Denmark's Ethics Council rejects legalising euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Denmark's parliament

The Local news Denmark reported on October 4, 2023 that Denmark's Ethics Council advised the Denmark parliament not to legalise euthanasia. The local reported that:

An overwhelming majority of the Danish Council on Ethics have advised the country's parliament against voting to legalise euthanasia.

Fully sixteen out seventeen members of the committee concluded in a report that it was "in principle impossible to establish proper regulation of euthanasia", and as a result recommended that the law in Denmark should not be changed to allow people suffering mental or physical distress to receive help to end their own lives.

The ethics council wrote in the full report that:

"The very existence of an offer of euthanasia will decisively change our ideas about old age, the coming of death, quality of life and what it means to take others into account,"

"If euthanasia becomes an option, there is too great a risk that it will become an expectation aimed at special groups in society."

The Local news reported that Denmark's Prime Minister Mette Frederiksen brought the issue onto the agenda in June when she said that she might be in favour of a law allowing some people to die by euthanasia.

Birgitte Arent Eiriksson was the only member of the Danish Council of Ethics to support euthanasia but she suggested that:

euthanasia should only be legalised if there was sufficiently strong regulation in place, and called for further debate on the circumstances in which it should be allowed and how the process should be regulated.

After the report was released, politicians from the three parties in Denmark commented. The Local reported:

"The prime minister has expressed her own position, and now we need to have a discussion of the whole issue as this is a subject with a lot of ethical dilemmas," Flemming Møller Mortensen, health spokesperson for the Social Democrats said, adding that he believed parliament should hold a free vote on the issue with no party lines.

Monika Rubin, health spokesperson for the Moderate Party, said that she wanted to broaden the discussion to also cover shortcomings in the way chronic pain is treated. "This is also about the health care system that we have today. And as it is right now, we need to get better at pain relief,” she said.

Sophie Løhde, Denmark's health minister, who comes from the Liberal Party, told Ritzau in a written comment that she hoped the debate would lead to a discussion in parliament on a "Danish model for a more dignified death"

Denmark needs to examine Canada's experience with euthanasia. The Danish Council of Ethics report re-enforces Canada's experience with euthanasia.

EPC Press Conference supporting Bill C-314.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Link to the press conference recording (Link)

Gordon Friesen (on the left)

On October 3, EPC held a press conference at the Parliamentary Press Gallery in Ottawa in support of Bill C-314, the private members bill that would prevent euthanasia (MAiD) for mental health issues in Canada.

The Hon. Ed Fast (Abbotsford) MP sponsored Bill C-314, the mental health protection act, which has its second hour of debate in parliament on Thursday October 5.

Gordon Friesen, who is President of the Euthanasia Prevention Coalition was the press conference (MC). Friesen explained why EPC supported Bill C-314 and he told the media that Québec has rejected euthanasia for mental illness.

Anike Morrison

The first speaker was Anike Morrison, who lives with a severe mental health condition. Anike explained that in 2014 she lost her brother and has never been the same since. In 2018 she fell into such a deep depression that she was hospitalized 5 times.

Anike told the media: 

if MAiD had been presented as an option to her at that time as a solution to her emotional pain and distress, that I may not be here today. It was a very rough time and it was only through the care of the psychiatrists, psychologists, pharmacists and social workers that she was able to get better and move through that time in her life.

Since then Anike has completed her undergraduate degree, she has travelled, gone on a mission trip and most importantly she loves her life. She now feels that she is on the "other" side of that dark period.

Anike spoke about all the suicide prevention measures that were put in place for her, measures that care for people at a vulnerable time. Anike then stated:

As Canadians we can't do both. We can't put our emphasis on preventing suicide while also presenting MAiD as an option.

Garifalia Milousis

The next speaker Garifalia (Lia) Milousis, told the media that she is a 27 year-old lawyer who has struggled with depression for more than 10 years. Lia explained that she worked to defeat Bill C-7, the bill that expanded Canada's euthanasia law in March 2021, but since the passing of Bill C-7, which permits euthanasia for mental illness, she has decided to tell her story.

