Thursday, July 20, 2017

Not Dead Yet UK intervenes in assisted suicide court case.

Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Disability rights group - Not Dead Yet UK is intervening at the UK High Court 
in the Conway case. The Conway case seeks to strike down Britain's law that protects people from assisted suicide in the UK.

In their press release, Not Dead Yet states that legalising assisted suicide by any means would put other disabled and terminally ill people at risk. The Not Dead Yet UK press release states:
Not Dead Yet UK maintains any imposed safeguards will never be watertight enough to successfully protect all ill and disabled people from a change to the Suicide Act. The Act currently provides much needed protection to disabled and terminally ill people by prohibiting anyone from assisting another person to kill themselves. Even if only one person dies against their wishes as a result of a change to the law that is one death too many and completely unacceptable. We argue that disabled and terminally ill people are just as entitled to this protection as everyone else; to single out one group of society as different to the rest is a dangerous move and will be open to misinterpretation. Legalising Assisted Suicide for disabled and terminally ill people would again set us aside from the rest of society. We would effectively be second class citizens again, with suicide seen as a valid choice for us while non-disabled people would be encouraged to live. 
This issue was last considered by Parliament almost two years ago (September 2015) when Rob Marris MP’s “Assisted Dying Bill” was decisively defeated by 330 to 118 votes in the House of Commons. Mr Conway is now attempting to override Parliament’s decision by seeking a change in the law through the Courts.
The Press release then quotes from a few of their notable leaders:
Baroness Jane Campbell
Disability campaigner Baroness Campbell of Surbiton, one of the founders of Not Dead Yet UK said,
We have successfully seen off attempts to change the law on Assisted Suicide in Parliament. Now we must change tactics to ensure the Courts continue to uphold our equal right to life. The law must not be weakened via the back door.” 
Speaking for Not Dead Yet UK, co-founder Phil Friend said, 
A change in the law is a terrifying prospect to the vast majority of disabled and terminally ill people who work hard towards achieving equality for all. Until we have reached that objective Assisted Suicide will remain a dangerous and prejudiced option, likely to increase suffering and distress”. 
Liz Carr
Liz Carr, star of BBC1 drama ‘Silent Witness’ states,
Disabled and terminally ill people want support to live – not to die. It is important that the Court hears from the people most at risk from any change to the current law. As a long standing supporter of Not Dead Yet UK I am keen to take an active role in making that happen”.
Link to other articles concerning the disability rights group Not Dead Yet.

Assisted Suicide – Is It All About The Money?

The following article was published by Hope Australia on July 20, 2017.

Paul Russell
By Paul Russell - the Director of Hope Australia

CEO of St Vincent’s Hospital network, Toby Hall must have been wondering at all the fuss over a simple observation in a recent article in The Australian about his network stating its blanket refusal to cooperate with assisted suicide should Victoria pass the Andrews’ Government mooted legislation.

I have written previously about the Greens’ Party spokesperson, Colleen Hartland calling for the government to review St Vincent’s funding as a response. A veiled threat if ever there was one. Surely the mantras of tolerance and diversity are broad enough to include a health service that has a conscientious objection? Maybe not.

But the most scathing criticism of Hall’s comments came from journalist Andrew Denton; also on the pages of The Australian. Denton was responding to the following statement in the original article:
“St Vincent’s Health Australia chief executive Toby Hall said the Andrews government’s proposed “conservative” euthanasia model was flawed and vulnerable patients would be put at risk by the proposed legislative changes, which he described as a “cheap economic way out”. 
“He accused the government of taking the cheaper option to “give someone a drug and kill them” rather than providing sufficient palliative care for the majority of Victoria’s terminally ill.”
But rather than providing any concrete evidence to support his criticism of Hall’s comments, Denton simply asserts that, “It is both incorrect and highly insensitive to the reality of how Victorians are dying” and then moves on. That is, except for this curious claim:
But by palliative care’s own admission all the resources in the world aren’t going to help them deal with all pain and suffering. It is not medically possible. And until we find a cure for cancer, MND and other diseases, this is unlikely to change.
The first statement seems to be a paraphrase that is, at the very least, debatable – depending on what one might take to be the precise meaning of each of its phrases. The second is redundant – if there were no difficult diseases there would clearly be little if any difficulty in managing symptoms.

But there’s a bigger picture here that Hall was alluding to, made abundantly clear by the call this week by Palliative Care Victoria for an additional $65M in funding in the state to help meet the need and to fill the service delivery and educational gaps. This follows closely upon the New South Wales Government recently committing $100M towards regional and rural palliative care services in that state.

The reality is that, in spite of Australia’s Palliative Care Services being ranked second in the world behind Britain, there are still service gaps and funding shortfalls. In that context and for some, the supposed ‘choice’ of assisted suicide is, in reality, no choice at all.

This is also true when you consider that in a landmark study by the Grattan Institute a few years ago confirmed that something like 70% of Australians expressed a deep desire to die at home when only 14% of people were actually able to exercise that choice.

So if you live in rural or remote parts of Australia not only will you likely not be able to die at home, but the services you receive could be well below Australian standards or you may need to choose between dying in a regional hospital that may not be able to meet your needs or being transferred to a big city hospital with all of the attendant dislocation. Perhaps assisted suicide becomes a more pressing option when other legitimate choices are limited. Hardly fair is it?

