Saturday, May 31, 2014

Not Dead Yet - UK launches petition against British assisted suicide bill.



Sign the petition opposing the legalization of assisted suicide in Britain.

Not Dead Yet UK (NDYUK) is a campaigning group of disabled people who believe that it would be a mistake to legalise Assisted Dying. Lord Falconer’s bill in the UK aims to make it legal for doctors to end the lives of those they judge to be terminally ill, if the dying individual requests this intervention. This issue affects everyone, but our experience as disabled people, informs our belief that the assisted suicide law should not be changed.

NDYUK opposes assisted suicide because:

● It would be unacceptably dangerous to make it legal for one individual to end the life of another, because statutory safeguards cannot be made effective;

● People can be led to perceive themselves as a burden, especially when support services are cut, and this may contribute to their decision making;

● We believe that a positive approach to the lives of disabled people, old and young, should be a priority for society;
● This means appropriate support for living and an accessible environment;
● Disabled people are being hit harder than many by the recession, which gives us the clear message that our rights and opportunities are low priority when times get hard. ‘Assisted Dying’ is often linked with the cost of disability, particularly Social Care and Continuing Health Care, which are becoming increasingly unavailable. We find this a legitimate and relevant cause for concern;
● In a recent poll by the Royal College of GPs, 77% voted against legalising assisted suicide and many doctors acknowledge that it is very difficult to accurately predict when someone will die and they often get this wrong.

Thursday, May 29, 2014

Starvation As The New "Death With Dignity"

By Wesley Smith, First Things - May 30, 2014 (Link to the original article).

Wesley Smith
Self-starvation has become the latest craze among the “death with dignity” crowd. This has been coming on for some time. Removing feeding tubes from cognitively disabled people who can’t swallow has been allowed for decades, under the right to refuse unwanted “medical treatment.” But what about people who can eat and drink by mouth? Assisted suicide advocates argue that it isn’t fair that they can’t die too.

So, activists promote a form of “self-deliverance” that they call “voluntary stopping eating and drinking,” (VSED), by which suicidal people declare their wish to starve to death. As a matter of respecting autonomy, doctors won’t force feed these suicidal people. Some even agree to facilitate the death by helping palliate the potential agony that can be associated with starving and dehydrating.

Some bioethicists even argue that nursing homes and hospitals should be legally required to starve patients who can eat and drink, if they have serious dementia and have ordered their starvation deaths in an advance medical directive. In Canada, a lawsuit has already been filed, and I consider it the most important—and dangerous—litigation in bioethics today.

The case involves Margo Bentley, a woman from British Columbia. A believer in assisted suicide, Bentley signed an advance directive instructing that she be refused life-sustaining medical treatment and even be euthanized if she had Alzheimer’s and could no longer recognize her children. Bentley is now in that condition, but she doesn’t require life support—so there is no treatment to withdraw—and willingly accepts food and water by mouth, meaning that the conditions of her directive aren’t met. And as for euthanasia, it’s illegal in Canada. Thus, there is no immediately available legal way to make her dead even though that is what she clearly wanted.

Palliative Care Motion 456 receives near unanimous support in Canadian Parliament

Alex Schadenberg
By Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Congratulations to Charlie Angus (MP NDP) who successfully steered Motion 456 through parliament. Motion 456 calls for a National Palliative and End-of-Life Care Strategy in Canada. The Euthanasia Prevention Coalition (EPC) was one of many groups that supported Motion 456. 

Motion 456 is the result of the work of the Parliamentary Committee on Palliative and Compassionate Care that released its report: Not to be Forgotten: Care of Vulnerable Canadians, on November 18, 2011 that focused on improving: palliative care for all Canadians, suicide prevention strategies and protecting people from elder abuse.

Motion 456 hopes to lead to the creation of a pan-Canadian Palliative and End-of-Life Care strategy that would enable the Provinces, the National government and other important stake-holders, to work together for a common implementation and improvement of palliative and home-based care for all Canadians.

Charlie Angus MP
Charlie Angus responded to the support for Motion 456 with the following media release:

As Canada's ageing population puts unique stresses on our medical system, it is increasingly important that we have a coherent strategy for palliative and end of life care across Canada. 
This is an issue that touches every Canadian and leaves an impact on every single family. When we have good options for palliative care, we can ease the many burdens on families so they are able make these difficult transitions. Where the services are fragmented, too many people fall through the cracks - right when they need support the most. 
We are happy there was all-party support for a Pan-Canadian Strategy for Palliative and End of Life Care as laid out in motion M-456. Together, we must thank the many people and organizations across the country who worked hard to advance this important issue.
EPC recognizes that the federal government already supports the Pallium Foundation of Canada a group that EPC also supports.

