Sunday, May 19, 2019

Belgian tug-of-war over euthanasia for mental illness and dementia

This article was published by Mercatornet on May 13, 2019

By Michael Cook:

Wim Distelmans
Belgium’s leading advocate for euthanasia liberalisation is campaigning vigorously for euthanasia for people with dementia. According to the current euthanasia law, patients are only eligible if they are fully aware and competent. This can lead to distressing situations and must change, says Professor Wim Distelmans.

Distelmans is chairman of Belgium’s chairman of the Federal Euthanasia Commission, the body which assesses whether euthanasia cases have been carried out legally. But he is also the chairman of LEIF (the Life End Information Forum), Belgium’s leading end-of-life lobby.

LEIF has organised an online petition which has been signed by scores of well-known academics, journalists and politicians as well as thousands of others. LEIF has also posted three heart-tugging videos of people with dementia putting the case for euthanasia.

Distelmans asks on the LEIF website:
“What are they waiting for to give priority to this basic human and patient right on the political agenda? After all, no one is obliged to euthanize or to implement it, not even in the proposed amendment to the law. But one can avoid a lot of situations that are considered 'degrading' by those involved by making the prior directive also applicable to those who suffer from dementia or other incapacity.”
However, at the same time and moving in the opposite direction, the Belgian medical association has implemented a far more restrictive policy on euthanasia for psychiatric patients. This is a very significant shift in policy. Some supporters of the country’s euthanasia law differ on the wisdom of making a liberal law even more liberal.

Belgium’s euthanasia law says that the treating doctor must seek advice from two other doctors, including at least one psychiatrist who is not the treating psychiatrist. But the new guidelines from the Orde van Artsen set down that the treating doctor should consult not just one but two independent psychiatrists who should meet face-to-face to discuss the case. This new standard is far more demanding. According to an April 29 directive:
the doctor considering euthanasia in psychiatric patients should go one step further and physically meet with the two psychiatrists. A physical meeting results in an interdisciplinary collaboration where every doctor explains his views as objectively as possible. The doctors should prepare a joint report and come to a joint decision, without being required to agree on everything. 
It is recommended that this physical consultation involves all healthcare providers who are in regular contact with the psychiatric patient. In addition to the nursing team, it is recommended that the psychologists and psychotherapists who help realize the care process are also involved in the consultation.
Theoretically, this implies that a doctor could be sanctioned by the Orde van Artsen over a euthanasia which was perfectly legal.

My feeling, for what it's worth, is that Belgium will keep relaxing its 2002 law until it becomes effectively euthanasia on demand. Doctors will end up becoming mere suicide enablers.

There may be one way to stop this juggernaut, or at least to slow it down. And that is to dismiss the chairman of the Federal Euthanasia Commission, Dr Wim Distelmans. This gentleman is not only the senior regulator of euthanasia in Belgium. He is also a media star as the chief spokesman for the right to die and one of the main practitioners of euthanasia (he also operates the euthanasia clinic). In other countries, this would be regarded as an egregious conflict of interest.

A new chairman who is not immersed in the world of Belgian euthanasia politics would be in a better position to identify abuses and refer doctors who fail to comply with the law to the public prosecutor.

Michael Cook is editor of MercatorNet

Key Messages: Palliative Care and Medical Assistance in Dying (MAiD) May 2019

The following was recently published by the Canadian Society of Palliative Care Physicians. 

The CSPCP supports conscience rights for physicians, they believe that (MAiD) euthanasia should not be the responsibility of individual physicians and they view (MAiD) euthanasia as separate from palliative care. The statement follows:

Key Messages: 
Palliative Care and Medical Assistance in Dying (MAiD) May 2019


In June 2016, the Federal Government enacted Bill C-14 legalizing assisted death under certain circumstances and adopted the term ‘Medical Assistance in Dying’. ‘Medical Assistance in Dying’ (MAiD) includes both euthanasia and assisted suicide, whereby under Canadian law eligible patients may have their lives intentionally ended through either the direct administration, typically injection (euthanasia), or self-ingestion (assisted suicide) of a lethal dose of drugs prescribed by a physician or nurse practitioner. The vast majority of MAiD procedures in Canada are provided through euthanasia. The term ‘Medical Assistance in Dying’ continues to cause confusion with respect to the role of palliative care. Palliative care provides medical assistance/aid in dying every day to patients and their families, to help them live as fully as possible until their natural death. The goal of this Key Messages document is to help clarify and define the role of palliative care within the Canadian context of legalized euthanasia and assisted suicide, these latter practices hereafter referred to as “MAiD”. 