In spite of the need for increased funding for palliative care and end of life care being recognised in the Victorian Auditor General in 2015, the End of Life Choices Inquiry in 2016 and by the Productivity Commission this year, there was no additional funding for such services in the recent Victorian State Budget.

Yet, according to Palliative Care Victoria:
"Currently 55% of Victorian palliative care services report that they are unable to meet the current demand for palliative care. At least 26% of Victorians who die are missing out on the benefits of palliative care, according to the international measures of population need for palliative care."
They further note that there has been no nett increase in palliative care funding from the government since 2014.

Does this sound like a government that has a handle on its agenda? Surely, if they were serious about ‘choice’ as a value in promoting assisted suicide they would have increased funding in the last budget a few months ago; even if only to make the point that they take end of life care seriously.

No doubt they will point to the mooted lead in period until their assisted suicide regime becomes active. But Palliative Care Victoria’s plaintive cry for support won’t fix the gaps overnight. As Liz Carr told Victorian Parliamentarians a few months ago – fix the first 48 recommendations of the Parliamentary Inquiry Report before you tackle number 49 (the suicide recommendation).

Without such funding the CEO of St Vincent’s assertion of assisted suicide may be seen by bean counters as a ‘cheap way out’ has a ring of authenticity.

In Canada, less than a year after the Quebec and Ottawa government's legalised forms of euthanasia and assisted suicide, a research paper entitled: Cost analysis of medical assistance in dying in Canada appeared in the Canadian Medical Journal (CMAJ). It found that "Medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million." The bean counters must have been in seventh heaven.

The authors summarized: "Our analyses suggest that the savings will almost certainly exceed the costs associated with offering medical assistance in dying to patients across the country, and that the inclusion of medical assistance in dying in the services covered by universal health care will not increase health care spending, but rather will release funds to be reinvested elsewhere." Adding lamely: "We are not suggesting medical assistance in dying as a measure to cut costs." Really?

Daniel Fleming took up the 'economic argument' on the pages of the ABC's Religion and Ethics website, citing the Canadian study:
"Soon after the legislation was introduced in Canada, the above mentioned study was undertaken which had the object of demonstrating the savings to Canadian tax-payers as a result of the legislation. At this point in time, such savings might be considered an ancillary purpose to the explicit purpose of providing PAS-E (Euthanasia and Physician Assisted Suicide). However, they reveal important facts: end-of-life care is expensive, and it is not impossible to imagine a government or healthcare organisation which needs to face this fact during a hard budget agreeing to focus more attention on the cheaper options of PAS-E than on other forms of end-of-life care, an approach which has already been suggested by one of the world's leading economists."
Even the famous Dutch euthanasia enthusiast, Dr. Boudewijn Chabot recently lamented the effect of financial considerations in relation to euthanasia for psychiatric reasons in his own country:
"Ever since budget cuts turned chronic psychiatry into a diagnosis-prescription business, good treatment has become scarce."
Fleming warned in conclusion:
"These are uncomfortable considerations, and they take the debate outside of its typical contours which consider the suffering of an individual and sometimes their family, and whether or not it is right for that person to end their own life with medical assistance. That debate still needs to be had. However we land there, it is crucial to remember that the debate takes place in an ideological context, and if or when the legislation is enacted it will be done in a way that takes it beyond the intent of those proposing it, and into the realm of the value set of capitalism. Any legislation or major social interventions has social consequences beyond its original purpose."
There’s always the money question just as there will always be people who are at risk under any form of legislation. There are winners and losers in all of these debates.

Even Premier Andrews, now the prime mover in the assisted suicide agenda, once noted the money question, as Fairfax media reporter, Farah Tomazin noted last December:

Andrews' resistance was not based on faith, he explained, but from his stint as health minister under the Brumby government. It was during that time the Labor MP saw firsthand the incessant demand for hospital beds in an overstretched system and became increasingly concerned that "these laws might see a rationing of precious health dollars".

Andrews may have changed his mind to support assisted suicide, but his observations about the health system and the temptation to cut and/or limit budgets remains.

Euthanasia, Conscience and Canadian doctors

This article was published by Physicians Alliance Against Euthanasia on July 16, 2017

In the year since euthanasia became legal, we have witnessed a powerful political push to normalize it as part of medicine in Canada. Yet many doctors remain opposed to the practice. Most would like to see it rigorously limited. And some, for reasons of personal and/or professional conscience, refuse categorically to be part of it.

Unfortunately, our politicians have made it perfectly clear that they intend to ignore the judgement of opposing doctors and to stifle their dissent. In fact, the worst of these politicians are to be found within our own profession.

Consider, as a case in point, the new (2015) College of Physicians and Surgeons of Ontario policy on doctors’ conscience rights.

This CPSO policy is identified as a mere “revised update”, but it actually bears little resemblance to the earlier version (2008).

And it is obvious why this is so: Without ever honestly mentioning euthanasia, assisted suicide, or even MAID, the new policy was designed from the start to facilitate a radical new Orwellian redefinition of “euthanasia”, from homicide to medical treatment. It effectively obliges all Ontario physicians and surgeons to participate in the euthanasia program.

In practical terms:

“Where physicians are unwilling to provide certain elements of care for reasons of conscience or religion, an effective referral to another health-care provider must be provided to the patient.”
This, of course, is the main sticking point for many doctors, who consider referring their patient to any agency of death to be an act just as abhorrent as performing the euthanasia themselves.

