Friday, October 10, 2014

Big picture missed in Canadian euthanasia poll.

This article was written by Susan Martinuk and published in the Calgary Herald.

By Susan Martinuk is regular columnist.

Susan Martinuk
A famous quote, attributed to 19th century British prime minister Benjamin Disraeli, says: “There are three kinds of lies — lies, damned lies and statistics.”

Forget the lies and the damned lies for now. Let’s consider statistics, particularly as they relate to online public surveys. Statistics resulting from surveys can be problematic in that the answers pollsters get are directly correlated to the questions asked. That can be good or bad, depending on what perspective you are attempting to illuminate.

It’s something to keep in mind as current media and activist reports tell us that Canadians “overwhelmingly” support changing our laws to allow physician-assisted suicide.

An online survey on the public’s perception of dying with dignity was conducted by Ipsos Reid. It was commissioned by Dying with Dignity Canada (a group pushing for the legalization of doctor-assisted suicide) and therefore it is certain they had significant input (at minimum) into determining the wording of questions and the questions asked.

The very fact the poll was released this week, just days before the Supreme Court of Canada hears a case claiming laws banning assisted suicide violate an individual’s charter rights, also speaks to the activist underpinnings of this particular survey.

Activist groups do it all the time, so there’s nothing wrong with it. The point is that the public should be aware (yet rarely is) of the possible political angles attached to any survey.

The most significant claim is that 84 per cent of Canadians agree (51 per cent strongly and 33 per cent somewhat) that doctors should be able to end someone’s life if they are competent and suffering or if strong safeguards are in place.

The survey question is loaded with caveats that can easily be overlooked or unrecognized by the survey taker. The 84 per cent stems from the question: “As long as there are strong safeguards in place, how much do you agree or disagree that a doctor should be able to help someone end their life if the person is a competent adult, who is terminally ill, suffering unbearably and repeatedly asks for assistance to die?”

Here’s the caveat — “as long as there are strong safeguards in place.” Every jurisdiction that has legalized euthanasia has done so with the perception that there were strong safeguards in place. These include such things as the patient is an adult, competent, terminally ill, makes repeated requests, experiences unbearable suffering and has consulted with at least two physicians.

Other rules may say the patient must make the request freely, in writing and when they are fully informed. Still others have end-of-life panels that have the power to grant or refuse the request.

Overall, the rules seem to have covered everything. The safeguards appear to be comprehensive and strong. At least, in theory.

In 2002, the Netherlands implemented strong safeguards. Yet, today, contrary to Dutch law, studies show that physicians don’t bother to discuss their life-ending actions with the patient, relatives or another physician in 41.2 per cent of cases. In 23 per cent of cases, doctors don’t even report their actions, as required.

Then the safeguards began to shift. In 2005, assisted suicide was granted to those who are not physically ill, but “suffering through living.” As a result, those who are depressed or simply tired of living are now candidates for assisted suicide. So are children over the age of 12, although their parents have the final say until the age of 16. At the mature age of 17, they can do what they want.

In Belgium, similar safeguards allow those who are incapacitated and non-competent to access euthanasia. Data from 2007 show that 32 to 47 per cent of assisted deaths were performed without the patient’s request, and age restrictions have been removed.

Safeguards change. They can easily be ignored. The safeguard requirement for “competent adults” has now morphed into death for anyone at any age and any degree of competency.

Almost incredibly, the terminally ill caveat no longer stands. In 2012, 45-year-old Belgian twins who were born deaf were euthanized when glaucoma started to take their eyesight. An unhappy transgendered individual was also granted a permanent exit.

Last month, a Belgian murderer and rapist who is serving a life sentence was granted permission for an assisted death to end his unbearable mental anguish.

All of the above safeguards that were specifically cited in the polling question are typically ignored and the safeguard process means nothing in clinical practice. Apparently, 84 per cent of Canadians need to know that.

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