Key Messages 
1. Patients with life threatening conditions have a right to high quality palliative care regardless of their end of life choices, including MAiD. 
2. Provision of MAiD is a practice distinct from palliative care. 
3. Palliative care strives to reduce suffering, not to intentionally end life. 
4. Requests for MAiD may be indications of suffering that could be ameliorated by high quality palliative care. No patient should choose MAiD because of lack of access to palliative care. 
5. The Canadian public must be able to continue to trust that the principles of palliative care remain focused on effective symptom management and psychological, social, and spiritual interventions to help people live as well as they can until their natural death. 
6. Physicians who do not wish to participate directly or indirectly in MAiD should have their integrity and fundamental freedoms, including freedom of conscience, protected. 
7. MAiD needs to be a healthcare system responsibility, rather than the responsibility of individual practitioners, with a separate and parallel system to provide awareness, information, counselling and linkages to the appropriate service(s) that can be directly accessed by patient, families, non-medical health care professionals and institutions without the requirement for a referral. (e.g. Alberta system). 
8. Given the nature and role of the physician-patient relationship, a mandatory non-patient initiated ‘duty to inform’ all those with serious illness about a right to access MAiD as an end of life option could exert undue pressure or cause subtle/overt coercion of patients. Clinicians should only be required to inform a patient that MAiD is a legal option in Canada if a patient makes an inquiry or request. 
Role of Palliative Care 

As a specialty, we see our contribution when patients with a life-threatening illness express a desire to die as the following: 
1. To explore the nature of a patient’s suffering and to address it through effective symptom management and psychological, social and spiritual support. 
2. To provide education and support to colleagues regarding the role of palliative care to help patients live as fully as possible until their natural death. 
3. To advocate for a high quality, accessible palliative approach to care with access to specialist palliative care services when needed for more complex cases. 
4. To prioritize and advocate for harm reduction, including: 
a. Potential harm to patients who choose MAiD because of inadequate support, including palliative care;  
b. Potential harm to any other person who may be negatively impacted, including those physicians that object to participating directly or indirectly in actions involving MAiD based on medical, moral or religious principles;  
c. Potential harm to the specialty of palliative care. 
The CSPCP strongly advocates for universal access to high quality palliative care to address the suffering experienced by patients with life-threatening illness and their families.

Friday, May 17, 2019

Petition supporting Bill C-418 to protect conscience rights for medical professionals.

Link to sign the Enlish language petition. 
Link to sign the French language petition.
Petition to the Government of Canada

  • The fundamental freedoms of conscience and religion are guaranteed to all Canadians in the Charter of Rights and Freedoms;
  • Bill C-14 (Medical Assistance in Dying) prohibits the compelling of health care providers or institutions to provide medical assistance in dying, to refer or transfer a patient to another health care provider, or to take other actions which could impact on health care providers’ freedom of conscience or religion;
  • Bill C-14 lacks clarity for effective enforcement;
  • Bill C-418 aims to protect the fundamental freedom of conscience guaranteed to all Canadians; and
  • Bill C-418 makes it an offence to intimidate a health care professional for the purpose of compelling them to take part, directly or indirectly, in the provision of euthanasia and assisted suicide. Bill C-418 also makes it an offence to dismiss from employment or to refuse to employ a health care professional for the reason only that they refuse to take part, directly or indirectly, in the provision of medical assistance in dying.

We, the undersigned, residents of Canada, call upon the Government of Canada to ensure that the conscience rights of medical personnel are protected, by passing Bill C-418.

Link to sign the Enlish language petition.

Canada euthanasia - The numbers game.

This article was published by Paul Schratz on his blog on May 17, 2019.