It is our hope that every Canadian will receive excellent care in their time of need.

Links to related articles:

Wednesday, May 28, 2014

Belgian euthanasia deaths increase by 26% in 2013.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

The 2013 Belgian euthanasia report indicates that the number of reported euthanasia deaths in Belgium increased by more than 26% in 2013 to 1807 reported deaths


Sign the EPC - Europe Petition demanding a moratorium on euthanasia in Belgium.

In 2012 the number of reported euthanasia deaths in Belgium increased by 25% to 1432 reported deaths.

The Belgian euthanasia report indicates that the number of reported euthanasia deaths is growing at a faster rate. In Belgium, there were 1133 reported euthanasia deaths in 2011 and 954 reported euthanasia deaths in 2010.

At the same time Belgium has recently extended euthanasia to children. The child euthanasia bill was passed after protests against the bill were held in Brussels and 160 Belgian Paediatricians denounced the child euthanasia bill.

Studies concerning the practice of euthanasia in the Flanders region of Belgian in 2007, found that: 32% of all assisted deaths were done without request, 47% of all assisted deaths went unreported, nurses were euthanizing patients even though the Belgian euthanasia law prohibits nurses from doing euthanasia. There has never been an attempted prosecution for abuses of the Belgian euthanasia law.

In Canada, the Québec government should be very concerned about the practice of euthanasia in Belgium since they have based euthanasia Bill 52 on the Belgian euthanasia law.

In January, the Belgian media reported that a euthanasia doctor admitted to not reporting his euthanasia deaths. The article confirms that many euthanasia deaths in Belgium are not reported and the actual number of euthanasia deaths is much higher than 1816.

In February, Dr Tom Mortier launched an official complaint against the doctor who euthanized his healthy mother who was living with depression. Mortier questioned:
"how it is possible for euthanasia to be performed on physically healthy people"
In April 2014, a 20-year-old Belgian woman, named Margot launched a second official complaint against the same euthanasia doctor in response to the euthanasia death of her 47-year-old mother who was physically healthy but living with depression. Margot asked:
"how could someone who has not even received treatment for depression, get euthanasia?"
There are also serious questions being asked concerning the purpose and effectiveness of the Belgian euthanasia control and evaluation committee. The President of this committee is the leading euthanasia doctor in Belgium who also operates a euthanasia clinic with half of the membership of the committee composed of members of the euthanasia lobby.

In November 2013, I debated Dr Jan Bernheim, a pioneer of the Belgian euthanasia law. During the debate in Brussels I quoted from the earlier studies showing that euthanasia deaths were occurring without request, that euthanasia deaths were not being reported and that nurses were ignoring the law and euthanizing their patients. Bernheim responded to those statements by saying:
"There are problems with the Belgian euthanasia law."
I responded by saying:
"That is cold comfort for the dead."
The safeguards and controls in the Belgian euthanasia law do not work. The Belgian government needs establish a moratorium on its euthanasia program and re-evaluate its euthanasia law, or the number of euthanasia deaths will continue to grow exponentially.

Lifting the veil on euthanasia in Belgium: a nurse's story.

Claire-Marie Le Huu-Etchecopar is a French nurse who worked in Brussels for 6 years, and who witnessed many euthanasia deaths. Le Huu-Etchecopar wrote the following which was published on the Collectif Plus Digne La Vie website.

Like many healthcare professionals in Belgium, Claire-Marie Le Huu-Etchecopar denounces euthanasia, based on her observations, of the downward spiral in the application of euthanasia law since 28 May 2002. Her testimony is important and contributes to the wider debate.

By Claire-Marie Le Huu-Etchecopar


In his press conference January 14, 2014 François Hollande, the President of France, listed the terms of the Belgian law on euthanasia without ever mentioning the word. In Belgium, they boast that there is no drift in their law, which is completely controlled by a Federal Commission for monitoring and evaluation of euthanasia. To date, according to the Commission, every single one of all identified euthanasia deaths were performed according to the conditions and procedure laid down by the law of 28 May 2002.

As a nurse in Brussels, I first worked in a cancer ward and in a care unit support. So I was very quickly confronted with the demands and the practice of euthanasia. For six years, I have seen how this law significantly undermines the links of solidarity we have for the sick. More than just highlighting dubious procedures, today we are now helping along a radical change in attitudes towards death and care of the dying.