Lia wrote a letter to every Member of Parliament and Senator that, as a person who lives with mental illness, that she is opposed to the expansion of euthanasia to include mental illness.

Lia's story began when she was 15 year-old when she "descended" into darkness. She described her depression as the world losing its colour. Her first experience with depression lasted for 6 months and it caused her to experience anorexia, bulimia, and self-harm.

Her depression returned again and again and she decided that she would have to live with her depression forever. She decided that facing the prospect of life-long mental health suffering, that death was her only solution. She attempted suicide seven times during her period of acute pain. Lia said"

If you had offered me Medical Assistance in Dying at that time I would have taken it because she genuinely believed that death was the only solution.

Lia explained that unless you have experienced mental illness you can't understand how patronizing it is to hear people distinguish between medical assistance in dying and suicidality.

The arguement is that those who are suicidal are irrational while those who want MAiD are rationally choosing to die. But if you had told me while I was suffering that I could have MAiD and escape the suffering, I would have taken it.

She said that"

Death was not something I pursued because it was what I wanted, it was something I pursued because I thought it was the last solution to the suffering I was experiencing.

Any differentiating between suicide and MAiD is non- sensical and we have almost recognized this by how we have expanded euthanasia (MAiD) to include individuals whose only underlying condition is a mental illness.

I have watched society debate this academically and I ask people to consider how it will impact individuals like me?

Dr Paul Saba (Center)

Dr Paul Saba, the final speaker, explained that 1 in 5 Canadians experience mental illness and less than half of those people seek treatment while approximately 4000 people die by suicide in Canada each year.

Dr Saba explained that half of the people seeking treatment first talk to their family doctor. The problem is that there is a shortage of family doctors, psychiatrists and psychologists. He explained that our health care and our social system is deficient for people with mental health problems. Dr Saba continued:

The average waiting time for mental health treatment in Québec is 5 months, and yet, our MAiD law, for those who are not terminally ill, has a 90 day waiting period, so many people won't even have a chance to receive treatment.

There is always a reason to live, but as care-givers we have to help our patients find a reason to live. No one actually wants to die by suicide. People just want to end their distress.

Dr Saba continued:

90% of people who suicide a suicide attempt and receive treatment don't want to die. Most psychiatrists don't support euthanasia for mental illness because of their concern for their vulnerable patients. It is also impossible to decide who'se condition is irremediable.

Mental illness does not meet the legal condition for free and informed consent for medical aid in dying. The more a person struggles with mental illness, the less likely they are to meet the criteria for free and informed consent.

By expanding medical aid in dying to the depressed they are finding a quick and easy solution to get rid of people with mental health disorders.

It is killing those who need to be cared for. We must become a society that cares for people with mental health problems rather than killing them.

Bill C-314 will protect people who are living with mental illness from medical assistance in dying (MAiD). The latest Angus Reid Institute survey that indicated that only 28% of Canadians support MAiD for mental illness while 82% of Canadians stated that mental health care should be improved before MAiD is considered.

Support Bill C-314. The Canadian Association for Suicide Prevention (CASP)

Bill C-314, the bill that would prevent euthanasia for mental illness, will have it's second hour of debate on Thursday, October 5.

Message from the Canadian Association for Suicide Prevention (Link)

If you agree that MAiD should not be applicable for persons suffering solely from mental illness, now is the time to make an impact and help us support Bill C-314.

Contact your local MP and ask them to vote Yes on Bill C-314. Below is a suggested template you can use to email or leave a voicemail for your MP. Find out your MP’s contact information by using the link below and entering your postal code.

Suggested template:

I support Bill C-314 and agree with Honorable Ed Fast and the Canadian Association for Suicide Prevention that MAiD (Medical Assistance in Dying) should not be applicable for persons suffering solely from mental illness. I am asking for you to vote YES allowing Bill C-314 to be referred to the parliamentary committee.

Press Release (Link).