By Paul Schratz
I’m indebted to Alex Schadenberg at Canada’s Euthanasia Prevention Coalition for this week’s column, since he not only did all the research but a fair chunk of the number crunching.

You may or may not know that it’s been frustratingly difficult to obtain information on euthanasia and assisted suicide since Canada legalized “medical assistance in dying” in June 2016. Trying to find out how many people are euthanized or “assisted” in dying is like trying to estimate how many traffic jams take place each day in Vancouver. It’s not at the top of anyone’s list of things to do.

News organizations have no interest in knowing how many Canadians are dying by assisted suicide. I wrote in March that the most recent data we had was from 2017 and it was still unclear how many people were legally killed in 2018.

So slow was the federal government in releasing data that the Euthanasia Prevention Coalition requested “Medical Aid in Dying” data from every province. Most of them refused to provide it.

So the EPC did its own investigative research. Based on a presentation for the Royal Society of Canada by Jocelyn Downie, an academic euthanasia activist, the EPC reported 4,235 “Medical Aid in Dying” euthanasia deaths in 2018, an increase of 50 per cent over 2017 and representing approximately 1.5 per cent of all deaths in Canada.

Schadenberg also examined data from Ontario and Alberta indicating a 78 per cent increase in Ontario euthanasia deaths and a 50 per cent increase in Alberta.

Finally, at the end of April, Health Canada released the Fourth Interim Report on Medical Assistance in Dying, which stated there were 2,614 assisted deaths in 2018.

Unfortunately, the data was short by two months (it only reported up to Oct. 31, 2018) and didn’t include four jurisdictions (Quebec and the three territories.) Based on that limited information, the report drew the conclusion that assisted deaths represented 1.12 per cent of all deaths in Canada.

Now it turns out Health Canada not only gave us inaccurate numbers, its analysis of them was wrong.

The Canadian data came under scrutiny by Richard Egan, a researcher with Australian Care Alliance, who said the report’s calculation of the percentage of deaths by euthanasia as 1.12 per cent was wrong and should have been quite a bit higher.

Egan explains: Health Canada used data for the total number of deaths in Canada, but only counted assisted suicide deaths in the jurisdictions it had data on … which excluded Quebec and the territories. An accurate percentage of deaths by euthanasia based only on reporting provinces is actually 1.47 per cent. That may not seem like much of a difference, but it’s a 30-per-cent error rate and represents hundreds of more dead people.

That figure also more closely matches the data reported by Jocelyn Downie, whose numbers put the euthanasia rate at 1.5 per cent.

Egan published further research on the data in an article published by Australian Care Alliance.

Among the provinces, euthanasia deaths as a percentage of all deaths varies widely, with British Columbia at 2.37 per cent of all deaths and as high as 3.6 per cent on Vancouver Island. That’s nearly three times as deadly as Saskatchewan (0.84 per cent of all deaths). But “Health Canada does not appear overly concerned about the quality of the Medical Aid in Dying report,” says Schadenberg.

And when some of its data is so wrong and outdated, how can we trust government to get its response – comprehensive palliative care – correct?

Thursday, May 16, 2019

Jacqui Dean: Why I oppose euthanasia.

I was reading through my google news and came across this article by Jacqui Dean, a Member of Parliament in New Zealand titled: Heartfelt Testimonies Strengthened My Resolve, published by the Otago Daily Times. 

This article effectively explains why Dean opposes euthanasia.
Jacqui Dean MP
MPs will again vote on David Seymour’s End of Life Choice Bill when it comes back before Parliament later this month. Waitaki MP Jacqui Dean outlines why she will vote against it.

I have decided to vote against the End of Life Choice Bill before Parliament.

I have lost family and friends over the years, I have listened to others, met those involved in palliative care and talked with those suffering a terminal illness.

In 2016, I sat on Parliament's Health Select Committee, which launched an inquiry in response to a petition calling for a law change to permit medically assisted dying in the event of terminal illness.

Over 20,000 submissions were made at that time, with analysis showing 77% were opposed to changing the law. While that inquiry won't influence this latest Bill, it did give me an insight into this sensitive issue.

