Thursday, September 16, 2021

Doctors warn: One in ten wrongful assisted suicide deaths.

This article was published by the Australian Care Alliance on September 16, 2021

Professor Paul Glare
Thoracic physician, Dr Luke Garske and Professor Paul Glare, Specialist Physician, Pain medicine have warned that under Queensland's Voluntary Assisted Dying Bill 2021 an estimated 10 out of 100 Queenslanders who access assistance to suicide or euthanasia will end their lives based on a wrong belief that they have a terminal illness.

As euthanasia enthusiast, comedian Andrew Denton admits "there is no guarantee ever that doctors will be 100% right".

Dr Garske and Professor Glare explain:
The Queensland Bill simplistically assumes that doctors can accurately predict how long patients with severe life limiting disease will live. It requires two doctors to agree that a patient is expected to live for less than 12 months (compared to less than 6 months in four other states). It is known that doctors are very poor at accurately predicting whether you will live less than 12 months.

At least 10% of patients predicted to live less than 12 months would have still been living in three years.

If the Queensland bill is passed, we estimate that 10 out of 100 Queenslanders who choose assisted suicide will have done so based on the wrong belief that they had a terminal illness. In contrast, in the four other states, which offer assisted suicide when you are expected to live less than 6 months, we estimate that 1 out of 100 patients will have chosen to have an assisted suicide, based on the wrong belief that they had a terminal illness.
Is it acceptable for Queenslanders to have so many extra wrongful deaths, because of an arbitrary extension of an eligibility criterion that isn’t based on expert medical advice? Why is this extra 6 months even necessary, when the assessment process takes only 9 days, and we are supposedly doing this to prevent suffering at the end of life?
Dr Luke Garske
They also note that:
The Queensland bill does not require the doctor to have any expertise in predicting death, or expertise in identifying depression. And it is very loose in its requirements to assess decision making capacity. We should identify and treat depression to relieve the desire to suicide, rather than promoting your suicide if this is caused by mental illness.

The bill also assumes that an accurate diagnosis will always be made of an incurable disease, and doctors will never miss the diagnosis of a condition that could have been treated. Yet it allows doctors in training, without any knowledge of the condition you have, to make a diagnosis that they have not been trained to make, and certify you for [assisted suicide or euthanasia]. This compares to other states, which have the advantage of specialists with experience in the disease you have. People with curable diseases have been wrongly assisted to suicide in other jurisdictions, because of a wrong diagnosis. The inexperience of the Queensland doctors would cause more wrongful assisted suicides based on incorrect diagnoses of treatable diseases.
The two experienced physicians warn of the impossibility of always identifying coercion and elder abuse and the inevitability that some Queenslanders will die wrongful deaths after being coerced by others to "request" assistance to suicide or euthanasia.
Everald Compton is a longstanding campaigner for [euthanasia], who has stated that he “has faith” that this law won’t be abused. This is a fantasy land where no-one lies, cheats or steals; in the real world, this law will be abused. It is naïve to believe that doctors, family members and others will not sometimes pressure vulnerable patients to have an assisted suicide. Elder abuse is common and the Queensland Bill would create the perfect scenario for this.

The people charged with detecting coercion are time pressured doctors, who unlike judges and lawyers, have no expertise or skills to detect coercion. If a loved one pressured you to have an assisted suicide, or you felt such a burden that you felt obliged to choose it, would you tell your doctor, or would you “go quietly”? Based on our professional experience, we strongly disagree with the “faith” that Everald Compton has, that the Queensland bill has any realistic ability to prevent or detect abuses.

For example, Queensland doctors would be able to initiate the conversation about assisted suicide. In other states the patient must initiate the discussion. It is fanciful to believe that a doctor would not sometimes guide a patient to have assisted suicide because of their own prejudices or opinions. Many patients will trust their doctor and follow their advice, and these conversations will be occurring within private non-recorded medical consultations. The fact that this change has been allowed into the legislation underlines the lack of medical experience in guiding the supposed attempts to protect the vulnerable.
Dr Garske and Porfessor Glare call for the Parliament to reject the Bil, and instead to adequately fund palliative care for all Queenslander.
We know that in overseas jurisdictions where assisted suicide has been going for about 2 decades, there is an ongoing rapid growth of numbers, and a gradual extension of indications to less serious conditions. With all of the unsafe aspects of the Queensland legislation being proposed from the outset, how can we have any confidence in how many Queenslanders will have wrongful and coerced deaths in 10-20 years? The only reliable safeguard is to keep the current law, and reject the bill.