Euthanasia legal, ethically precarious


From my arrival in Belgium in 2008, I witnessed first-hand many euthanasia deaths. All were accountably legal and registered officially in the medical records of patients. From the moment I took on the role, and despite my limited knowledge at the start, I found serious failures of ethics and moral obligations. Through my personal experience in care services practising euthanasia in Belgium, I wish to show that it is possible in a hospital room, just like in a television programme, to manipulate opinions and consciences, to transform euthanasia into an ideology of dying with dignity’.
Monsieur R. never asked for euthanasia: he was released from life out of ‘compassion’
This was the view of an oncologist just after the euthanasia of Mr R. Some days before, the doctor informed his wife that her husband was in the terminal phase of lung cancer. The doctor added that the patient ‘will suffer enormously, even though he was showing no signs of pain or distress at the moment’.

His wife asked the specialist not to say a word to her husband ‘so he doesn’t suffer further’ and at the same moment seeks euthanasia to spare him the ‘horror of the end of life’. Mr R died by euthanasia without ever knowing of his illness and without deciding or even once expressing the wish to have recourse to euthanasia.

Following this euthanasia death, I asked for explanations from my superiors in the multi-disciplinary team meeting. In a chorus, the psychologist, the head of service, the nurse director and the cancer specialists explained to me how this death was ‘gentle, peaceful and painless’ ‘a dignified end of life’ (‘a fitting end’) in summary. In a patronising tone, they reminded me that ‘in respect of caring, we must be compassionate’ that ‘the prognosis of Mr R was imminent death’ and that ‘he would certainly have suffered terribly’. The aplomb of their speeches, the logic, appearing implacable and reasonable, reduced the care team to silence.
Monsieur L. ‘benefited’ from emergency euthanasia for the relief of terrible suffering not sufficiently relieved
Monsieur L. suffered from an osteosarcoma of the right femur. Hospitalised, he asked for euthanasia should his health deteriorate. One day, in a crisis of overwhelming pain, his wife, desperate, calls for help from the medical staff: she believes it is imperative to respond to her husband’s request for euthanasia. The nurses, panicked, call the emergency oncologist. They propose to increase the dose of morphine and set up a provisional protocol for sedation to relieve his symptoms and distress. But the oncologist refused. Amid all the anguish and agitation, the physician directs the care team to prepare a lethal injection which he immediately administered to Mr. L. A year later, his wife returned to the service accusing the care team of having ‘murdered her husband’.

Oncologists are reluctant to use morphine treatments. Even today, despite frequent and well-controlled use of morphine, some doctors are still afraid. Many patients in terrible suffering are [therefore] not getting adequate pain-relief. In this context, we can see imagine how despair can be the source of a request for euthanasia. On the other hand, the undue haste with which this euthanasia was carried out resulted in a deeply shocking and inhumane brutal death, for the wife as well as for the care team. However, the patient is deemed to have met the criteria of law, repeated request, unbearable suffering, incurable disease, etc.
Madame G ‘released’ from prolonged agony
Palliative sedation was administered to Mrs. G. She was in a coma for five days. Her family, deeply upset, were watching for the slightest sign of end of life. The healthcare team, continually pressurised, was tested by the incessant agitation. It was then that the doctor clearly weary of the prolonged dying, decided to ‘shorten [Mrs G’s] days to save her from the long decline’. Nobody condemned this act which, in the minds of the family and care team, demonstrated the altruism and humanity of the doctor. A brutal act however that drastically solved the ‘problem of dying [in great pain]’. 

In Belgium, attitudes have changed

After eleven years of legal euthanasia practice in Belgium, attitudes about the image of death are profoundly changed. More and more, unlike euthanasia, palliative sedation at the end of life is considered a death without meaning, devoid of humanity and discouraging. Some doctors even consider it hypocritical if we liken it to a natural death: ‘Conflating sedation and natural death is actually a construct that serves to remove guilt and consider the act to be morally good, superior to other possible medical interventions.’ [1]

It is certainly difficult for relatives to ‘journey’ with a person at the end of their life. However, I have noticed over my different experiences (in a palliative care unit in France and then in oncology and care and support units in Belgium), how the ideas and choices of a family are influenced by the image that their healthcare team reflects about the patient, themselves and their situation. The difficulty for a family to live through a loved-one dying, is largely due to the perception that the environment (caregivers, institution, society) has of dying.

From the moment the healthcare team is clear about an agreed plan of support for living people, but also on its representation of death and the intention it puts behind palliative sedation (it is not to ‘kill the person’ but ‘to relieve suffering’), the family’s support is much calmer. On the contrary, when there is the possibility of euthanasia, it can plant in people's minds the idea of ​​a death more ‘swift, painless, clean, clear’ The period at the end of life no longer has any value, no reality, it is a piece of life which is considered superfluous. This confusion stems from the fact that the Belgian law, unlike the Leonetti law, did not frame the practice of sedation, does not define and does not integrate it into the practice of care.