I am opposed to euthanasia, with my resolve only strengthened after sitting on that committee and hearing the heartfelt testimony of hundreds of people who bravely faced death and the families who lost loved ones.

I heard some wonderful stories of love and tenderness, sad stories of heartbreak and loss, stories of great courage and inner strength, and through it all I had the utmost admiration for those who came before us to share their deepest fears and their greatest joys.

The Samoan grandmother who talked of the death of her father - a beautiful and moving family experience which she told us was gentle and loving and filled with prayer.

The woman whose husband was diagnosed with a brain tumour at 28, but who outlived three fatal prognoses and didn't actually pass away for fourteen years.

This woman pointed out that no-one can predict the final outcome of a terminal illness, and she and her daughter were grateful that they never gave up and that the family got to share those extra years together.

And the blind man who had fought against adversity all of his life and wanted to encourage people to live in hope and not give in to despair.

There were stories of courage and strength, which reflected the best of the human spirit.

Stories from those who made it their life's work to support the dying through palliative care, and submissions from groups motivated by strong beliefs around death and dying.

We also heard from those approaching the end of their lives.

This included a man, in his 40s who was dying of prostate cancer, who spoke with anger about his life being robbed. And others who said they feared death and wanted to take the pain away as quickly as possible when their time came.

There's no doubt decisions made at the end of life are emotionally charged, highly personal and reflect circumstances and timing that vary from individual to individual.

The care that people get at this time can make a fundamental difference to people's experiences.

For that reason, I support the power of good that hospice and palliative care services provide.

Dedicated and diligent guidance from these providers can assist terminally ill people to die peacefully and with dignity.

They believe that if people can come to a place where they can accept their end of life, it can have a huge impact on them and a lasting positive effect on their families.

I was deeply affected by the impassioned testimony the committee also heard from groups representing the disabled, elderly and the mentally ill.

Many of these people genuinely fear for the future if they become a physical or a financial burden on their families. They also questioned whether there could be circumstances where they may be manipulated or pressured into ending their lives.

This worries me deeply. If we legislate for the right to die, the negative impact on vulnerable groups will be huge.

In my heart I simply cannot accept that a law can be developed which will completely protect the vulnerable.

One of the most moving moments of the select committee process came when we heard from a Wellington man who said in the past he had been suicidal.

He recognised the grave consequences if euthanasia was made legal in this country. The option of taking one's life would become much more normalised and he believed vulnerable people might make a decision that could never be reversed.

Our suicide rates are already too high - we don't need death by choice as another signal that ending one's life is OK. I am mindful that there are many differing views around legalising euthanasia and I acknowledge that my voice is just one of many.

As politicians we are now faced with a difficult choice around this issue, but it is one that we do not make without the greatest thought and consideration.

Wednesday, May 15, 2019

Ontario Court of Appeal upholds lower court decision forcing doctors to refer patients to their death.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Ontario Court of Appeal in its decision concerning physicians conscience rights in Ontario, upheld the lower court decision. 

The Court found that physicians who challenged the College of Physicians and Surgeons of Ontario (CPSO) policy requiring physicians to make an "effective referral" for Medical Aid in Dying (euthanasia and assisted suicide) and other morally contentious issues, that their Charter rights were infringed by the policy, but the infringement is reasonable in a free and democratic society.

Link to Court of Appeal decision.

The CPSO policy is different than other jurisdictions since the policy requires an "effective referral" which means that a physician must refer patients to a physician who is willing to carry-out the act. In the case of euthanasia it means that a physician who opposes killing his/her patients must send his/her patients to a physician who will kill.

The CPSO defined effective referral this way:

Where a physician declines to provide medical assistance in dying for reasons of conscience or religion, the physician must not abandon the patient. An effective referral means a referral made in good faith, to a non-objecting, available, and accessible physician or nurse practitioner or agency.
There are some interesting comments in the Court of Appeal decision. Paragraph 16 emphasizes that the CPSO referral is a policy and not a standard, code or guideline. The Court of Appeal focuses on how the referral policy will not lead to professional misconduct for non-compliance possibly to encourage the CPSO and the objecting physicians to find a negotiated outcome.