Let’s instead focus on properly resourced palliative care. Why is it good enough for Premier Palaszczuk to provide only a fraction of the funds required to provide all Queenslanders with access to quality palliative care - when billions can be found for the 2032 Olympics? Why doesn’t parliament just properly fund palliative care for all? This is the far more compassionate option, which in clinical reality will relieve suffering for many more people. Properly funded palliative care can terminate the suffering, which is far safer than terminating the sufferer.
More articles from the Australian Care Alliance (Link).

Wednesday, September 15, 2021

Euthanasia and organ donation in the Netherlands.

This article was published by Mercatornet on September 15, 2021

By Michael Cook

One inevitable development of euthanasia which its supporters seldom mention is organ donation after euthanasia. A good number of people who request euthanasia suffer from neurological disorders, but their organs are still shipshape.

A question which many doctors ask, then, is this: why should all those perfectly good kidneys and lungs and livers go to waste? Death by misadventure cannot be timetabled, but euthanasia can. Why not arrange things so that a person can die on an operating table where his organs can be transferred quickly to the recipient?

In fact, this is not a theoretical scenario. It happens, on a small scale, in the Netherlands, Belgium and Canada. However, it still is not a very popular option. It seems to have been performed only 70 times in the Netherlands. The problem is that most people prefer to be euthanised at home and by the time their body arrives at hospital, the organs are no longer usable.

Is there a way around this problem?

Several Dutch physicians and a bioethicist believe that there is. They recently published a paper in BMC Medical Ethics recording how they successfully managed to carry combine dying at home and organ donation (ODAEH). The man who was euthanised was a healthcare professional and the husband of one of the authors of the article.
“The patient was sitting in his lounge chair in the living room facing a beautiful outdoor environment,” they write, “with his wife, children, grandchildren and his dog surrounding him, while music was playing in the background.”
Logistically, the procedure is a bit tricky. The 63-year-old patient, who was suffering from multiple system atrophy, was sedated at home and then transported to a nearby hospital. There he was euthanised by his family doctor. The transplant specialists waited for the mandated 5 minutes and then extracted the organs. They were able to retrieve both kidneys, the liver and the pancreas.

Legally, the authors acknowledged that the procedure stretched the letter of the law. In the Netherlands, a patient must be suffering hopelessly and unbearably. However, after being sedated, he is no longer suffering. How could he possibly consent to euthanasia? However, everyone involved agreed that the procedure honoured the spirit of the law.

Ethically, the authors ticked off all of the Belmont principles of autonomy, beneficence, non-maleficence, and justice. “From a utilitarian perspective,” they say, “the decision to honour the last wishes of the patient produced the greatest good for many other patients.”

They concluded that: 
“From the patient’s perspective, falling asleep in the intimacy of his own home and with his loved ones present appears to be a good alternative to the medicalisation of organ donation after euthanasia in the hospital.”

“Organ donation after euthanasia,” they declare, “is a pure act of altruism.”
Does anyone sense anything unethical about this scenario?

The authors of the proposal are confident that a home setting for organ donation after euthanasia “maximally contributes to the patient’s autonomy”. But they ignore the enormous potential for emotional blackmail if this become common. The doctors would effectively be extorting those valuable organs in exchange for a pat on the head and a few heart-warming words about their generosity.

These potential donors often feel that their lives are useless; shouldn’t we try to argue them out of their demoralised state, rather than agree with them so that we can harvest heir organs?

But this is the manipulative psychology involved in this procedure. The authors conclude with this chilling gem of utilitarian wisdom: 
“Normalizing ODAEH could make it more attractive to patients who want to donate after euthanasia but do not want to die in hospital, thus providing more organs for transplantation. Given the prospective benefits, the marginal and relative extra costs of implementing this procedure are likely to be justified.”
What was that about a slippery slope?