But “effective referral” is by no means all. There is also the “duty to inform”:

“Physicians must provide information about all clinical options that may be available or appropriate to meet patients’ clinical needs or concerns.”

“Physicians must not withhold information about the existence of any procedure or treatment because it conflicts with their conscience or religious beliefs.”
Please note the italics: The physician apparently has a duty to inform his patients of all options legally available even if they are inappropriate! And this obligation shall override any moral or professional convictions that physician might hold.

The violence of the obligation to “inform” goes even beyond that of “effective referral” itself. Every patient who fits the criteria for euthanasia must be subjected to the terrible stress and doubt of learning that he or she belongs to that select group of people for whom medically-inflicted death has become an option. And no objection of judgement or of conscience can free the doctor from delivering that terrible message and its implicit suggestion.

In Ontario, then, by proclamation of the CPSO, the doctor’s role is reduced to that of an automatic vending machine which simply displays state-mandated euthanasia options and passively offers corresponding buttons for the patient to push.

Obviously, the scope and impact of such a policy is astounding. Professional judgement is the bedrock of medical practice. Freedom of conscience is the underpinning for our entire system of secular democracy. Both are set aside. The scale of the emergency must be colossal to require such draconian measures!

But, of course, there is no such urgency.

Let us remember that the original euthanasia program was sold to us as an imperative response to a hypothetical terminally ill patient in unbearable and untreatable pain. Let us recall how that extreme, no, that virtually mythical case, was leveraged into all of the totally unrelated deaths that we now apprehend. Once again, a similar strategy is at work. This time, the absolute need for all doctors to promote euthanasia (all the time and to all of their most vulnerable patients), is presented as a required response to the hypothetical possibility of even one patient, desirous to die, but who is frustrated in her wish.

We are asked to believe that any real burden whatsoever, financial, professional, or moral, can be justified in the interest of allowing that one sacred voluntary death. It is a sort of grotesque inversion of the proposition that “no price is too high” provided that “only one child be saved…”. Which becomes in this case: “if only one person might die…”.

Other jurisdictions, no less respectable than Ontario have taken an opposite stance, and there is no evidence that anybody has suffered or will suffer.

Manitoba is in the process of explicitly recognizing the right of non-participation and non-referral of all health professionals and others working in health care. Major hospitals in Winnipeg have announced their refusal to euthanize patients.

In the State of Vermont a judicial battle over similar issues has resulted in an unambiguous victory for doctors’ rights.

And in Ontario, a group of dedicated and courageous doctors launched a court challenge in defense of doctors’ conscience, which was heard June 13-15, 2017.

That judgement will be rendered later this year. Let’s hope our courts get it right this time! But regardless of that outcome, regardless of the timeframe, and regardless of expense; regardless of the legislative efforts that may ultimately be required: This authoritarian policy of the College of Physicians and Surgeons of Ontario is neither necessary nor justified. It is not desirable. It is not even reasonably defensible. It is extreme. And it is irrational. Above all, it is profoundly harmful to individual doctors and patients and to the whole medical profession. It constitutes both an injustice and an embarrassment which cannot be allowed to stand.

Friday, July 14, 2017

US House Appropriations Committee approves repeal of the DC assisted suicide Act

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Great News: Yesterday the US House of Representative Committee on Appropriations approved an amendment by Representative Andy Harris (Maryland), who is also a physician, that prohibits funds for assisted suicide in the District of Columbia, and repeals the DC Death with Dignity Act. The amendment was adopted on a vote of 28-24.

Information about the DC assisted suicide act.

The law must protect, doctors must care, and euthanasia undermines both

The following article was published by Mercatornet on July 13, 2017

A British palliative care pioneer talks to MercatorNet about the campaign for assisted suicide.

By Carolyn Moynihan

Baroness Ilora Finlay
There is not much you could tell Professor, the Baroness Ilora Finlay about death and dying – outside of a war zone, perhaps. The Welsh doctor and Member of the British House of Lords (since 2001), was the first consultant in palliative medicine in Wales back in 1987 and set up the hospice system there. In 1989 she introduced the Diploma in Palliative Medicine at Cardiff University where she still teaches. She co-chairs Living and Dying Well, a think tank to examine the evidence around euthanasia and assisted suicide.

Over the decades Professor Finlay has cared for thousands of people at the end of their lives, and in opposition to the growing euthanasia movement has become an internationally recognised champion of the need for good palliative care for all those diagnosed with a terminal illness.

In 2005 she served on the House of Lords select committee on the Assisted Dying for the Terminally Ill Bill – an exhaustive inquiry into assisted suicide that resulted in the UK parliament rejected the bill. She was also a prominent opponent of a similar bill introduced in 2014 (that was also rejected).

Recently she visited New Zealand where a private member’s euthanasia bill (not the first of its kind here) is now before parliament. David Seymour’s End of Life Choice Bill would allow terminally ill people with six months to live, or people with a "grievous and irremediable" condition – that is, the chronically ill -- to ask a doctor to help end their lives.

Mental capacity and vulnerability

“It’s very similar to the law in the Netherlands,” she told me during an interview in Auckland. “It could even be wider in its effect.” For one thing the Seymour bill does not have an explicit requirement for mental capacity.

“It only states that the person concerned must ‘have the ability to understand’ the nature and consequences of assisted dying. There’s no requirement to ask whether a person at this moment is thinking straight, whether their judgement is unimpaired.