The marginalisation of the care team

It is from these real-life situations that I realized that caregivers were deliberately kept in ignorance or silenced. 

Ignorance of the law on euthanasia and end of life

In a service where I worked, some patients are greeted in the morning in a room and leave two hours later for the morgue, after euthanasia programmed by the oncologist. Nurses are not aware. One can easily imagine the emotional impact that this deliberate lack of information and communication may cause. Even if they are upset, caregivers do not revolt because they know little about the law. No training is offered.

Fear of reprisal

In this same service, management (doctors, care manager, health managers) puts caregivers in fear of reprisals. Many of them regularly express fear of losing their jobs if they were to question the system. This fear is well founded: some caregivers wishing to leave the service were threatened with exclusion from the entire network to which the hospital structure belongs, management can exert pressure so they do not find work.

The evidence of nurse is suppressed

At multidisciplinary team meetings, originally created to share our views on the care of patients, the voice of nursing is completely silenced. Nobody dares speak of euthanasia deaths [where the patient experiences difficulties] or can call to account certain medical decisions. When nurses questioned a euthanasia death, the conversation on the merits and facts is diverted. Physicians and healthcare executives respond systematically with the same formula: ‘the act was chosen, [it was] humane’.

No remedy

Not being heard by my immediate line-managers, I went to [higher] management to denounce these illegal acts. The nurse director would not listen to me. She ordered me to shut up. Also, litigation seems impossible, as this requires evidence, the testimonies of families who wish to engage and report, and the courage of caregivers to confront a health system that protects doctors.

For eleven years, the Commission on monitoring and evaluation of euthanasia never, not even once, sent a file to for legal investigation [2], nor found any disturbing practice among cases for which clarification was requested. Does this not show that the law is not so restrictive and that the conditions required to be met can be easily manipulated?

Add to this context, the increasingly important requests for euthanasia due to emotional suffering unbearable when the person is tired of living in a situation where they are not even suffering from incurable disease or in physical suffering.

Mental suffering: the new Eden of the "good death"

Through examples of media-staged deaths deemed ‘exemplary’; then through a euthanasia death recently experienced, I would like to show how euthanasia stands as an ideology. Eleven years after the decriminalization of euthanasia more and more applications are related to mental distress. At the ethical level, these applications raise many questions, often the subject of discussion and disagreement between caregivers, as they are on the frontier of what is legal.

The media themselves, see no contradiction or offer no caution. The euthanasia deaths they report can therefore seem emerge as a logical step in the natural extension of the law.

Cases [reported in the] media that shape the dogma of the ‘good death

Anticipation of future suffering: 

These are people who do not suffer now, but anticipate probable suffering linked, for example, to loss of autonomy.

Marc and Eddy Verbessem …[we know the story of these deaf twins that Distelmans euthanized]

We see the implied ethical risk: can we euthanize people who do not fall within the criteria of the law in the name of potential future suffering? In this particular situation, the request for euthanasia was justified on the basis of legal criteria and not ethics. A reporter asked Jacqueline Herremans, president of the Association for the right to die with dignity (ADMD), and a member of the Control Commission of euthanasia, if ‘The request for euthanasia meets the legal requirements’ [4] , raising it was exclusively ‘mental suffering’. The President replied: 
‘Indeed, they did not suffer actual physical pain. That said, if one refers to three essential requirements of the law, they meet the criteria. They have been requesting [euthanasia] for a year. For this type of case, where the death is not predictable in the short term, we need at least two consulting physicians, the second paying special emphasis to the quality of the application. You have to see whether this is a voluntary request, repeated and deliberate and if you have discussed all possible options before reaching this decision. The second condition is suffering, which can be physical or psychological, which was the case here. The third condition is that suffering is caused by a serious and incurable condition, which is also the case. Currently at least, even if in the future we can expect to find solutions.’ [5]
The conditions of the law are therefore fulfilled. On the other hand, [think again how] society sees the plight of these patients, or raise the lack of creativity in human relations, or finally, consider the support for the twins to adapt to their disability, none of this is in question.

Old age as suffering: 

Christian de Duve, Nobel Prize winner for medicine in 1974, died by euthanasia May 4, 2013 at the age of 95. In honouring him the president of the ADMD failed to show that the professor met the criteria of the law: 
‘Must we justify ourselves when choosing euthanasia?’ [6] 
Why choose death at age 95, still in good physical and mental health? The professor went every day to the swimming pool and participated regularly in television programmes. The first sign of weakness (a fall) made ​​him understand the natural vulnerability which comes with old age.