Read Bill C-314 (Link).

Find your Member of Parliament (Link).

Letter from Hon Ed Fast (MP) (Link).

Media Release: Supporting Bill C-314 – the Mental Health Protection Act

Media Release: Supporting Bill C-314 – the mental health protection act.

Press Conference: Tuesday October 3, 2023 at 9:30 a.m.

Location: Parliamentary Press Gallery – Room 135B West Block

The Hon. Ed Fast (Abbotsford) MP and the Euthanasia Prevention Coalition are hosting a press conference in support of Bill C-314, the mental health protection act.

Bill C-314 will protect people who are living with mental illness from medical assistance in dying (MAiD). The latest Angus Reid Institute survey that indicated that only 28% of Canadians support MAiD for mental illness while 82% of Canadians stated that mental health care should be improved before MAiD is considered.

Anike Morrison and Garifalia Milousis will both be speaking about their personal experiences as people who have lived with serious mental health issues. They will speak about the importance of passing Bill C-314.

Dr Paul Saba will be speaking about his experience as a physician.

Bill C-314 is scheduled to have its second hour of debate on Thursday, October 5, 2023.

For more information, call Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition at 519-851-1434 (cell) or email alex@epcc.ca

Participation in the question and answer portion of this event is in person or via Zoom, and is for accredited members of the Press Gallery only. Media who are not members of the Press Gallery may contact pressres2@parl.gc.ca for temporary access.

Euthanasia Prevention Coalition
Box 25033 London, ON N6C 6A8 Canada
Cell 519-851-1434
Email alex@epcc.ca
Website www.epcc.ca

Anita Cameron: Don’t Be Fooled, Assisted Suicide IS Suicide

The following article was published by Not Dead Yet on September 25, 2023.

By Anita Cameron

Suicide is devastating. Take it from someone who has lost dear friends to it. It’s an especially difficult death for families to deal with. Loved ones often feel guilt, wondering was there anything they could have done to prevent it. I, too, felt that horror and guilt after learning that a close friend had died by suicide hours after visiting me. 

September is National Suicide Prevention Month. The Centers for Disease Control and Prevention reports that suicide is a serious public health issue whose rates have increased approximately 36% between 2000–2021. It reports that suicide was responsible for 48,183 deaths in 2021.

Many resources exist to inform the public about suicide – what it is, it’s impact on the country and on certain communities, the signs to watch for and how to prevent it – but no resource addresses the state sanctioned suicide masquerading as health care, that proponents call medical aid in dying, but opponents call by its true name: assisted suicide. 

Assisted suicide is a practice legal in 10 states and the District of Columbia, where a doctor, or in some states, a physician assistant, writes a prescription for a lethal drug that terminally ill patients – those with six months or less, to live – fill and subsequently take. No doctor or witness is required to be present, so no one would know if the medication was purposely taken or if the person was coerced or convinced to do so. 

Proponents say that this is not suicide, but the Oxford Dictionary of English lists the definition of suicide as “the action of killing oneself intentionally.” Proponents refuse to call assisted suicide what it actually is, probably due to the stigma associated with suicide. One can call it all kinds of fancy terms that hide the truth, but don’t be fooled – assisted suicide IS suicide.

Though assisted suicide is supposedly only for those who are terminally ill, it’s hard to predict that, so doctors often make mistakes. There are countless stories of people living years or even decades beyond their doctors’ predictions. 

Assisted suicide creates a two-tiered system where younger, healthier folks expressing thoughts of harming themselves are more likely to get mental health treatment whether they want it or not, while disabled people, who often lack access to such care, are more likely to have suicidal feelings rationalized, so are less likely to receive mental health treatment. 

This is especially important when someone is diagnosed with a terminal illness. It’s normal to become depressed after such a diagnosis. Mental health counseling, along with other services and supports should be offered from the beginning and tailored to meet the person’s changing needs. 