“This would make people with learning difficulties extremely vulnerable. A person with Down syndrome, for example, could ‘understand’ from what they hear and see around them what euthanasia ‘means’ and say yes to it when they have not really understood at all.”

The latest official reports from The Netherlands show that 1 in 26 of all deaths there come about through euthanasia or physician assisted suicide, with an increase of 15 percent year on year. In the words of one of the original promoters in The Netherlands, euthanasia is becoming “the default mode of dying” there.

The majority of doctors remain opposed

You would expect Britain, where Dame Cicely Saunders founded the hospice movement 50 years ago, to be good at looking after the dying. In The Economist’s Quality of Death Index 2015, the UK ranked first out of 80 countries for palliative care, followed by Australia and New Zealand.

But is the medical profession there standing firm in its opposition to euthanasia?

“All the professional colleges in the UK as well as in most places around the world remain opposed, as do the majority of doctors,” says Professor Finlay. “Even in Oregon, where they changed the law, two-thirds of the doctors don’t want to be involved. I met with the New Zealand Medical Association whose chairman is absolutely clear that this is not a role for doctors.

“And indeed it is not the place of doctors to sit in judgement on who is or is not eligible for assisted dying, and then be part of the process of bringing about the person’s death deliberately with lethal drugs, when what they should be doing is getting on with looking after patients and caring for them, helping them maintain their dignity and keeping them comfortable, irrespective of what has happened to them.”

Being in control is not most people’s priority

One of the cultural forces driving the euthanasia movement is the desire of some people in prosperous countries who have always had “choices” and been in control of their lives, to remain in control to the end.

How much do people who actually are terminally ill care about being in control of everything?

“I’ve looked after thousands of dying people,” says Professor Finlay, “and what they want is to feel better than they do at the moment, to live better during whatever time they have left. It has often struck me that people who were adamant when they were well that they would want euthanasia or assisted suicide, when they are ill suddenly change their minds and are desperate to carry on living. When they face the reality of losing life they want everything done to help them live as fully as possible.

“The demand for euthanasia is coming, by and large, from those who are not in the last stage of illness, whereas those who are in the last stage are actually being looked after very well. People are frightened of things that, with good care, will probably not happen to them: that they might lose their mind, become breathless, that pain will become unbearable.”

The grey wave and the cost factor

There’s another kind of fear behind the “demand”, too – fear of the cost of caring for an ageing society. How are we going to care for all the people living longer lives but needing help?

“That’s a really interesting question. What the research shows is that if you look after people well, if you provide palliative care early, and you help them live as well as possible, their depression is lower, hopelessness is lower, the quality of life is higher – so paradoxically they live longer, but the costs are not higher. Because you are helping people maintain independent living and carrying on.

“If you look at the statistics for Oregon, for example, the peak age group for assisted suicide requests is 65-80, it’s not among the 80-plus year olds. And people in their 80s are generally much fitter today than they were.”

Are we up to this kind of care?

Can we, though, count on having enough professionals who want to do this kind of care, with its extra demand for empathy, understanding and personal skills? Are we cosseted Westerners up to it these days?

“Oh yes, we are completely up to it. There’s no problem about people wanting to go into specialist palliative care at all. It is one of the most competitive fields of medicine in the UK.

“I think, also, that there is an awareness that we need to be putting more into care, helping people make decisions, helping them understand that they can refuse treatment. Nobody is being forced to stay alive, nobody is being forced to suffer, as people campaigning for Euthanasia claim.

“However, there is always a power differential in the doctor-patient relationship, and we do need to train doctors to listen to what people need, to help them plan in advance and to modify their wishes as they go along.”

Fragile families and loneliness

Fear of death and requests for assisted suicide may be partly driven by changes in the family. Small families, distant families, broken families, families burdened by big mortgages so that both spouses have to work full time – these trends mean that someone who needs support because of old age or a degenerative disease will often not be able to find it in their family.

“Loneliness is a big killer. There certainly is evidence that it shortens your life expectancy, and both loneliness and the fear of it is a major problem in society today.”

Whatever the problem, the answer is not suicide, not killing. But how should opponents of euthanasia focus their case? Professor Finlay strongly emphasises the proper role of the law.

Prime focus: the law must protect the whole population

“First, you have to ask those wanting to change the law, does the law we have now not work? Laws have to protect the whole population, not just a few, so if we change the law, will more people be protected? Or will you be removing protection from people? All the evidence I have seen shows that these laws cannot protect everyone. The process becomes quite arbitrary: here is a suicide we will try to prevent; here is one we will assist. But why?

“You can’t be neutral. The law is written in a way that will involve you. People who think, ‘I’ll leave that to someone else to deal with,’ are deluding themselves. I think if you object to euthanasia and assisted suicide you have a duty to say so, to collect your thoughts and express them sensibly.

“This, by the way, has nothing to do with religion. It is not a question of what you believe -- people on both sides have their beliefs. Your arguments have to be based on evidence. Sometimes the evidence used is not very strong – you get stories going around that might or might not be true.

“But here is a story that comes straight from the most recent full report from Holland’s monitoring committees. There were three young women who were each severely psychologically disturbed. And in all three it could be traced back to abuse in childhood or early teens. Yet they were allowed to be euthanased because they were so disturbed.

“I have a real problem with a society that says, we will kill the victim with a lethal injection, but the perpetrator is out there, free.”

Carolyn Moynihan is deputy editor of MercatorNet.

