Will Canada extend Euthanasia for Psychiatric reasons alone?

Canada legalized euthanasia and assisted suicide in June 2016 under the term: Medical Assistance in Dying (MAiD). 

Download this article in pamphlet format.

In December 2016, the federal government announced that the Council of Canadian Academies would research and provide recommendations concerning the expansion of euthanasia in three areas: mature minors, people who are incompetent but previously requested MAiD and euthanasia for psychological suffering alone. This article concerns the last group.
 

Dr Damiaan Denys

The Netherlands and Belgium legalized euthanasia in 2002. The legislation in both of these countries technically allowed euthanasia for “psychological suffering.” In the early years, euthanasia for psychological suffering was rare but in the past few years it is sky rocketing.

A commentary by Dr. Damiaan Denys, the President of the Dutch Society of Psychiatrists, was published in The American Journal of Psychiatry (September 2018) titled: Is Euthanasia Psychiatric Treatment? 

Denys commentary is based on a 42-year-old married woman who requested euthanasia for psychiatric reasons while receiving treatment from his team. The Psychiatric team disapproved of her euthanasia death because treatment options existed but the woman died by euthanasia anyway. Denys wrote:

Although we had treated her intensively for 2 years, our advice was disregarded. Eight weeks later we received the obituary of the patient.

Denys outlines the problems with psychiatric euthanasia based on experience in the Netherlands. He wrote:

…whether euthanasia is an option for psychiatric patients, there are medical and ethical dilemmas related to the practical process of decision making and execution. How can we reconcile the daily practice of reducing suicidal ideas and behaviors in patients with respecting a death wish in single cases? How can we distinguish between symptoms and existential needs? How can we decide whether a psychiatrist is sufficiently autonomous to judge euthanasia? Does the fragile therapeutic relationship between psychiatrist and patient not bias judgment? How are differences in opinion between psychiatrist and patient resolved? Although psychiatrists are not legally obliged to approve or execute euthanasia, neither can they interfere once a request is granted by a third party, as illustrated in the aforementioned case.

Dr. Mark Komrad

Dr. Mark Komrad, an American Psychiatrist on the Faculty at John’s Hopkins University examined the experience with euthanasia for psychiatric reasons in the Netherlands and Belgium. He wrote in a commentary published by the Psychiatric Times (Feb 2017) that:

Some remarkable stories have been profiled in the Dutch media. For example, a woman was granted euthanasia for chronic PTSD due to childhood sexual abuse. The arguments based on personal autonomy to justify such access to PAS/E are being pushed even further in the Netherlands. Ministers of Health and Justice have proposed to their Parliament that criteria not be limited to medical conditions, but be extended to average citizens who feel they have lived “completed lives.” 

Prominent cases profiled in the Belgian media include a pair of deaf twins euthanized on request because they were going blind, a man with gender identity disorder who was unhappy with surgical results, and another man who sought euthanasia for ego-dystonic homosexuality.

Canadians were told that euthanasia would be legalized with safeguards to prevent the problems that have occurred in the Netherlands and Belgium. Canada is now considering extending euthanasia beyond the original parameters.

The Canadian law states that MAiD can be done when it is approved by 2 doctors or nurse practitioners when the person fulfills the following conditions:

• The person is at least 18 years old, 
• The person has a serious and incurable illness, disease or disability, 
• The person has an advanced state of irreversible decline in capability, 
• The person has an enduring physical or psychological suffering that is intolerable to them, 
• The person’s natural death must be reasonably foreseeable (no definition). 

Therefore, Canada’s euthanasia law does not permit euthanasia for psychological reasons alone.
 
In fact, Canada has gone too far already. Euthanasia for psychological suffering is a bad idea that is abused in other jurisdictions and will be abused in Canada.

Download this article in pamphlet format.

Spain to debate legalizing euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Spain Legislature

Spain's socialist government introduced a bill, last June, to legalize euthanasia. The debate on the bill is scheduled for October 25.

The Conservative - Popular Party - strongly opposes the bill and their leader has announced that it will introduce alternative legislation to provide greater support for palliative care.

Media reports are suggesting that the bill has support from the majority in the 350 member Spain legislature.