Tuesday, September 14, 2021

Swiss assisted suicide group will continue to do foreign suicides.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A Swiss assisted suicide group has decided to continue providing assisted suicide for assisted suicide tourists. Exit, which is the largest assisted suicide group in Switzerland, was considering limiting assisted suicide to Swiss citizens but was pressured by its members to continue providing foreign suicides.

According to an article published on September 14, 2021 by Swissinfo:
EXIT’s board of directors had wanted to restrict the service to within the borders of Switzerland as it was becoming difficult to obtain the necessary documentation from abroad and to arrange journeys to Switzerland.

But earlier this year, Swiss media reported that the proposal was not being viewed favourably by members. For this reason, EXIT’s directors decided to drop the proposal.
Exit carried-out 913 assisted suicide's in 2020. Unlike the other assisted suicide groups, such as Dignitas, that focus on suicide tourism, only 1% of Exit's assisted suicide deaths were suicide tourists.

Care Not Killing disappointed at “divisive” BMA vote, which shows divide between doctors on assisted suicide and euthanasia

Dr Gordon Macdonald
Following today’s extremely close vote, 49% – 48% that sees the British Medical Association adopt a neutral stance on assisted suicide and euthanasia, Dr Gordon Macdonald, Chief Executive of Care Not Killing commented: 

“We are naturally disappointed at the divisive nature of this vote as it exposes the divide between doctors who care for patients at their end of life whether in hospitals or hospices, who oppose assisted suicide and euthanasia and those medics who work in unrelated discipline such as child and adolescent psychiatry and occupational health.

“As the BMA’s own survey found doctors at the coal face, who deliver care to the elderly and terminally ill, who work in Palliative Care, Geriatric Medicine and General Practice continue to oppose assisted suicide and euthanasia, because they know it is not needed and the subtle pressure it could put on patients to end their lives prematurely.

“The doctors’ group should have used this conference to find out why their members who are least likely to treat those with terminal and chronic conditions, such as medical students still training in universities are most likely to support assisted suicide and euthanasia. Is this simply a generational shift or a lack of understanding of the range of treatments available to palliative doctors?”

Dr Macdonald continued: 

“Was any consideration given to the concerns of those doctors who work with disabled people and elderly about the discriminatory message that singling out terminally ill and disabled people would send, the worrying link between legalising assisted suicide and euthanasia and increases in the suicide rate which we see in Oregon and the Netherlands or the erosion of so-called safeguards?

“We only have to look at Canada, which legalised so called ‘physician assisted dying” in 2015, to see what can happen. This law which was originally limited to those with a foreseeable death, came into force in the summer of 2016.

“In September 2019, the Quebec Superior Court struck down the requirement that a natural death must be ‘reasonably foreseeable’. This followed the case of Alan Nichols, a former school caretaker who was physically healthy, but struggled with depression. His life was ended by lethal injection in July. In the same year we saw the chilling case of Roger Foley, who was repeatedly offered the drugs to kill himself, while being denied the social care to live a dignified life, due to the cost.

“At the same time, deaths from lethal injection continue to rise. In 2020 7,595 had their lives ended this way, including 1412 who cited loneliness as a reason for opting to be killed, no doubt this was compounded by COVID.

“The rapid extension of Canadian law to those with chronic disease, mental health problems and disability shows the fallacy of trusting in proposed legal safeguards and how only safe system is the one we currently have – a complete prohibition on state sanctioned killing.”
Dr Macdonald concluded: 

“The BMA now finds itself out of step with medical organisations such as the World Medical Association (WMA) which has recently reiterated its opposition to euthanasia and physician-assisted suicide saying, ‘No physician should be forced to participate in euthanasia or assisted suicide, nor should any physician be obliged to make referral decisions to this end…’.

“Our current laws protect vulnerable people and do not need changing, instead we need to refocus our attention on how to ensure we provide the very best palliative care to those who need it.”
For media inquiries, please call 07970 162225.