Thursday, July 13, 2017

New York Times article promotes infanticide - killing (euthanasia) newborns with disabilities

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

In 2004, the Groningen Protocol was approved in the Netherlands which permitted the killing, by lethal injection of newborns with disabilities. In 2014 a Canadian bioethicist wrote an article titled: Physicians can justifiably euthanize certain severely impaired neonates. 

This week the New York Times has published an article by philospher Gary Comstock promoting infanticide of newborns with disabilities.

Comstock tells the story of Sam, his son with Trisomy 18, a condition that is claimed by many to be "incompatible with life."

Read: Trisomy 18 is not a dead sentence  - The story of Lilliana Dennis.

The story of Sam's brief life, his birth, his treatment and his death is moving and compelling.

The narrative explains the decision to withdraw the baby's ventilator. The child did not die a beautiful death. Comstock writes about the baby waking and grasping silently for breath. After the child dies Comstock writes:
You should not have let your baby die. You should have killed him.

This thought occurs to you years later, thinking about the gruesome struggle of his last 20 minutes. You are not sure whether it makes sense to talk about his life, because he never seemed to have the things that make a life: thoughts, wants, desires, interests, memories, a future. But supposing that he had thoughts, his strongest thought during those last minutes certainly appeared to be: “This hurts. Can’t someone help it stop?” He didn’t know your name, but if he had, he would have said: “Daddy? Please. Now.”

It seems the medical community has few options to offer parents of newborns likely to die. We can leave our babies on respirators and hope for the best. Or remove the hose and watch the child die a tortured death. Shouldn’t we have another choice? Shouldn’t we be allowed the swift humane option afforded the owners of dogs, a lethal dose of a painkiller?

For years you repress the thought. Then, early one morning, remembering again those last minutes, you realize that the repugnant has become reasonable. The unthinkable has become the right, the good. Painlessly. Quickly. With the assistance of a trained physician.

You should have killed your baby.
There are so many loving parents who cared for their child and hoped for the best and others who held and loved their child until the child died naturally. This story tells them that they should have killed their child.

Comstock boldly states that it is better to kill a baby with disabilities and then lies by stating that there are only two options, kill the baby or let the baby die a tortured death. 

What about having hope? What about proper pain and symptom management to allow a peaceful natural death?

 This article is designed to redefine love, from that of caring parents who live through the death of their child to that of parents and doctors who kill newborns with disabilities.

Tuesday, July 11, 2017

Someone Else can Administer the Lethal Assisted Suicide Dose to the Patient

This article was published by Choice is an Illusion on July 10, 2017

Margaret Dore
By Margaret Dore, Esq., MBA

The South Dakota measure allows someone else, such as a doctor or family member, to administer the lethal dose to a patient. This is true for three reasons:

1. The Measure Merely Says That the Patient “May” Self-Administer the Lethal Dose

The measure says that a patient may self-administer the lethal dose.[1] There is no language that administration “must” be by self-administration.[2]

2. Generally Accepted Medical Practice Allows Someone Else to Administer Medication to a Patient

The measure describes the lethal dose as “medication.”[3] Generally accepted medical practice allows a doctor, or a person acting under the direction of a doctor, to administer medication/drugs to a patient.[4] Oregon doctor, Kenneth Stevens, states:

Common examples of persons acting under the direction of a doctor, include: [N]urses . . . who act under the direction of a doctor to administer drugs to a patient in a hospital setting; . . . and adult children who act under the direction of a doctor to administer drugs to their parents in a home setting. (Emphasis added).[5]
With self-administration not mandatory, generally accepted medical practice allows a doctor, or a person acting under the direction of a doctor, to administer the lethal dose (a “medication”) to the patient.

3. “Self-administer” Is Specially Defined to Allow Someone Else to Administer the Lethal Dose

The measure states:

Terms used in this Act mean:

(11) “Self-administer,” a qualified patient’s act of ingesting medication to end the patient’s life . . . (Emphasis added).[6]
The measure does not define “ingest.”[7] Dictionary definitions include:
[T]o take (food, drugs, etc.) into the body, as by swallowing, inhaling, or absorbing. (Emphasis added).[8]
With this situation, someone else placing a medication patch on the patient’s arm qualifies as self-administration because the patient will be “absorbing” the lethal dose, i.e., “ingesting” it. Gas administration qualifies because the patient will be “inhaling” the lethal dose, i.e., “ingesting” it. Putting the lethal dose into the patient’s mouth qualifies because the patient will be "swallowing" it, i.e., “ingesting” it. With self-administer defined as ingesting, someone else is allowed to administer the lethal dose to the patient.


[1] The Initiated Measure, § 1(6), states:
“Informed decision,” a decision by a qualified patient, to request and obtain a prescription for medication that the qualified patient may self-administer to end the patient’s life . . . (Emphasis added).
[2] See the measure in its entirety at this link:
[3] See § 1(6), which states:
“Informed decision,” a decision by a qualified patient, to request and obtain a prescription for medication that the qualified patient may self-administer to end the patient’s life . . . (Emphasis added).
[4] Declaration of Kenneth Stevens, MD, 01/06/16, ¶10,
[5] Id.
[6] Initiated measure, § 1(11).
[7] See the initiated measure in its entirety.
[8] Your (defining " ingest").

Monday, July 10, 2017

Elderly man with dementia punched 11 times by personal care worker in Ottawa.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Elder abuse is a growing scourge in Canadian society, a problem that is based on the dehumanization of the victim. Human society has always faced a level of abuse, but in a society that claims to be based on the equality of all human persons, it is horrific when we look into the mirror and recognize that in fact our society has denigrated certain human persons leading to abuse of those persons.