Last May, a similar bill was expected to pass in the Portugal legislature but it was defeated after the Communist Party voted against the euthanasia bill.

In Canada, Euthanasia Yes — Palliative Care, Not so Much

This article was published by National Review online on October 16, 2018

Wesley Smith

By Wesley Smith

Canada has created a positive right to euthanasia — including coercing dissenting doctors into participating in the deed in Ontario. Yet, according to a study published by the Canadian Institute for Health Information, only 15 percent of dying Canadians have access to quality palliative care in their last year of life. But that dry statistic doesn’t reveal the true depth of the problem, according to Globe and Mail columnist, André Picard:

The numbers, as appalling as they are, don’t adequately convey how badly dying patients are treated by the failure to provide palliative care in the community.

They are, in dry academic language, “subject to multiple transitions of care.” That means very sick patients are shuffled – often repeatedly – from home/nursing home to emergency, then up to the ward, and back home again.

We all know that in Canada, an ER visit for a frail elderly person (the main clientele for palliative care) means lying on a gurney in a hallway for hours. That is the last place a dying person – often confused, incontinent and in pain – should be. This kind of humiliation is untenable and we should be ashamed at how commonplace it is.

Shortage of palliative care is pushing people to euthanasia.

Good grief! No wonder so many Canadians seem to be embracing euthanasia. They are being herded by poor-quality care into that awful choice — which in a single-payer system, not coincidentally, is also far less expensive.

The legalization of euthanasia didn’t cause this problem. But I suspect that its widespread availability will make it much more difficult to correct.

‘Flawless’ Fatal Flaws Reviews from around the World

Fatal Flaws Ad in Guernsey

Kevin Dunn
Director - Fatal Flaws

As screenings of Fatal Flaws continue throughout the world, we’ve been overwhelmed by positive responses from high-profile individuals from both medical and legal professions internationally.

For instance the screening in Guernsey helped to defeat an assisted suicide proposal.

Purchase the DVD or pamphlets include taxes and shipping: All orders can be made online (Link).

• We recently added the Vimeo On-Demand Rental Release providing 48 hours access for $5 US (Link).

• DVD: $40 each, 3 for $100, or 10 for $300.
• DVD: online download $30 US (Link).
• Pamphlets: $40 for 100, 300 for $100, or 1000 for $300.

You can purchase Fatal Flaws as a download through VIMEO ON DEMAND for $30 US. (Link).

The Fatal Flaws pamphlet is based on the stories in the film. The pamphlet is excellent for distribution at a screening. (Inside of the pamphlet) (outside of the pamphlet).

Further Discounts: All orders can be made online (Link).

• 1 DVD + 100 pamphlets for $75,
• With any Fatal Flaws order, get The Euthanasia Deception documentary for $20.

Further bulk orders are available upon request.

Order the Fatal Flaws DVD with pamphlets online, or email: info@epcc.ca or call EPC toll free at: 1-877-439-3348

As you consider a screening of Fatal Flaws in your area, we invite you to read what others are saying about the film:

“Slippery slope arguments have often been criticized as philosophically weak. There could be no stronger evidence for the reality the slippery slope than Fatal Flaws. As both a psychiatrist and a palliative care physician, I cannot overemphasize the importance of this film as a spiritual call, a moral message, a social statement and a clinical intervention. Kevin Dunn is a modern day Cassandra who has produced a film that describes what would be terrifying science fiction, were it not already social fact: the legalization of the termination of the lives of the vulnerable, isolated, marginalized, and anguished in state after state and country after country. Even more disturbing those deaths come at the hands of physicians whom for millennia have sworn to heal and not to harm. Through interviews with patients, families and experts, Dunn gives a neglected and urgently needed critique of the euphemistic masking of suicide as compassion and in so doing exposed the dark side of the gilded claim that the relief of suffering lies in the affirmation of hopelessness, the embrace of futility, and the betrayal of the historic goals of medicine.”

Cynthia Geppert MD, MA, MPH, MSB, DPS, MSJ, DFAPA, FCLP, Professor of Internal Medicine and Psychiatry, Director of Ethics Education ,University of New Mexico School of Medicine, Adjunct Professor of Bioethics Albany Medical College, USA

• Fatal Flaws film will change the way you view assisted death.