Paragraphs 183 to 187 emphasize that a physician can retrain or change their specialty. I consider this to be paternalistic, at best, especially the concept that if I oppose killing patients I can be a foot doctor or have a specialty in athletic training.

The key problem with this decision is it negates the reality that an effective referral does force physicians, who oppose killing, to participate in the act. The court suggests that the decision "strikes a reasonable balance between patients' interests and physicians' Charter protected religious freedom" but in fact it is not a reasonable limit prescribed by law in a free and democratic society.

The objecting physicians only asked that they not be required to directly refer their patients and that Ontario bring-forth a policy similar to Alberta that enables physicians to inform patients that Medical Aid in Dying can be accessed through a government toll free number.

What is also missing in the decision is the fact that many patients seek a physician who will not kill them. We have the right to seek medical assistance from a physician who shares our beliefs. Why should people who believe in killing be the only healthcare consumers who have "rights" in the medical system?

I think another error in the decision is the assumption that MAiD (euthanasia and assisted suicide) are healthcare. 

In fact, the federal legislation legalized MAiD by defining it as an exception in the criminal code.

The defeat at the Ontario Court of Appeal is concerning, especially considering who is sitting on the Supreme Court of Canada, if an appeal is sought.

The physicians and organizations involved in the case need to fully examine the decision and possibly consider alternative solutions to this problem, such as, convincing Provincial governments to protect conscience rights, such as the  Manitoba legislation or helping to elect a federal government that will protect conscience rights through federal legislation, such as David Anderson's Bill C 418. 

Wesley Smith: Medical Conscience for me but not you.

This article was published by Wesley Smith on May 14, 2019

Wesley Smith
By Wesley J Smith

The New York Times has published an opinion column by cardiologist Sandeep Jauhar that decries the Trump administration’s increased enforcement of medical conscience. But he actually promotes a one-way conscience right that favors protecting the predominate ideological views of the medical intelligentsia, while forcing dissenters to sacrifice their own religious and moral beliefs.

First, he endorses “futile care,” the bioethics authoritarianism that allows doctors to refuse wanted life-sustaining treatment based on the doctor’s values. From, “Can Doctors Refuse to Treat a Patient?”
A consensus exists among legal and bioethics experts that doctors can refuse to provide treatment in certain situations. For example, courts have ruled that doctors may refuse to treat violent or intransigent patients as long as they give proper notice so that those patients can find alternative care. Forcing doctors to treat such patients, courts have said, would violate the 13th Amendment’s prohibition on involuntary servitude…. 
Doctors may also refuse to provide treatment if it conflicts with good medical practice. Physicians in intensive-care units, for example, routinely limit treatment they believe will provide no benefit, especially in cases of terminal illness.
Did you see the sleight of hand there? The doctor may think that living longer provides “no benefit” and limit treatment even though the patient/surrogate/family does. That’s not a medical decision, it is a value judgment.

So in a situation of life and death — Jauhar believes the doctors values should trump those of the patient — presumably, even if stated by a competent patient or instructed in an advance directive. But when it comes to elective interventions identified by the Trump rule — such as abortion, assisted suicide, and transgender interventions — Jauhar is all “patient rights!”:
Doctors have an obligation to adhere to the norms of their profession. In my view, as long as treatments are safe and approved by medical organizations, doctors should have limited leeway in refusing to provide them. Patients’ needs should come first. At the very least, patients whose medical needs violate a doctor’s deeply considered beliefs should receive a timely referral to an alternative provider.
So a pediatrician who believes circumcision is child abuse — as some do — should be forced to remove his patient’s foreskin because it is approved by the American Academy of Pediatrics (AAP)? No! That is an elective procedure. The parents can find another doctor on their own.

Jauhar’s advocacy would also force a doctor who believes it is wrong — and indeed, harmful — to inhibit the normal onset of puberty in a child diagnosed with gender dysphoria, to do it, procure a willing doctor, or face litigation or professional discipline. After all, puberty blockers are now considered a norm for treating transgender pre-adolescents by the AAP.