Proponents rename assisted suicide as “aid in dying” so it sounds like end of life care. However, it is not. End of life care is all of the services and supports, including pain management, that a person needs to be as comfortable as possible while the dying process takes place naturally. Assisted suicide is just that – suicide. Death. No care. 

It’s said that access to housing, healthcare, clean water and food security is suicide prevention. Getting rid of assisted suicide as public policy is also suicide prevention.

28% of Canadians support euthanasia for mental illness

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

New polling data from the non-profit Angus Reid Institute, in partnership with Cardus, published on September 28, 2023 indicated that:

Three-in-ten (28%) say they support allowing those whose sole condition is mental illness to seek MAID, while half are opposed (50%).

Four-in-five (82%) Canadians feel mental health care should be improved first before MAID eligibility is expanded to include those whose sole condition is a mental illness. That includes seven-in-ten (69%) of those who support this expansion of MAID eligibility.

The data revealed that:

a vast majority of Canadians are concerned with the mental health care resources available in the country (80%) and the state of Canadians’ mental health overall (81%).

According to the Angus Reid Institute poll:

Overall, one-in-five (19%) Canadians say they’ve looked for treatment for a mental health issue from a professional in the last 12 months. In that group, two-in-five say they’ve faced barriers to receive the treatment they wanted. These obstacles appear to be more of an issue for women (45% of those who sought treatment say it was difficult to receive) and young Canadian adults aged 18-34 (51%).

The poll found that 40% of the people who sought treatment for mental health in the last 12 months faced barriers to receiving treatment.

Considering the difficulties that Canadians experience accessing mental health treatment, the Angus Reid Institute asked participants about their support for MAiD (euthanasia) in general and if they support the expansion of MAiD to include the sole condition of mental illness. The poll indicated that:

Majorities of Canadians support the previous rules governing MAID, first passed in 2016 (64%) and then updated in 2021 (60%), but there is more hesitation when it comes to this next step. Three-in-ten (28%) say they support allowing those whose sole condition is mental illness to seek MAID, while half are opposed (50%).

Nationally, 28% of Canadians support allowing those whose sole condition is mental illness to die by MAiD but the data varies by province. The poll indicated:

There is much more opposition to the proposed expansion to include mental illness as an eligible sole condition for MAID. At most, one-third in B.C. (33%), Manitoba (35%) and Quebec (31%) say they support this change to MAID eligibility.

The lowest support for MAiD for mental illness alone was (21%) in Alberta.

Support for MAiD for mental illness alone also varied by political affiliation. (22%) of Conservatives voters, (31%) of Liberals voters, (37%) of NDP voters, and (28%) of Bloc voters supported euthanasia for mental illness alone.

The Hon Ed Fast sponsored private members Bill C-314 to prevent the implementation of euthanasia for mental illness alone in Canada. Bill C-314 will have it's second hour of debate in parliament on Thursday October 5, 2023.

Canadians clearly support Bill C-314.

The Angus Reid Institute is a national, not-for-profit, non-partisan public opinion research foundation. The Institute surveyed 1872 Canadians between September 19 - 22, 2023.

MAiD (euthanasia) a threat to Indigenous youth

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Meaghan Walker-Williams, a Cowichan Tribes Band member and former Gladue reports writer, has written "MAiD (euthanasia) is a threat to vulnerable indigenous youth" [National Post on September 27, 2023].

Walker-Williams' biological Indigenous mother died by suicide in 1975. She acknowledges the painful consequences of policies, over the years, that didn't respect or understand Indigenous cultures:

Another policy, blind to my culture, may soon join them: assisted suicide for mental illness.

Walker-Williams explains:

Today, suicide is a silent crisis unfolding within Indigenous communities, striking at the very heart of our future: our youth. According to Statistics Canada, the suicide rate for First Nations individuals is about three times the national average. The numbers for youth are even more heart-wrenching. First Nations individuals between ages 15 and 24 are six times more likely to die by suicide than those who are not Indigenous.