ENDS

Editors Notes

Care Not Killing is a UK-based alliance bringing together over 40 organisations - human rights and disability rights organisations, health care and palliative care groups, faith-based organisations groups - and thousands of concerned individuals.

We have three key aims:
  • to promote more and better palliative care; 
  • to ensure that existing laws against euthanasia and assisted suicide are not weakened or repealed;  
  • to inform public opinion further against any weakening of the law. *As this story is dealing with suicide, please could we ask that you include details about organisations that offer help and support to vulnerable people who might be feeling suicidal such as the Samaritans, CALM or similar - Thank you.*

Monday, September 13, 2021

California euthanasia court case - a further analysis.

"There is no right to assisted suicide, the court must reject euthanasia."

Alex Schadenberg
Executive Director, Euthanaisa Prevention Coalition

On August 30 I published an article about a California court case that would permit euthanasia within the California assisted suicide regime. The case argues that some people who are approved for assisted suicide are unable to self-administer the lethal drugs, therefore, based on equality, the court needs to approve euthanasia (doctor administered death) in these cases.

The California court needs to reject this challenge to the state assisted suicide law based on:

1. There is no right to assisted suicide, therefore there is no legal requirement to amend the perceived inequality within the state assisted suicide law.

2. The Supreme Court, in Glucksberg, recognized that there is no right to assisted suicide and it recognized that one state interests in prohibiting assisted suicide was the prevention of euthanasia. This court case specifically seeks to permit euthanasia.

3. Permitting euthanasia is not an extension of the state assisted suicide law but rather it requires the court to legislate a new law, that being legalizing euthanasia, which is a form of homicide.
Lisa Krieger for the Bay Area News reported that the case involves Sandy Morris, who is living with ALS, and challenging the California assisted suicide law based on it being discriminatory towards people with disabilities.

According to Krieger due to the degenerative effects of ALS, Morris may not be capable of self-administering the lethal drug cocktail. Krieger reported:
Doctors who help the terminally ill confront a legal dilemma: Disability law mandates assistance and equal access to health care, while the aid-in-dying law mandates the opposite.
As already stated, the case argues that in the circumstance where the person who is approved for assisted suicide cannot self-administer the lethal drug cocktail that the doctor should be permitted to administer these drugs (euthanasia).

Assisted suicide activist, Kathryn Tucker, is the lead lawyer for the plaintiffs and Lonny Shavelson is a plaintiff. After California legalized assisted suicide, Shavelson turned his attention full-time to assisting suicides.

This case makes several false and critical assumptions, such as:
  • there is a right to assisted suicide in California and 
  • assisted suicide and euthanasia are (legally) the same.

Legally, assisted suicide is a form of suicide where the law requires the person to "self-administer" a lethal drug cocktail with the assistance of a "medical professional." Euthanasia is a form of homicide whereby the "medical professional" lethally injects the person with a lethal drug cocktail. 

There are similarities between assisted suicide and euthanasia but legally they are different.

Therefore the assisted death lobby is not asking a California court to extend the assisted suicide law but rather they are asking the court to legislate an exception to homicide.

The other issue is more nuanced. To require the California law to equally apply to people who requested and approved for assisted suicide assumes that there is a right to assisted suicide. According to the Supreme Court Glucksberg decision (1997) there is no right to assisted suicide (Link).

Glucksberg also recognized that there were at least five legitimate reasons why the state had an interest in prohibiting assisted suicide. One of those reasons was the prevention of euthanasia. As stated in Gluckberg:

These interests include prohibiting intentional killing and preserving human life; preventing the serious public-health problem of suicide, especially among the young, the elderly, and those suffering from untreated pain or from depression or other mental disorders; protecting the medical profession's integrity and ethics and maintaining physicians' role as their patients' healers; protecting the poor, the elderly, disabled persons, the terminally ill, and persons in other vulnerable groups from indifference, prejudice, and psychological and financial pressure to end their lives; and avoiding a possible slide towards voluntary and perhaps even involuntary euthanasia.