Someone recently asked me - how can we protect people in our culture - and I responded that you cannot leave them alone.

The abuse of George Karam (89) by Jie Xiao (44) his "care worker" that was caught on video at Garry J. Armstrong long-term care home in Ottawa emphasizes the brutality and dehumanization associated with elder abuse.

The Ottawa Citizen reported on the case and includes a video link with the story.
The video, which was provided to the Citizen by Karam’s family, shows the elderly man lying in bed as personal support worker Jie Xiao yanks him back and forth while removing his diaper....
An agitated Karam took a pair of swipes with a crippled and shaking hand at Xiao during the diaper change. 
It was after a third swipe that came closer to Xiao’s face that the 44-year-old care worker unleashed a series of rapid punches with his gloved hand to the side of Karam’s face on March 8. 
Xiao frequently paused between the blows, delivering two or three punches at time with his left hand as his right hand took hold of Karam’s arm. The sound of the fist making contact with Karam’s face is clearly audible on the video.
In between the punches, Xiao frequently raised a closed fist next to Karam’s face. Before delivering the final punch, Xiao appears to be swearing at Karam. Karam then lets out a shout. The whole assault lasts about 28 seconds.
Horrific incidences of elder abuse are not uncommon. In 2013 a similar story of elder abuse was caught on film in Peterborough.

On June 30 the Euthanasia Prevention Coalition reported on the recent data from a study examining how people die in the Netherlands. The study indicated that there were 431 hastened deaths without explicit request and 1693 unreported assisted deaths in 2015 in the Netherlands.

A similar study that examined how people died in the Flanders region of Belgium found that there were more than 1000 hastened deaths without explicit request and approximately 1380 unreported assisted deaths in 2013.

It is disturbing that the Belgian data indicates that more than 80% of the hastened deaths without explicit request were people with dementia, Alzheimer's or coma, people who are incompetent to make decisions for themselves. 

I am convinced that the dehumanizing attitude that has led to the scourge of elder abuse in has also led to de-stigmatizing the concept of doctors killing patients by euthanasia.

The concept that euthanasia or assisted suicide can be administered without abuse within a society that has dehumanized people living with certain conditions is naive at best.

Irwin promotes assisted suicide by promoting his suicide.

No assisted suicide.
No assisted elder abuse.
Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Michael Irwin (86), an assisted suicide lobby activist and retired physician in the UK decided to end his life in order to promote the legalization of assisted suicide in the UK. 

As sad as it is that Irwin is promoting assisted suicide through his own death, the reality is that the attitude and language that Irwin uses concerning his own life mirrors the attitude of the assisted suicide lobby towards the lives of others.

Irwin refers to himself as "existing beyond my sell-by date" and that he doesn't want his friends or family to remember him as "an increasingly decrepit person."

By using this terminology Irwin is degrading people who are elderly (beyond their sell-by date) or living with disabilities (increasingly decrepit).

Liz Carr

Liz Carr, a disability rights activist and actress in the UK, last year stated in an interview why she opposes assisted suicide and why she produced a musical on the topic. Carr states:
“Until we value ill, older and disabled people as equals; until there are no more hate crimes; until their deaths or murders are no longer portrayed or perceived as mercy killing, and until there’s real equality and validity for those groups of people, then maybe we can have that conversation.”
Carr later states in the interview:
“The problem with disability is social oppression, not disability. The solution to that is not to kill a person; it’s not to give them easy access to end their life. It’s to look at the reasons why that person wants to end their life. And are we doing everything we can? 
Irwin, who is a past-president of the World Federation of Right to Die Societies and has promoted old-age suicide since 2009, was "struck-off" the list of physicians in 2005 for breaking the code of ethics.

Irwin's personal campaign to legalize assisted suicide devalues the lives of people with disabilities and older people. Irwin is promoting his own death in a manner that devalues the lives of other people creating a new pressure to die.

Friday, July 7, 2017

Charlie Gard situations have happened here too

This article was published by National Review online on July 4, 2017.

By Wesley Smith

Wesley Smith
There is a proper international uproar over U.K. doctors winning the right in court to unilaterally remove the infant Charlie Gard from life support. 

Some have commented on the case as if that is a product of the UK’s socialized medical system. It’s not. It is a product of utilitarian bioethics advocacy for the right to refuse wanted life-sustaining treatment — called “futile care” — based on the doctor’s or a hospital bioethics committee’s values on the moral worth of the ill patient’s life and/or the high cost of care. 

Whose baby is Charlie Gard anyway?