And what if the vaunted “norms of the profession” should one day approve the amputation of a healthy limb, blinding, or severing the spinal cord (as the case may be) as a “treatment” for “body identity integrity disorder”— in which the “transable” patient identifies as a disabled person — as is sometimes now advocated in bioethics? Should a doctor be forced to mutilate a patient too?

Or what if organ harvesting as a form of euthanasia became acceptable, as has been pushed in some prominent medical and bioethics journals? Should transplant surgeons then be force to kill by procuring organs?

Jauhar throws down the gauntlet that would force pro-life and traditional Hippocratic Oath believing MDs out of the profession–as it dissuaded talented students from entering the medical professions if they disagree with the current ideological trends in medicine:
And to avoid such conflicts, medical students who foresee problems of conscience should steer clear of certain fields, such as obstetrics-gynecology, when making career choices. Broad conscientious objection of the sort the Trump administration is defending could lead to chaos in health care.
No. The more elective the desired intervention, the greater should be the right of medical conscience. In a society as morally polyglot as ours, such comity is the only chance we have of remaining cohesive.

Let me put it this way: I only want to be treated by a doctor who would never be willing to kill me or assist my suicide. If Jauhar and his authoritarian ideological school of bioethics prevail, one dark day I might be unable to find such a traditional Hippocratic Oath-believing physician because such doctors would be persona non grata in specialties that treat serious conditions. How frightening would that be?

Tuesday, May 14, 2019

The assisted suicide lobby opposes Oregon bill expanding the law to euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Oregon Senate
The Oregon legislature is currently debating assisted suicide bill Bill HB 2217 to expand the assisted suicide law and permit euthanasia (homicide) by redefining the term "self administer" to allow patients to take the lethal drugs into their body using any method, including an IV tube or injection. The bill states:

“Self-administer” means a qualified patient’s physical act of ingesting or delivering by another method medication to end his or her life in a humane and dignified manner.
The assisted suicide lobby, which supports euthanasia, recently came out against HB 2217 because of the complications related to IV tubes. Compassion and Choices stated in their letter to the Oregon Senate Judiciary Committee regarding HB 2217:
Allowing patients to self administer an IV is very different than allowing them to self administer medication through a feeding tube or a macy catheter. I can’t imagine that we want to risk botched deaths because we have allowed a law that would have patients administering medications through equipement they have no training to use. This is a risky proposition. The law, as written, does not protect patients from those risks. 
...Given this, we strongly oppose advancing this bill and ask the lawmakers in Oregon to please give sufficient time to draft legislation that achieves the goal of supporting patients in realizing a compassionate death.
* Oregon doctor speaks out about depressed patient who died by assisted suicide.

An article by Elizabeth Hayes published in the Oregon Business Journal on May 10, outlines how Dr Charles Blanke, an Oregon doctor who actively participates in assisted suicide plans to implement the new regulations under HB 2217. The article states:
Blanke is vetting the regimen with a team of anesthesiologists and pharmacists. He contemplates a multi-channel infusion pump that the patient would turn on by hitting a button with their hand, elbow or wrist. The drugs would be liquid, not gas.
Bioethicist, Richard Doerflinger challenged HB 2217 in his testimony to the Oregon Senate titled: Oregon HB 2217 greases the slippery slope from assisted suicide to euthanasia.

I reported in January that Kim Callinan, the CEO of Compassion and Choices, stated:

If lawmakers want to improve medical aid in dying laws, then let’s address the real problem: There are too many regulatory roadblocks already!  
Actually, the problem with assisted suicide and euthanasia laws are that they give death enthusiasts the right to kill you.

Medicating people without consent or against their expressed wish is illegal.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition regularly receives stories from family members or friends concerning medical decisions.

Yesterday I was sent a story from a grieving son whose mother died a few days after she was given medication that she had specifically refused. 

The issue of consent can be difficult. A person, while competent, will usually be respected when they refuse medication or treatments, but when a person becomes incompetent, their previous expressed wishes are sometimes ignored.This is not the first story I have been sent from a family member or friend concerning medical treatment or medication administered against a persons known wishes.