No matter Christian de Duve was not suffering from any incurable disease; old age can be considered as suffering. Prime Minister Elio di Rupo himself welcomed ‘the commitment of a citizen shown by Christian de Duve throughout his life’. [7] This tribute reveals a central idea: euthanasia is the ‘act of a citizen’, a model of society. The wise example of this Nobel winner was honoured in the press: everyone applauded his lucidity and strength. A journalist with the daily Le Soir tells us his last interview with the old man: ‘I am much closer to death than that, I have to organize my passing’ he told me. He had felt unwell and remained on the ground, unable to get up. He acknowledged that it was a sign. This was an extremely dignified man, happy and satisfied with his life […], but in fact, diminished.’ His euthanasia appears as an obvious choice, even an act of generosity, having decided to die before [he represented any] cost to society. The value of his life depended on his ability to be productive and useful in society (mobility, vitality, achievement), up to his control even of his death. Can we ask for euthanasia in anticipation of a state of decline due to age? What message is relayed through the media to elderly people?

Loneliness: 

Caregivers begin to be concerned about the growing number of euthanasia deaths of people who are deeply lonely. This was the case of Nathan…the transsexual person…. Mental illness, depression, were they diagnosed? Had he already been assessed by a psychiatrist, a psychologist? Officially, he’s not depressed, this criterion does not fall within the scope of the law. To accept the request for euthanasia, it is therefore concluded that Nathan is in unbearable emotional distress due to a body that he could not accept.

A model of ‘a good death’: the couple: 

‘An elderly couple from Brabant (in the Flemish part of Belgium) sought and obtained a double euthanasia. This was a first in Belgium. The man, aged 83, was suffering from terminal cancer. His wife, aged 78, had conditions related to old age, incurable and painful, and could not imagine life without her husband. The couple had no children and was relatively isolated. They died Tuesday at home.’ [11]

Dr. Mark Englert (Honorary Professor ULB, rapporteur to the Commission for regulation of euthanasia) advances the arguments of Dr. Marc Cosyns (GP in Ghent), in favour of the euthanasia.

Objective: To minimize the risk of suffering due to a failed suicide attempt (euthanasia is a gentle death ... ): ‘I consider it very important that these folk have shown that one can die and that the one who survives in despair need not procure a rope or a gun but that a legal solution is possible when, like this woman, one is suffering from incurable ailments that can be demonstrated. "[12]

In response to the loneliness of the elderly: ‘We know that the number of suicides of people over 80 years is particularly high. This is certainly among those who are left alone and who wish to die because of this. It is not incomprehensible. There are people who have had a very deep union with their partner, as expressed so well in Jacques Brel ‘The song of old lovers.’ [...] But at the same time, we need to let those whose suffering cannot be relieved really that euthanasia is possible ... " [13]

The express wishes of a couple gives them all the rights: ‘While it is rare, it is not unique.’ Dr. Cosyns cites five similar recent cases, including two euthanasia deaths he did himself. He thinks that nevertheless that the history of this couple is special because the patients explained in their obituaries that they died on the same day and they thanked the doctor who helped them. He believes they have broken a taboo and says he admires for doing so. [14]

So the wife, who ‘could not imagine life without her husband’ [15], was euthanized on the grounds of age-related diseases such as rheumatoid arthritis. Recall that under Belgian law, it is not necessary to be terminal for the right to euthanasia and that the suffering is unbearable is enough. Is the deterioration in the quality of life and reduced autonomy due to old age a justification of euthanasia? Because of the number of incurable diseases (diabetes, osteoarthritis, osteoporosis, deafness, Alzheimer's, etc. ..), the restrictions of the law on euthanasia are a fiction.

Euthanasia Practice in hospital

For my part, I can expound the concrete case of euthanasia in the past that I attended. This story shows both:
- The lack of solidarity of an entire society;- The pressure on caregivers;- Physicians become more militant than therapists.
This is a lady of sixty years whose cognitive faculties and the ability to move deteriorated due to the effects of chemotherapy. It was also in remission from her cancer. She said she made ​​an early request for euthanasia and reiterated her request in view of her loss of autonomy and her significant loss of memory.

