to be killed due to lack of alternatives.

Grant reported that Ebru Kaya, a Toronto palliative care specialist questioned this assertion:

...“They use this blanket term. Palliative care providers could mean anything. The MAID assessor who is also a palliative care physician may use that clinical encounter to assess for MAID as a palliative care encounter, but the two are very different.”
Similar to previous studies, this study examines data from reports submitted by doctors and nurse practitioners who did the lethal injection. There are no interviews with patients, before they died, to determine why are they asked for death. There are no "third party" reports to ensure that the "letter of the law" was followed.

We do not know why people are dying 2.6 years earlier than those who died a natural death.

It is likely that many of the people were not terminally ill but facing the dilemma of having to live in a long-term care institution because their health condition required care.

I suggest that this study proves that people with disabilities are right. Canadians are deciding that death is preferable to living with a disability.

Thursday, February 13, 2020

Massachusetts assisted suicide bill may permit euthanasia (homicide). Steering is the elephant in the room.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

It is important to examine the language of assisted suicide bills. The promoters of assisted suicide will often claim that a bill does one thing, where in fact the language of the bill has wider interpretations.

Assisted suicide is an act whereby one person (usually a physician) provides a prescription for a lethal drug cocktail knowing that the patient intends to use it for suicide.

The Massachusetts assisted suicide bills (S. 1208 and H. 1926) are designed as an application process for obtaining a lethal drug cocktail. 

Most assisted suicide bills state that the person must self-administer the lethal drugs, making it an assisted suicide.

The Massachusetts bills state that the patient can choose to self-administer, meaning that the law permits another person to administer the lethal dose.

The bills states: 
“Self-administer” means a qualified patient’s act of ingesting medication obtained pursuant to this chapter.
This definition does not prevent another person from administering the lethal dose, that the person "ingests." 

When another person administers the lethal dose, the act is called euthanasia or homicide.

Nancy Elliott, EPC-USA Chair, in a letter to Massachusetts politicians states that "steering is the elephant in the room." She wrote:
...Steering is the elephant in the room. I was at a hearing for Assisted Suicide in Massachusetts a few years back where a doctor stated that Assisted Suicide laws were something he was in favor of. He continued with his points and ended by saying that he felt it was the responsibility for a good doctor “to guide people to make the right choice.” I do not think he intended to say that but is there any doubt that this pro suicide doctor would try to persuade his patients to follow his wishes, concerning their Assisted Suicide.
The Massachusetts bill does admit that most assisted suicide deaths are not quick and painless. The bills state:
I further understand that although most deaths occur within three hours, my death may take longer and my physician has counseled me about this possibility. (my emphasis)
An recent article in the Spring Hill Insider looks at human experiments being done to find a cheaper lethal drug cocktail for assisted suicide. 

The article states that assisted suicide researchers are promoting a third generation of lethal drug cocktails. The results of the first two lethal drug cocktails were:
The (first) turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, used 67 times, has led to deaths that stretched out hours in some patients — and up to 31 hours in one case.
The current drug cocktails have caused painful assisted suicide deaths that may take many hours to die.

Last month a Massachusetts Superior Court decided that there is no right to assisted suicide. The court explained:
Finally the Commonwealth produced expert testimony that the permissible end-of-life alternatives potentially involve far less risk than MAID because they occur in hospitals or other institutions devoted to medical treatment and involve numerous physicians and staff personnel, which together provide an environment that lends itself to oversight and responsibility... MAID, on the other hand, potentially takes place in an uncontrolled environment, without assurance that the patient will administer the medication when close to death and without physician oversight.
The Massachusetts assisted suicide bills are not designed to protect people at a vulnerable time in their life, but rather to protect physicians who are willing to assist in killing their patients. The bill is not limited to assisted suicide and it ignores the decision of Massachusetts citizens who rejected an assisted suicide referendum a few years ago.

Massachusetts legislators need to reject these assisted suicide bills.