Similar authoritarian care withdrawals as has been imposed on Charlie Gard have happened here too — and to very ill patients of all ages. I get into a few of these cases involving infants today over at First Things. 
  • There was the Baby Ryan case in Seattle, in which a hospital actually reported a family for child abuse because they obtained an injunction against removing kidney dialysis. In the end, the doctors were wrong that death was imminent. The boy lived four years as a happy, if sickly child, who loved to give high-fives. 
  • The parents of Baby Terry in Michigan were stripped of their parental rights for refusing to consent to withdrawing life support. 
  • In Canada, doctors treating Baby Joseph insisted on the right to remove life support from a terminally ill baby and refused a tracheotomy that would have permitted the baby to go home to die with his family. Priests for Life eventually paid for the baby to be flown to the USA for the procedure, which was successful. Joseph died several months later in his parents arms. 
Charlie Gard
The Charlie Gard case is unique in only one respect: It is the only futile care case I know of in which the hospital and the law is preventing discharge to another facility or allowing the patient to go home to die. From, “Whose Baby is Charlie Gard, Anyway?” 
The refusal to allow Charlie’s parents to remove their baby boy from the hospital is an act of bioethical aggression that will extend futile-care controversies, creating a duty to die at the time and place of doctors’ choosing.  
And that raises a crucial liberty question: Whose baby is Charlie Gard? His parents’? Or are sick babies — and others facing futile-care impositions — ultimately owned by the hospital and the state? 
Again. This isn’t about socialism — although that issue is relevant. More, it is about cost containment — including in free-market systems — and the attempt by the bioethics movement and medical intelligentsia to replace the equality/sanctity of life ethic with a more utilitarian “quality of life” view.

Thursday, July 6, 2017

Canadian media campaigns for more euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Recently, Canadians have once again been inundated with articles concerning euthanasia. I am convinced that the media is pressuring physicians to join the "list" of those who are willing to kill their patients and the media is campaigning against the "safeguards" in the law 
to increase access to death by lethal injection.

Thank you Dr Ramona Coelho, Dr Mark D'Souza and the many caring physicians and nurse practitioners who continue to oppose killing patients or directly referring patients to death.
Dr Ramona Coelho

In an article published today by CBC London Dr Coelho says that she is being pressured to be involved with euthanasia.
One year after medically assisted death was made law in Canada, a London physician is adamant the rules are putting undue pressure on physicians who don't want to refer patients for the procedure.
A recent Globe and Mail article quotes Dr Mark D'Souza, who stopped his palliative care practice because the euthanasia law put him at direct risk of losing his medical license because he opposes euthanasia:
“If [patients] complain that I’m not the one picking up the phone [to do the referral], my licence would be in jeopardy,” he said. “That’s not a scenario I want to expose myself to, and that’s why I left palliative care.”
The media is campaigning for more euthanasia.

The Globe and Mail published an article on July 3 about a doctor who has lethally injected 20 people in British Columbia who decided to stop doing euthanasia because the BC government isn't paying him enough money to kill.

An article published by CBC London, promotes Dr Scott Anderson, who is one of two doctors in London Ontario who is willing to kill patients. This article appears to encourage other physicians to participate in euthanasia and to inform local physicians to refer their patients for lethal injection to Dr Anderson.

Dr Anderson offers some interesting quotes in the article:
"When somebody is asking for your help to die, I don't see how the answer can be no." 
In another instance, the patient wanted a medically assisted death but his family was against it. With his main responsibility to the patient, Anderson performed the procedure while the family was away from the residence.
If Dr Anderson is visiting your depressed family member or friend, don't leave them alone.

The Globe and Mail published an article on July 5 which also appears to be campaigning for more physicians to kill and for more resources for euthanasia. The article claims that there are only a few doctors who are willing to kill people in Ontario.
Only 74 doctors and nurse practitioners have signed up for the new care co-ordination service, down from 181 when the Ontario Ministry of Health and Long-Term Care shut down its old confidential referral list of medical-aid-in-dying (MAID) providers on May 31.
The also publishes a quote from Chantal Perrot, a doctor who has participated in 20 euthanasia deaths but who is not on the referral list.

The Globe and Mail article concludes by stating that there have been 548 euthanasia deaths in Ontario since June 17, 2016 when euthanasia became legal in Canada. A CBC article published in April stated that on March 31, there had been 365 euthanasia deaths in Ontario. Therefore there has been 183 euthanasia deaths in the last two months in Ontario. 

There are not too few euthanasia deaths, but rather too many. 

Sadly, the number of euthanasia deaths in Canada far exceeds the original predictions. Canada is becoming the example to America of why euthanasia should never be legalized.

Wednesday, July 5, 2017

America: Let Canada be your example and warning of why you must not legalize assisted suicide.

This article was published by OneNewsNow on July 5, 2017
Alex Schadenberg

An opponent of euthanasia believes Canada's statistics on the subject should send a strong message to the United States.

Canada's Supreme Court forced euthanasia on the country, and Parliament enacted a law to implement it. Alex Schadenberg of the Euthanasia Prevention Coalition says the law used imprecise language, so vague it could have varied interpretations. And the country is seeing that now.

"We've already seen the extension of what was deemed to be the spirit of the law, so we have already had a case here in Ontario where somebody who was not terminally ill has been permitted to have euthanasia," Schadenberg reports. "We've then seen also the pressure on Quebec, where Quebec came out with a report showing that 21 of their euthanasia deaths in their first year were outside of the law."
There was also under-reporting of euthanasia in the Netherlands in the last couple of years. The Coalition executive director has previously pointed to how when euthanasia was legalized in Europe, abuses began to occur, including the killings of people – because of mental problems, not terminal illnesses -- who did not request euthanasia. Some were killed just because they were lonely or depressed.
"We're seeing all this data out of Canada where, in fact, we're heading down the exact same direction," Schadenberg warns. "Expansion of euthanasia to children is the next pressure, psychological suffering alone -- these are all the pressure points going on in Canada for extending euthanasia, and yet we're only one year in."
The door is opening wider and wider as each week passes.
"For everybody in America, Canada has become the example of why you cannot legalize euthanasia or assisted suicide," 
The euthanasia prevention advocate concludes.