Faced with this request for euthanasia, the difficulty for caregivers was threefold, due to:
1. Her cognitive losses. One day she asked me, ‘but in reality have [agreed to] euthanize me or not?’, like it was an ordinary treatment. She did not seem to remember what it meant. But for the doctors, it was a good thing, she had finally uttered the word ‘euthanasia’! This was the first time in years, she had spoken about it spontaneously. To revive a request, the challenge was for her to say ‘I want euthanasia’ without seeming to propose it to her, as in law, the request must be voluntary and repeated. 
2. The fuzzy nature of her suffering (no pain or refractory symptoms to be treated). Physically she has no pain and is in remission from cancer. So no incurable disease, death is not imminent. The only solution was to find how her mental suffering was unbearable. When caregivers would sit beside her to talk, she smiled again and asked that we stay close to her. For weeks, she no longer asks for euthanasia. However, when she felt lonely, she'd speak of it again in a pretty vague way. 
3. The worrying influence of her entourage. The entourage, consisting of friends and some family due to conflict, seemed totally unprepared. They kept harassing caregivers demanding euthanasia for this lady. The Care team felt uncomfortable because they understand that despite the request of the patient there is another reality: that of feeling abandoned because of a lack of solidarity. Her companions were undoubtedly sincere, seeking [her] well-being. But their kindness was devoid of empathy, the perspective necessary for real solidarity. The whole time she was in hospital, the asked for a toothbrush. Instead of a toothbrush, they bring her what they believe to be good according to them: wine, cakes, but never meeting the lady’s request.
Also, the majority of the care team feel frustrated because lots of measures have been put in place to improve her comfort and her desire to be more surrounded. Initially, she agreed appropriate structures to her needs, and then under the influence of her environment, she rejected them. Those close to her are locked in the emotion of seeing their friend disabled. They cannot bear to see her different. Any other solution than euthanasia seems unimaginable to them. In a small notebook where they leave her messages while she’s sleeping, the question of euthanasia is on every page. You can read words such as: 
‘Do not forget your euthanasia, it is your right, you have to ask the doctors or they’ll never do it for you…’
It is in this context that the doctors who were in favour of this euthanasia, found arguments. To circumvent each of these difficulties, and legally meet the demand for euthanasia, ‘solutions’ were found:
1. Because it was impossible to properly assess her request for euthanasia due to cognitive loss, it was decided to accept her beliefs and requests prior to her memory loss, (supported by the advance directive), rather than a change of mind which could be due to her memory loss. 
2. Moreover it was necessary to determine the nature of her mental distress. The diminution of her autonomy was irreversible, which is what gave rise to her emotional suffering unbearable. 
3. Finally, as regards the failure of perspective influencing their choices, the argument in favour of euthanasia was: her entourage was part of well-being, even if the influence on her personality and her decisions were harmful, it is not for us to judge. Similarly, it is not for the care team to compensate for the lack of perspective.
Conclusion: an unrestricted interpretation of the law prevents any ethical reflection

The media coverage of these ‘beautiful deaths’ seems to induce the idea that euthanasia is the most dignified, most humane death. She became a model of how to die well according to some criteria of beauty and dignity. In this sense, guilt to go on living can be established in patients. Euthanasia become an exemplary human act. The mental dichotomy between ‘good’ and ‘bad’ death distorts the links of solidarity in a community and finally, makes death taboo.

On the other hand, the interpretation of ‘psychological suffering’ is so broad that it seems not to have any legal limits in the practice of euthanasia (reduced autonomy due to old age, fear of being alone, fear of future suffering, weariness of life , etc. . ) .

It is the same for the criterion of ‘incurable disease’. The law allows euthanasia for diagnoses of diseases where death is not expected in the short term: Alzheimer’s, asthma, diabetes, osteoarthritis, arthritis, blindness, etc.

Finally, that it is not necessary to be in the terminal phase of an illness, provides the possibility of anticipating future suffering, which is not current reality, but which generates an ever greater fear of death.

Do these corruptions of the law not hide a reality of ever greater desertion? Isn’t this state of affairs symptomatic of a society prey to loneliness, fear of bad company, and a lack of trust in caregivers?

The opening now for euthanasia of children is just the result of a gradual progressive normalization of euthanasia attitudes and reveals more and more the facture between campaigners and doctors in the field. One hundred and sixty paediatricians sent an open letter to members of parliament saying that there was neither emergency nor value in the extension of the law to children. The paediatricians argued, expressing their opinions as experts in the field. They have not yet been included in the debate. It has taken place, but, it seems, between advocates only.

The question of support at the end of life appears therefore, as raising a question about the particular values of a society: what place we give to sick people? What image do we have them? What humanity belongs to a person? These questions being so much more primal than the ideas and the choices of a family are influenced by the image that the healthcare team reflects back to the patient, of themselves and their situation.