In Glucksberg, the Supreme Court recognized that creating a right to assisted suicide, which it rejected, could lead to permitting euthanasia.

The California case is not surprising. It is well known that the assisted death lobby considers the legalization of assisted suicide as a stepping stone to the legalization of euthanasia. The Supreme Court, in Glucksberg, recognized that legalizing euthanasia is a much broader license which would prove extremely difficult to police and contain.

Friday, September 10, 2021

Canadian Cancer patients dying by euthanasia are less likely to have the diagnosis confirmed or attempted effective treatments.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Ed Susman published on September 9 in Medpage Today reports on a presentation to the World Conference on Lung Cancer by Dr Sara Moore, a  University of Ottawa medical oncologist. Moore examined 45 euthanasia (MAiD) deaths of people with lung cancer living in the Ottawa region. She concludes that people with lung cancer who died by euthanasia were less likely to consult with a radiation or medical oncologist and less likely to undergo effective treatments.

According to Susman, Moore's research found that 20% of those who died by euthanasia did not consult a radiation oncologist and 22% did not consult a medical oncologist. Susman further reports:

"Biomarker-driven targeted therapy and immunotherapy offer effective and tolerable new treatments, but a subset of patients undergo medical assistance in dying without accessing -- or, in some cases, without being assessed for -- these treatment options," Moore continued. "Most patients were assessed by an oncology specialist, though less than half received systemic therapy."

"Given the growing number of efficacious and well-tolerated treatment options in lung cancer, consultation with an oncologist may be reasonable to consider for all patients with lung cancer who request medical assistance in dying," she said.
Further to that 13 of the 45 lung cancer patients who died by euthanasia did not have a biopsy to confirm the diagnosis.

Even though lung cancer survival rates have improved, the presentation proved that some people diagnosed with lung cancer will ask for MAiD without confirming the diagnosis or trying effective treatments. The Canadian (MAiD) euthanasia law does not require a person to try treatments.

The data from this study is consistent previous data indicating that people who ask for assisted suicide are often experiencing feelings of depression or hopelessness.

Not to suggest that euthanasia is ever justified, but since euthanasia ends the person's life, an act that cannot be reversed, therefore euthanasia should not be approved until the diagnosis is confirmed and effective treatments are attempted.

Jeannette Hall, of Oregon would have died by assisted suicide 21 years ago if her oncologist didn't convince her to try effective treatment (Link).

The study is limited based on the small group examined by the researchers.

Biden’s Suicide Prevention Day Proclamation Fails to Repudiate Assisted Suicide

This article was published by National Review online on September 10, 2021

Wesley Smith
By Wesley J Smith 

Yesterday was World Suicide Prevention Day. You didn’t hear about it? If so, that’s pretty typical, which is why I call this annual event, “Invisible Suicide Prevention Day.

Once again, the obligatory official proclamations didn’t mention that suicide is now promoted widely in the media, popular culture, and by political activists seeking to legalize so-called “death with dignity” or “aid in dying.”

These euphemisms seek to convince people that committing suicide because of serious illness or disability, is not really suicide. But that’s a sophistic advocacy trope. Suicide is the act of self-killing. The reason for killing oneself has nothing to do with the nature of what was done. In other words, suicide is suicide is suicide.

A truly effective suicide prevention strategy must seek to prevent all suicides, which would require repudiating the pro-some-suicides messaging of the assisted suicide/euthanasia movement. Instead, prevention proclamations ignore the issue — perhaps for fear of being controversial — which undercuts most prevention efforts’ general effectiveness.

Joe Biden’s proclamation is no exception. First, it points out the extent of the suicide crisis. From "A Proclamation on World Suicide Prevention Day 2021":
In 2019, suicide was the 10th leading cause of death in the United States, and the second leading cause of death for young people between the ages of 10 and 34. And that was before the COVID-19 pandemic compounded, for many, feelings of isolation, exhaustion, and economic and public health-related anxieties. Increased rates of depression have sparked concern that we will see a further increase in suicide rates.
And note, since the laws legalizing assisted suicide dishonestly redefine those deaths as not being suicides, the actual number of suicide deaths in the U.S. is hundreds higher than the official national count.