As First Nations fight these high suicide rates, Canada could expand its Medical Assistance in Dying (MAID) regime. Initially, MAID was legalized in 2016, but only where a person’s death was “reasonably foreseeable.” Efforts are now underway to grow its reach. In March of this year, those suffering from mental illness were supposed to become eligible for MAID, but this was delayed to 2024. In the meantime, Canada continues to discuss the implications of this expansion.

Walker-Williams continues:

It’s essential to emphasize that the Coast Salish and many Indigenous cultures hold life as sacred. The narrative that MAID could even be an implicit option for those in despair due to socio-economic challenges is not only alarming but against the very fabric of our beliefs.

In an environment where Indigenous youth suicide rates are already of grave concern, media and the state have a responsibility. The portrayal of suicide, or suggestions of it as a solution, must be abandoned when dealing with Indigenous youth — especially those in foster care, or those facing dire poverty or severe disability. Promoting discussions or policies that even indirectly mainstream this tragic choice could inadvertently amplify the crisis.

Indigenous Canadians oppose MAiD

Canada must prioritize understanding and respect for its First Nations, recognizing the unique challenges we face. Addressing the root causes of despair among our youth — from the scars of historical traumas to current socio-economic challenges — requires comprehensive solutions. Offering pathways to end life prematurely should not be among them.

To truly embody its ideals of compassion and respect for diversity, Canada needs to approach the issue of MAID with a deep consideration for its ripple effects, especially those that impact Indigenous communities. And as society reflects on this topic, it’s crucial that the narrative remains firmly rooted in upholding the sanctity of life — a cornerstone of Coast Salish teachings.

 

Previous articles concerning MAiD and Indigenous Canadians:

• Indigenous peoples should not be compelled to provide or facilitate MAiD (Link).
•  Letter to indigenous Senators: Bill C-7 will hurt our communities (Link).
  

Queensland Australia reports 245 deaths in the first 6 months of the euthanasia law

Euthanasia and assistance to suicide became legal in Queensland on 1 January 2023 under the Voluntary Assisted Dying Act 2021.

Numbers

A report on the first six months of legalisation states that there were 245 deaths under the Act - 139 deaths (56.73%) by “practitioner administration”, that is euthanasia and 106 by “self-administration”, that is assisted suicide.

245 deaths in six months represents about 1.29% of all deaths - higher than WA after one year and twice Victoria's rate after 4 years.

One relevant factor could be that the eligibility criteria in Queensland include prognosis that the condition is " expected to cause death within 12 months" whereas it is six months (except for neuro-degenerative conditions) in other Australian States.

Practitioners

Registered nurses are allowed to administer the prescribed lethal substance to cause a person’s death. 144 registered nurses have done the training (compared to 155 medical practitioners and 19 nurse practitioners) with 12 of these so far acting as the “administrating practitioner” (compared to 35 medical practitioners and 2 nurse practitioners).

Of the 108 practitioners so far involved in at least one case 23 have been involved in between 11 and 20 and 14 in more than 20 cases (that is on average at least one case every 8-9 days).

Prognosis

Unlike other United States and Australian jurisdictions which limit assisted suicide (and, in Australian jurisdictions, euthanasia) to those with a prognosis of 6 months or less to expected death, the Queensland law allows access to those with a prognosis of expected death within 12 months.

This increases the likelihood of wrongful deaths from errors in prognosis.

Refusing treatment and symptom management

The Queensland Government explicitly states that those seeking euthanasia or assistance to suicide may meet the eligibility criteria of a terminal illness that is causing suffering by refusing medical treatment and symptom management.

This makes it clear that this regime is about facilitating the intentional ending of life and not about relieving unavoidable suffering at the end of life. Under these provisions people with otherwise non-terminal conditions such as a young person with insulin dependent diabetes could be euthanased.

Timeframe

The law generally requires a nine-day period between a first and final request but this can be waived if two medical practitioners agree the person may die or lose decision-making capacity within that period.

The first six monthly report does not indicate how many cases involved waiving the nine-day period but did state that “the median time from first to final request was 17.5 days”.