Today, it seems urgent for caregivers to reclaim a vision of the common good, if only to ensure the sick person appropriate care and dignity until the end of their existence.

[1] Lossignol D., Damas, F., « Sédations continue : considérations pratiques et éthiques », Rev. Med Brux., 2013, p.27.
[2] Rapport aux chambres législatives de la Commission fédérale de contrôle et d’évaluation de l’euthanasie, tous les deux ans depuis 2004.
[3] Dardenne L., La Libre.be, « Euthanasie: unis, à la vie. Et à la mort. », 14 janvier 2013.
[4] Ibid.
[5] Dardenne L., La Libre.be, « La demande d’euthanasie répondait aux conditions légales », 14.01.2013.
[6] Herremans J., « Christian de Duve, merci ! » in Bulletin de l’ADMD, n° 128, juin 2013, p.8.
[7] de Decker C., Colart L., « Décès de Christian de Duve : Une personnalité scientifique exceptionnelle», Le Soir, 6 mai 2013.
[8] Propos recueillis par Delvaux B., « Si on continue comme cela, ce sera l’apocalypse, la fin », Le Soir, 10 avril 2013.
[9] Rebillat C., « Un transsexuel euthanasié après avoir changé de sexe », Paris Match, 02 octobre 2013.
[10] Le Monde.fr, « Après un changement de sexe raté, un Belge obtient le droit à l’euthanasie », Le Monde, 02 octobre 2013.
[11] D’après « La Libre » du 28.03.2011, Englert M., « Mourir ensemble par euthanasie : une première ? », in Bulletin de l’ADMD Belgique, n° 120, juin 2011, p.11.
[12] D’après « De Morgen » du 28.03.2011, Englert M., « Mourir ensemble par euthanasie : une première ? », in Bulletin de l’ADMD Belgique, n° 120, juin 2011, p.11.
[13] Ibid.
[14] Ibid.
[15] Ibid.

Tuesday, May 27, 2014

Medical error, euthanasia and assisted suicide.

By Alex Schadenberg
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

A power point presentation developed by Christine Koczmara RN BSc and Cathy Isman RN(CPN) (C) for the Institute for Safe Medication Practices states that it was estimated in 1999 that 98,000 Americans die every year from preventable medical mistakes. This is almost equal to the number of yearly deaths from Car Accidents, Breast Cancer, and Aids (Link).

A Canadian study in 2004 found that 7.5% of patients in Canadian hospitals were harmed from their care, 37% of the adverse events were preventable and more than 9250 Canadians died that year from medical errors (Link). The same study estimated that only 3% – 6% of all medical errors are reported (Link).

Pietro D'Amico
In April 2013, Pietro D’Amico (62) from Calabria Italy died at the Dignitas suicide clinic in Switzerland after receiving a wrong diagnosis. Medical errors will often lead to negative health conditions, some medical errors will lead to death, whereas, assisted suicide always causes death (Link).

July 2013, a Swiss regional court found Dr Philippe Freiburghaus guilty of assisting a suicide without a proper diagnosis of the patient. On April 23, 2014, the Swiss court of appeal overturned the conviction of Freiburghaus on technical grounds (Link).

In September 2013, Nancy Verhelst asked to die by euthanasia in Belgium after experiencing a “botched” sex change operation (Link).

Statistics from Belgium indicate that up to 32% of all assisted deaths are done without explicit request (Link) and up to 47% of all assisted deaths go unreported (Link). In the Netherlands the rate of assisted death without explicit request is lower than in Belgium and the rate of unreported assisted deaths is 23% (Link).



Since acts of assisted death cause the direct and intentional death of the person, and since the “safeguards” that are designed to protect patients, in the law, are not followed, can legalizing euthanasia or assisted suicide ever be safe?

Considering the problem of medical error, the reality that human beings fail, the reality that many physicians have been taught to believe that certain human lives are not worth living (Quality of Life) and considering the regularity of medical error and the reality, can legalizing euthanasia or assisted suicide ever be safe?

These facts and many more speak for themselves.

Coalition of Physicians for Social Justice launch court case to stop Québec euthanasia Bill 52

Euthanasia : Since Québec has turned a deaf ear, 
they are now turning to the Courts in order to be heard


MONTRÉAL, May 27, 2014 /CNW Telbec/
 
A Motion for Declaratory Judgment is in the process of being filed in the Superior Court of the district of Montréal.