There were two questions from the caring son.
1. Did the drugs, that she clearly did not want, cause her death?
2. Was giving his mother these drugs illegal?
The first question is hard to answer. It is hard to know whether or not the medications led to his mother's death.

Do not use my comments as legal advice, but to answer the second question - in general it is illegal to administer drugs against someone's consent and if there is clear knowledge of a person refusing certain medications or treatments, while competent, then when incompetent that persons wishes should be respected by medical care-givers, institutions and persons who have the legal right to make medical decisions for that person.

In emergency situations medications will often be administered without consent, if consent is not possible. Another problem occurs when someone is incompetent, and the person they have appointed to make medical decisions has consented to the treatment.

It is very important to have a document, such as the Life-Protecting Power of Attorney for Personal Care (Link to order) that can be purchased from the Euthanasia Prevention Coalition and to appoint a medical decision maker who understands your wishes and shares your values.

Monday, May 13, 2019

America moves to protect Conscience rights for healthcare professionals.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Trump administration announced recently an order to protect conscience rights for healthcare workers in America. According to CNBC:
In a release last week, the Health and Human Services announced the issuance of its final “conscience” rule, which it said follows President Donald Trump’s May 2017 executive order and his pledge “to promote and protect the fundamental and unalienable rights of conscience and religious liberty.”
According to CNBC critics of the Trump conscience rights provision claim that it will lead to more discrimination. The city of San Fransisco has gone as far as filing a lawsuit claiming that conscience rights, as outlined by President Trump, are unconstitional.

Roger Severino, with the HHS Office of Civil Rights responded to the critics by stating to CNBC:
“The rule provides enforcement tools to federal conscience protections that have been on the books for decades,”

“The rule does not create new substantive rights.”

“We have not seen the hypotheticals that some have used to criticize the rule actually develop in real life. Faith-based providers just like all providers should be allowed to serve those most in need without fear of being pushed out of the health care system because of their beliefs, including declining to participate in the taking of human life.”
In March, a bill was introduced to legalize assisted suicide in Minnesota that requires physicians to refer for assisted suicide. Physicians who oppose assisted suicide should never be forced to refer.

Last Wednesday, I had the opportunity to speak at a parliamentary gathering in Ottawa on David Anderson's Conscience rights legislation (Bill C-418). Other than Manitoba, in Canada physicians conscience rights are not being respected.

Conscience rights are fundamental human rights that enable medical professionals to work as equal citizens while protecting the rights of patients who seek a physician who shares their values.

Nine Elderly Couples Were Euthanized in the Netherlands

This article was published by Wesley Smith on May 8, 2019.

Wesley Smith
By Wesley Smith

Joint suicides by elderly couples used to be considered a tragedy. In the Netherlands, doctors killing elderly couples together is a considered medical treatment (Belgium too, and at least once in Canada).
Last year there were nine such killings. Details were not available on most, but one involved a husband dying of cancer. His wife had MS. She asked to die with him because she would be unable to live independently and didn’t want to be cared for by strangers.

The Dutch believe that transparency is more important than right and wrong. So, they allow a continually expanding euthanasia license — but are careful to make sure they report later on what death doctors are doing. Hence, the government publishes a yearly, coldly statistical report about how many of their citizens were killed by doctors and why.

The 2018 numbers are alarming:
  • 6,126 deaths caused by euthanasia or assisted suicide — down 7 percent from last year’s toll — but when you consider other forms of patient eradication, such as terminal sedation (putting in a coma until the patient dehydrates to death), about 25 percent of deaths in the Netherlands are “induced.”
  • 67 patients were killed by psychiatrists and other doctors for mental illness. (The statistics don’t reveal how many of these were harvested for their organs afterward, an ongoing feature of Dutch euthanasia killings when the patient has “good” organs.)
  • Three children between the ages of 12 and 17 were put down.
  • There were 205 cases of homicide by doctors as a supposed treatment for two or more “elderly disorders,”i.e. issues such as hearing loss, balance issues, cognitive decline, etc.
Once euthanasia consciousness grabs a culture by the throat, it never stops squeezing.