In other jurisdictions with similar provisions this provision is frequently used to avoid any waiting period. For example, in Quebec in the period April 2021 to March 2022, 50% of people were euthanased less than 10 days after making a request. However, only 13% of people had a prognosis of less than 2 weeks to live.

Where a person is assessed as likely to imminently losing decision-making capacity there must be a real doubt as to the person ‘s current decision-making capacity so this provision increases the likelihood of wrongful deaths from lack of decision-making capacity.

Government facilitation of suicide and euthanasia

The Queensland Government has established Queensland Voluntary Assisted Dying Support Service which will only provide information and assistance on suicide and euthanasia and will not provide any assistance or information on “any other health concerns, including your underlying conditions”.

The QVAD-Support service will directly link a person seeking to end their life with a medical practitioner willing to help them do so.

Any registered health practitioner who has a conscientious objection to facilitating the suicide of or euthanasing his or her patients must if asked by any person for such assistance or information give the person either the details of QVAD-Support Service or of a registered health practitioner willing to facilitate the person’s death.

The Queensland voluntary assisted dying pharmacy is funded to supply the lethal poisons for suicide to individuals and for euthanasia to administering medical practitioners or nurses.

Reporting

Clause 8 of the Voluntary Assisted Dying Regulations 2022 requires the Voluntary Assisted dying Board to collect some minimal information that is then required to be published in an annual report to be provided by 30 September each year.

This includes basic demographic data (age, sex and region) of applicants and data on the underlying condition as well as the number of deaths from self-administration or practitioner administration of lethal poisons prescribed under the Act.

The time between first and final request is to be reported.

No data on referrals for additional assessments of eligibility or decision-making capacity is to be collected. Nor is there any provision for reporting on complications, the time between administration of the poison and loss of consciousness, or the time between administration of the poison and death.

Given the general complication rate of 7% or higher reported from other jurisdictions this is a concerning lack of transparency that undermines any future claim that there are no problems with the practice of assistance to suicide and euthanasia in Queensland. We will never know.

No safe space

The Act imposes on all hospitals, nursing homes and residential aged care facilities in Queensland the obligation to allow suicide and euthanasia by lethal poison on their premises for any permanent resident of the facility and for any other resident where a “deciding medical practitioner” determines transferring the person for this purpose is not “reasonable”.

This is a violation of the human rights of freedom of association, freedom of religion and freedom of conscience.

The sick and elderly should be able to choose to be treated or to live in a place where no-one is intentionally killed or helped to commit suicide.

Lethal substances at large

One of the obvious risks of prescribing and supplying lethal substances to be kept in the community is that the lethal substance may be ingested by a person other than the person for whom it is prescribed.

The Queensland coroner is reportedly investigating an incident, in which after a woman was prescribed lethal drugs under the Act but died in hospital before ingesting the drugs, her husband subsequently used the drugs to kill himself. 

Download  fact sheet here (Link).

More information on Queensland's euthanasia and assisted suicide experience.

• Man dies after taking wife's assisted suicide drugs (Link).
• Queensland euthanasia bill fails to protect from involuntary death (Link).

Euthanasia doctor suing hospital for not informing him of murder allegations

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

A euthanasia "provider," Dr Scott Anderson, has filed a $6.25-million lawsuit against the London Health Science Centre (LHSC) in Ontario because the hospital failed to inform him that he was under investigation for the possible murder of patients.

Even though the probe exonerated Anderson, he has filed a defamation lawsuit. Avis Favaro, CTV News medical correspondent, published her interview with Anderson on September 26 2023:

His concern is that the allegation might have been a suggestion he was performing medical assistance in death before it was legal. “The last thing you want as a MAID doctor is to have unsubstantiated allegations of murder. It is damaging to your career,” said Anderson.

Anderson says he has never seen the complaint and was assured it was investigated and deemed unfounded.

He discovered that despite that, someone at the London Health Sciences Centre ordered a second investigation. The hospital had assembled a team of investigators, some he now believes were his colleagues, who over seven months reviewed some 600 patient hospital deaths. Again, he was never informed until after the investigation was completed.