The proclamation barely mentions serious illness as a suicide cause:
My Administration is committed to treating suicide as the public health problem it is and helping to address the underlying risk factors for suicide. . . . While there is no one cause of suicide, we know there are many factors that increase a person’s risk for suicide, including the loss of a job; serious illness; and financial, criminal, legal, and relationship problems.
And of course the official pabulum makes no mention that laws allowing facilitated suicide impede the effective prevention of those suicides and insidiously sends a wider nihilistic message that self-killing as an acceptable answer to suffering.

We already know where this ideology ultimately leads. Germany’s highest constitutional court declared a fundamental right to commit suicide, have help in so doing, and to assist in suicide if requested — without regard to the whys or reasons. Just wanting to die is all that matters.

That’s death on demand folks, which makes effective suicide prevention a truly Sisyphean endeavor. If we truly want to prevent suicide, we must reject the suicide-promotion movement, because that’s what euthanasia advocacy really is. Until we do, prevention proclamations are just so much window dressing.

The Treasure of Palliative Care – a video series

The Treasure of Palliative Care - a video series Link to the PDF English version.

Press Release

The Treasure of Palliative Care – a video series

There is always a better option than euthanasia

A Quebec perspective for a better understanding of palliative care

Montréal, CANADA – September 9, 2021 – The Living with Dignity citizen network (LWD), founded in 2010 in advance of the debate on the issue of "dying with dignity" in Quebec, is officially launching The Treasure of Palliative Care video series today.

Since 2015, the Canadian province has been the first jurisdiction in the world to propose euthanasia as end-of-life care, known as medical assistance in dying. "In this context, a Quebec perspective on the many benefits of palliative care is particularly pertinent and we wanted to share it internationally. It is becoming increasingly clear to us that there is always a better option than euthanasia," said LWD’s president Alex King.

Produced in English and French, the 10-minute video The Treasure of Palliative Care answers six essential questions to help you better understand this form of care whose name "palliative" was coined in Montreal in 1973 by Dr. Balfour Mount. In addition to the brief answers provided by two Quebec experts in the field, Dr. Golda Tradounsky and Dr. Patrick Vinay, six additional videos explore the following questions in greater depth:
 

  • Is palliative care only for people dying of cancer? 
  • Where can we receive palliative care? 
  • Does palliative care hasten death? 
  • Does morphine cause death? 
  • Should pain be part of the end of life?  
  • Is medical assistance in dying (term used in Canada for euthanasia) part of palliative care?

Directed by Bruno Olivier and hosted in English by Angela Barrett and in French by Claudette Lambert, The Treasure of Palliative Care is available on the LWD Facebook page as of today (https://www.facebook.com/vivredignite/videos/560224695177761) as well as on YouTube via the https://vivredignite.org/treasure page.

A pre-launch of the video took place during the summer vacations on the occasion of LWD's participation in the Select Committee on the Evolution of the Act Respecting End-of-Life Care on August 9, 2021. This Quebec parliamentary commission is studying the potential extension of medical assistance dying (1) to people who have a mental illness as their only medical problem or (2) to those in a situation of incapacity (caused by a neurodegenerative disease such as Alzheimer’s) who have previously signed advance directives. For full details on LWD's participation in this committee, visit https://vivredignite.org/lwd-select-committee-2021.

The Living with Dignity citizen network is active on the following social networks:
Twitter https://twitter.com/Vivredignite
Facebook https://www.facebook.com/vivredignite
LinkedIn https://www.linkedin.com/company/vivredignite
YouTube https://www.youtube.com/channel/UCh3NsKMNpDum-RyhWSV4WzQ

Living with Dignity is a Quebec non-profit citizen network with no religious or political affiliation. Its mission is to promote the protection of the life and inherent dignity of people made vulnerable by sickness, old age or disability, by ensuring an end to their lives that is natural and respectful of the person and their dignity, through compassionate accompaniment.

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To request an interview with a member of the LWD team.

Jasmin Lemieux-Lefebvre
Coordinator, Living with Dignity
info@vivredignite.org