Tuesday, May 7, 2019

UN Committee prevents disabled man from being dehydrated to death in France.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Vincent Lambert's mother has been fighting for his life.
The United Nations committee on disability rights is intervening in the Vincent Lambert case in France. 

Lambert was cognitively disabled in a motorcycle accident injury in 2008. In 2015, his wife petitioned the court to have all treatment and care ceased including food and water. His parents urged that their son be transferred to a rehabilitation center. The legal battle concerning withdrawing fluids and food from Lambert has continued. 

According to, the French government responded to the UN disability rights committee by suspending any decision to withdraw fluids and food from Lambert. France's Health Minister, Agnes Buzyn stated:
...that although France would answer the committee, it was not under any legal requirement to abide by its request

"We are not legally bound by this committee, but of course we will take into account what the UN says, and we will respond," she told BFMTV on Sunday.
Vincent Lambert is a man with disabilities, who is not dying or nearing death. To intentionally kill a person by withdrawing fluids, when the person is not otherwise dying is euthanasia by dehydration since the person is directly and intentionally dies of thirst.

Recently a UN disability rights envoy urged Canada to amend its euthanasia law to ensure protections for people with disabilities from euthanasia.

Link to previous Vincent Lambert case articles.

Euthanasia drops by 7% in the Netherlands in 2018.

By Richard Egan, researcher with the Australian Care Alliance  

The latest annual report on euthanasia and assisted suicide from the Netherlands shows that in 2018 the number of reported deaths by euthanasia decreased – for the first time since legalisation - to 6126 (a 7% decrease from 6585 cases in 2017).

Dutch deaths by euthanasia for 2018 include nine couples euthanased together; two persons with advanced dementia based on an advanced request; 205 elderly people with two or more problems of old age; 67 people with mental illness, including 10 aged between 18 and 40 years; and three children aged between 12 and 17.
This represents 4% of all deaths in the Netherlands in 2018.

This data relates only to officially reported cases of euthanasia and assisted suicide. A more comprehensive picture is provided by the five yearly surveys by Statistics Netherlands on all deaths by “medical end-of-life decision”. The latest data reports on all deaths in the Netherlands in 2015.

In that year there were 7254 deaths caused intentionally by lethal medication – 6672 deaths by euthanasia with a request; 431 deaths by euthanasia with no explicit request; and 150 deaths by assisted suicide.

This represents nearly 1 in 20 (4.93%) of all deaths in the Netherlands.

More than 1 in 10 (10.5%) of all deaths (other than sudden and expected deaths) of 17-65 year olds in the Netherlands in 2015 were caused intentionally by euthanasia or assisted suicide.

For assisted suicide in the Netherlands the doctor is required to be present until death occurs. Attempts at assisted suicide regularly fail to bring about death in the desired timeframe. In these cases, under the Netherlands protocols, the doctor then administers euthanasia drugs. This occurred in between 7% and 13% of cases of assisted suicide in the years 2014 to 2018.

There were 67 cases in 2018 of euthanasia for psychiatric conditions, ten of these cases involved persons aged between 18 and 40 years.

There were 205 cases of euthanasia in 2018 for “a stack of old age disorders” such as vision, hearing disorders, osteoporosis, osteoarthritis, balance problems and cognitive decline. Of these cases 66 involved persons under 90 years of age. The remaining 139 cases accounted for 27.15% of all cases of euthanasia of persons aged 90 years or more.

A further three minors were euthanased bringing the total to fifteen children aged between 12 and 17 years euthanased between 2005 and 2018.

In 2018 nine couples were euthanased together. Case reports are available for one of these couples. The husband had oesophageal cancer. The wife had multiple sclerosis. Her reason for requesting euthanasia at the same time as her husband was “the prospect of having to be cared for entirely by strangers and unable to continue living independently”. While the case reports note that “In the event that partners make a request for euthanasia at the same time, it must be established that the request of one partner has not been influenced or has been prompted by that of the other partner” there is no discussion in the case report on the wife of any efforts being made to explore her fears of being cared for by others.

For a detailed report on seventeen years of legalised euthanasia in the Netherlands read here.