Even though Anderson was exonerated he believes that the probe itself, which did not include an interview with him, represents defamation since as a MAiD (euthanasia) doctor, these type of allegations may damage his career.

According to the CTV News article, a former nurse filed a complaint in March 2022 claiming that Anderson had caused the death of an elderly patient in 2014. Favaro reports:

The nurse originally made the complaint to the College of Physicians and Surgeons of Ontario (CPSO), the statement of claim says. However, the CPSO referred the matter back to the hospital since the college can only address complaints made by patients.

The Euthanasia Prevention Coalition is concerned that the allegation dating back to 2014 wasn't originally investigated. 

Anderson is known in London, Ontario as one of the few doctors who is willing to do MAiD (euthanasia). As he stated in a previous interview, most of the other doctors are only willing to provide assessments. 

Several physicians, who oppose euthanasia, have been investigated before a tribunal for statements they have made opposing euthanasia.

Previous news articles on this topic:

• Doctor's $6 million lawsuit alleges improper probe into end-of-life care (Link). 
•  Meet 1 of only 2 London doctors willing to help their patients die (Link).

Euthanasia: impossible to police once legal

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Professor Theo Boer

The Irish Law Society Gazette published an article on September 26, 2023 reporting on the presentation by Professor Theo Boer to the [Irish government] Oireachtas Committee on Assisted Dying.

Dr. Boer, who is from the Netherlands, supported the Netherlands euthanasia law in the past. However, after being a euthanasia case reviewer for 9 years (2005 - 2014) he has come to the conclusion that it is impossible to police the euthanasia law. 

Boer told the Committee:

Loneliness and meaningless are constituent reasons for asking for euthanasia.

Boer gave an example of how the law could not be upheld:

He cited a Dutch case where there was a question over the legitimacy of a signature requesting euthanasia, and from which an ethics committee had to step back, because it did not hold criminal investigatory powers.

“When the doctor was asked ‘are you sure that this signature is the signature of the patient’, the doctor said ‘I was told that it was’.

“So, in the end, we backed off,” Prof Boer said.

Boer commented on the "silent pressure" of euthanasia:

“Once you have a law … it is absolutely impossible to put a police officer in every hospital room or in every bedroom … and look [for] some silent pressure,”

“That is impossible, because that will infringe very much on the privacy of their patient-doctor relationship so there is no solution,”

'Assisted dying' and how it changes society:

‘Assisted dying’ is an umbrella term for two different things that reside under one law in the Netherlands – euthanasia by which the physician uses an infusion or injection to end a patient's life at their request, and secondly a physician-assisted suicide where a medic hands a patient a deadly poison to end their own life, he explained.

In 97 out of 100 assisted deaths in the Netherlands, up from 90 out of 100 in 2002, euthanasia is preferred over assisted suicide with the number strongly rising, he said.

Euthanasia has “sky-rocketed” in the Netherlands, he said.

“The legalisation of euthanasia has done much more than just providing some citizens the liberty to take a way out,” he said.

It has created death as a remedy against "unbearable suffering", he said, and moved society from the presumption of "not killing".

Boer's criticism of euthanasia is based on what he has seen happen: euthanasia has quadrupled in twenty years and in some regions of the Netherlands, 15% - 20% of the people are dying by euthanasia.

The numbers and reasons for euthanasia have expanded in the Netherlands:

“We see a shift to patients who fear years or decades of loneliness, alienation and care dependency,” he said.

In the Netherlands, as in other countries that have legalised assisted dying, this expansion is motivated by a “logic of justice”, he said.

The option of euthanasia expands from terminal cancer patients, to those with chronic illnesses, to anyone suffering from an illness, to non-medical suffering, to legalisation for anyone over the age of 75.

Parents can now request euthanasia for their young children he said. And teens over 16 may opt for euthanasia, simply by informing their parents, but without asking their consent.