The Plaintiffs are Ms Lisa D'Amico, a handicapped person, and Dr. Paul J. Saba, a family doctor. This Motion is instituted against the Attorney-General of Québec and also impleads the Attorney-General of Canada, in order to obtain a declaration to the effect that:

(1) The euthanasia of a human being by his doctor, a notion more known in Québec under the euphemism «medical aid in dying» or «aide médicale à mourir», is not medical care.

(2) Québec does not have jurisdiction to legislate on this subject.

(3) Euthanasia is contrary to the Canadian and Québec Charters of Rights, the Criminal Code of Canada, The Civil Code of Québec, the Health and Social Services Act of Québec, the Doctors' Code of Ethics and The Constitution Act, 1867.

(4) It is not and will not be possible in Québec for patients concerned by euthanasia to provide a free and informed consent because of their vulnerability which is exacerbated by a lack of resources in the health care system, because of their medical condition and the lack of universal access to palliative care for all persons who require such care, particularly to diminish suffering.

(5) It is illogical to entrust doctors only to verify the conditions for euthanasia and provide the lethal injection, as this would cause them to be in violation of their Code of Ethics as well as the criminal law.

Ms. D'Amico has a personal interest to act because she fears that the shortfall of medical care and social care in Québec will put her in a very vulnerable position and entice her to accept euthanasia as a result of the evolution of her condition.

Doctor Saba believes that no one should ask a doctor to perform euthanasia. He reminds us of two of the fundamental principles of the practice of medicine:

Swiss group to assist the suicides of elderly healthy people.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Swiss assisted suicide death.
Assisted suicide is facilitated in Switzerland by suicide groups who assist the suicide deaths of their members. The assisted suicide groups charge a "membership fee" and fees for assisted suicide itself. Assisted suicide groups have their own "rules and regulations." There are few national regulations for assisted suicide in Switzerland.

Assisted suicide is when someone, or a group, assists the suicide of a person who has asked to die.

Last weekend, at their annual general meeting, Exit, an assisted suicide group in Switzerland, decided to extend assisted suicide to healthy elderly people who are living with some form of physical or psychological pain.

Psychological pain refers to a person who lives with depression, mental illness or "feelings of hopelessness."

The UK Guardian reported that Dr Jürg Schlup, the President of the Swiss Medical Association denounced the decision to extend assisted suicide to healthy elderly people by stating:
"We do not support the change of statutes by Exit. It gives us cause for concern because it cannot be ruled out that elderly healthy people could come under pressure of taking their own life"
The Vice President of Exit, Bernard Sutter told the media:
"Our members told us to get active on this subject. It was ripe for a decision,"
A recent study found that in 16% of the assisted suicide deaths in Switzerland, the person had no underlying illness.

Pietro D'Amico
Pietro D’Amico, a 62-year-old magistrate from Calabria in southern Italy, died by assisted suicide in Basel Switzerland in April 2013 after receiving a wrong diagnosis.

In March 2010, the Atlantic monthly magazine did an exposé on the Dignitas assisted suicide clinic in Switzerland. The exposé confirmed the rumors that the leader of the suicide clinic kept jewelry and other items that were left behind after a client died to re-sell it and that crematory urns had been dumped in Lake Zurich.

Swiss assisted suicide organizations gained legal status in the 1980′s. The shift by Exit came shortly after a doctor was acquitted by a Swiss appeals court for administrating life-ending drugs to a 89-year old man without examining him first.

Links to similar articles: 

Sunday, May 25, 2014

The Federal government opposes Québec euthanasia Bill

Petition: Stop Euthanasia Bill 52 in Quebec.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Justice Minister Peter MacKay
A spokesperson for Justice Minister Peter MacKay responded on May 23 to the re-introduction of the Québec euthanasia Bill 52 by stating:
"The issue of assisted suicide creates great excitement and divisions among many Canadians. Our government believes that the provisions of the Criminal Code prohibiting assisted suicide and euthanasia are used to protect all people, including the most vulnerable people in our society."
The spokesperson for the Justice Minister also stated that the federal government uses the terms euthanasia and assisted suicide, rather than end-of-life care.


Québec's Bill 52 will give doctors the right to lethally inject their patients based on the patient having physical or psychological pain.

Bill 52 masks the reality of the bill by defining euthanasia as a form of medical treatment that is part of "end-of-life care."

Québec Premier Philippe Couillard responded by stating:

"This is a bill about end of life care, the continuum of care,"
If Bill 52 is passed by the Québec National Assembly, groups in Québec have already stated that they will bring the government to court based on the fact that euthanasia is a form of homicide and not medical treatment and therefore the Québec government does not have the right to legislate on this issue.

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