Tuesday, July 4, 2017

Euthanasia: The price on a life in Canada.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Globe and Mail reported that at least one doctor in British Columbia (BC) stopped lethally injecting people because the Provincial Ministry of Health is not paying enough money to kill (MAID).

The article by Kelly Grant, in the Globe and Mail, appears to pressure the BC government to pay more for euthanasia. Grant writes:
Dr. Pewarchuk, an internal medicine specialist in Victoria who has presided over 20 assisted deaths, took his name off the list of willing physicians last month after the body that sets doctors’ pay in British Columbia approved new fees that he and some of his fellow providers say are so low they could chase away even the most committed physician supporters of assisted dying.
The article outlines the BC government fee schedule that is paid to doctors for euthanasia:
Under the new fee schedule, B.C. physicians will now be paid $40 for every 15 minutes, up to a maximum of 90 minutes, to conduct the first of two eligibility assessments required by law. Each of the assessments has to be provided by a different clinician. That works out to $240, a significant increase from the $100.25 interim assessment fee that has been in place in B.C. since shortly after assisted death became legal. 
For second assessments, the time is capped at 75 minutes. 
In the case of providing an assisted death, the province has set a flat fee of $200, plus a home-visit fee of $113.15.
The price on a life in British Columbia is up to $240 + $313.15 or $553.15.

The article then compares the BC payment for killing to several other Provinces:
By comparison, if a doctor spent three hours start to finish on an assisted death – excluding the formal eligibility assessment – he or she could bill $621.60 in Alberta, $600 in New Brunswick, $499.80 in Quebec, $480 in Manitoba and $465.60 in Saskatchewan. If doctors in those same five provinces billed for two hours, they could still earn more than B.C.’s $313.15 in every province but Saskatchewan, though not by much.
In January the Journal of the Canadian Medical Association published an article indicating that the Canadian healthcare system could save  up to138 Million dollars now that euthanasia is legal.

Euthanasia: when safeguards become barriers to access.

This article was published by Mercatornet on July 4, 2017

Aubert Martin
y Aubert Martin, Executive Director of Vivre dans la Dignité (Living with Dignity) Quebec

A month after the publication of a letter by the secretary of the College of Physicians of Quebec – in which he expressed his concern about a growing “pressure, demanding a form of death à la carte” and in which he denounced those who interpret refusals of euthanasia as a form of exclusion – lawyer Jean-Pierre Ménard is challenging before the courts the cases of two people living with disabilities who were refused the assistance of a physician to kill themselves.

The plaintiffs requested the removal of the “reasonably foreseeable death” clause of the federal law as well as the “end of life” requirement in the Quebec law.

More voices were added to the chorus of “rebels” decrying the cruelty of all criteria that dare make reference to the proximity of death.

Yet not so long ago, the elected Members of the National Assembly in Quebec (MNAs) were congratulating themselves on the wisdom of their law that made reference to… the end of life. This is another reversal of logic in the long list of changes of rhetoric we have already witnessed.

Indeed, at the time of the adoption of the Quebec bill, words like “safeguard” and “strict conditions” peppered the speech of those seeking to calm the fears of people wary of allowing homicide under certain circumstances.

Today, potential extensions of the law are justified by referring to “consensus” and “the will of the people,” while the “safeguards” have turned into “barriers to access”.

Meanwhile, the same promoters of euthanasia who claimed that it was only a matter of “exceptional requests for exceptional cases” have updated their rhetoric to justify the explosion of euthanasia requests: it has become “a response to a need.”

Yet, before the legalization of euthanasia and assisted suicide in Quebec and in Canada, warnings of the slippery slope were met with mockery and contempt from those who embraced medical suicide with open arms.

At best, this cautious warning, based on the experience of countries that legalized euthanasia before us, was treated as a scarecrow brandished by alarmists. “The slippery slope doesn’t exist!” responded those anti-skeptics and other merchants of death.

Today, slightly more than a year after the Quebec bill 52 that legalized euthanasia came into force, we see the first obvious signs of the slippery slope: we have gone from exception to promotion. Already the “end of life” criterion is presented as discrimination which prevents people with disabilities from committing suicide, implying that their living conditions justify their desire to die.

Secondly, the argument that euthanasia is about “capable and consenting people” is giving way to the idea of killing an incapable person (with Alzheimer’s or dementia) regardless of the person’s consent at the time of death.

Finally, according to a Canadian study published in May, the proverbial patient writhing in pain on his deathbed has morphed into a person in existential crisis over his loss of autonomy (read: disability).

So we won’t be surprised if tomorrow we are presented with other ludicrous propositions, such as the one currently gaining popularity in the Netherlands: opening “medical aid in dying” to elderly people who feel they have accomplished their lives.

A society does not accept overnight the idea that the state should endorse the suicide of an elderly and healthy person simply because she is tired of living. It must first live through the deep malaise that accompanies every new expansion of euthanasia access that is sold to us as progress.

In fact, when we think about it, the only thing that is “reasonably foreseeable” is the extension of medically assisted suicide to more and more groups of people. If death is sold as a solution to suffering, and if suicide is viewed favourably when a doctor is involved, the real question is not why some are opposed to it, but rather “why say yes to one and no to others?”

Aubert Martin is the Executive Director of Vivre dans la Dignité (Living with Dignity), a Quebec-based organisation.