The legalisation of euthanasia has altered the whole landscape of dying including the societal view of illness, suffering, ageing, and care dependency,

Psychiatric euthanasia, the grey areas in the law, and legalized euthanasia have not resulted in fewer violent suicides:

A Dutch voluntary society runs an end-of-life clinic that will perform euthanasia without any prior patient-doctor relationship, he said, particularly in psychiatric cases.

There is also a ‘grey zone’ sub section where physicians would describe their own actions as termination of life but do not report it, which accounts for 1500 cases yearly.

Societal pressure, because of positive media reporting about euthanasia, also drives the figures up, he said.

“It is what I call internalised pressure,” the academic said, because the existence of legalised euthanasia impacts those who don't want to feel they are a burden on family or society.

Legalised euthanasia has also not lowered violent suicide rates, which have in fact soared by 35%, he said, far higher than in neighbouring Germany which does not permit euthanasia.

Links to previous articles from Professor Theo Boer:

• Let's not romanticise the Dutch euthanasia experiment (Link).
• Be careful what you wish for when you legalize active killing (Link).
• Legalizing assisted dying can actually increase suicides (Link).
• Rushing toward death: Euthanasia in the Netherlands (Link).
• Dutch ethicist, "Assisted suicide: Don't go there" (Link).

PCHETA (Pa Cheetah) -- the bill with 9 lives

By Sara Buscher, Attorney, Past Chair, EPC USA 

They say a cat has 9 lives. The  "Pa Cheetah" certainly does. 

The first version of the Palliative Care and Hospice Education and Training Act (PCHETA) was introduced in 2004. It evolved into the current version in 2015. Come 2024 that will be 9 years. The Euthanasia Prevention Coalition USA has been opposing PCHETA since 2017. According to the HHS Office of Inspector General:

“Our reports and investigations have revealed several concerning issues, including poor—sometimes harmful—quality of care, fraud schemes that involve enrolling beneficiaries without their consent, inappropriate billing practices, limited transparency for patients and their families, a payment system that creates incentives to minimize services, and a rapid growth in the number of new hospices, often to take advantage of these conditions.”

We see the Bill rewarding those who nudge people into hospice (by way of palliative care programs) where they are subjected to abuse and, in some cases, euthanasia. One reason supporters keep trying to get this Bill passed, are its meaningless safeguards.

The Bill’s Safeguards are Illusions.

The current bill, S. 2243 has two safeguards in Section 5. Two years ago, Senator Baldwin the bill’s sponsor, got PCHETA language added to a House budget reconciliation bill without the Section 5 safeguards. The Senate Finance Committee refused to include PCHETA, so once again the Bill died. In mid-September 2023, Senator Baldwin announced she will try to get it included in a bipartisan bill that must pass, probably without safeguards. She said this as she withdrew S. 2243 from action by the Senate Health, Education, Labor and Pension (HELP) committee.

The Section 5 safeguards are unenforceable and pretty much meaningless.

Don’t talk about it, Section 5(a). Section 5(a) prohibits using the Bill’s funds to provide, promote, or provide training about any item or service subject to the Assisted Suicide Funding Restriction Act (ASFRA). Nothing prohibits federal funding of teaching about assisted suicide and euthanasia as long as the funding does not come from PCHETA. The ASFRA itself does not prohibit federal funding for speaking about assisted suicide and euthanasia, only the provision of items and services for that purpose. Nor, does it prohibit withholding or withdrawing medical care, nutrition or hydration. It also allows funding for relieving pain or discomfort with an increased risk of death, as long as death is not intended. Lastly, Compassion & Choices has a goal of repealing ASFRA.

Don’t do it, Section 5(b). This section says: 

“As used in … [PCHETA], palliative care and hospice shall not be furnished for the purpose of causing, or the purpose of assisting in causing, a patient’s death, for any reason.” 

Sounds good, doesn’t it? Here’s the problem. It only applies to PCHETA funds, nothing else; PCHETA only funds education, research and public information, not the furnishing of care. In other words, Section 5(b) does nothing.