“Fatal Flaws is more than just a great documentary film. It is a clarion call to restore decency to the House of Medicine. For every doctor or patient who wants to understand the difference between medical killing and medically-responsible caring, this humane and sensitive film is a must-see.”

Ronald W. Pies, MD, Professor Emeritus of Psychiatry, and Lecturer on Bioethics, SUNY Upstate Medical University; Clinical Professor of Psychiatry, Tufts U. School of Medicine; Editor-in-Chief Emeritus, Psychiatric Times, USA.

"This is a brilliant film that should be compulsory viewing for busy legislators who haven’t time to do their own research into how euthanasia is changing death and dying in countries such as Canada and the Netherlands. Kevin Dunn interviews supporters and opponents of euthanasia and physician assisted suicide in a non-judgemental way and the responses he gets are extraordinary."

Professor the Baroness Sheila Hollins, House of Lords, Past President of the Royal College of Psychiatrists, UK

• Order the Fatal Flaws film and pamphlets.

“Compelling, timely and moving. Physicians must see this film, especially those in training as the euthanasia movement is trying to redefine the ethics of medicine. ”

Steven S. Sharfstein, M.D., Former President The American Psychiatric Association, USA

“Fatal Flaws should be necessary watching for anyone considering the legalisation of medical assistance in dying.” 

David Albert Jones, Director of the Anscombe Bioethics Centre, Oxford, UK

“Sobering and contemplative, Fatal Flaws is a must-see, regardless of one’s personal views about the rightness or wrongness of medical assisted death. The film challenges us to think critically about our individual and social responses to vulnerability and suffering, and, in particular, the re-shaping of the ‘house of medicine’ through the logic of law.” 

Mary J Shariff, Faculty of Law, University of Manitoba, Canada

“There are three words that should never have come together: “Physician Assisted Suicide”. This important film shines a critical light on the perverse reality that we are now training our medical students how to kill some of their patients. The medical arts of comfort and palliation are being supplanted by the seduction of euthanasia and the murky language of rights. We should all see this film and carefully weigh whether we really want our society to slide into a mire that extols medical murder.” 

John Maher MD FRCPC, Editor-in-Chief, Journal of Ethics in Mental Health, President, Ontario Association for ACT & FACT, Canada. 

• Fatal Flaws: A must see film.
• Fatal Flaws: A must see doc on euthanasia and assisted suicide.

A hearty thanks to the above contributors for their positive and passionate reviews. 
Kevin Dunn, Director - Fatal Flaws

Michelle Lujan Grisham would legalize assisted suicide if elected Governor of New Mexico.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Michelle Lujan Grisham

New Mexico has been debating assisted suicide for many years. During the previous legislative session the New Mexico Senate defeated the assisted suicide bill by a vote of 22 to 20.

Several years ago an activists Judge claimed that there was a right to assisted suicide in New Mexico.

On June 30, 2016 the New Mexico Supreme Court, in a 5 - 0 decision, upheld the New Mexico Court of Appeal decision that assisting a suicide is a crime in Morris v Brandenburg.

As part of a question and answer article in the Albuqueque Journal, Michelle Lujan Grisham, the Democrat candidate for Governor of New Mexico, stated that she supported the legalization of assisted suicide. In the article, Question 10 states:

10. Do you support or oppose updating the current prohibition in the law on assisted suicide in order to allow aid-in-dying under certain medical circumstances?

I support updating the current prohibition. We should provide patients with humane end-of-life options, including medical aid-in-dying for terminally ill competent adults.

Steve Pearce, the Republican candidate for Governor of New Mexico answered the same question by opposing assisted suicide.

I do not support assisted suicide. A patient near death is an understandable emotional situation, but history and morality teach us the government should not encourage patients to commit suicide. I will also guarantee conscience protection for doctors who do not want to assist in suicides.

RealClearPolitics indicates that Grisham is leading in the polls to become the next New Mexico Governor.

People who oppose assisted suicide must not vote for Grisham.

NDY & ADAPT Submit Public Comments To Virginia Commission Opposing Potential Assisted Suicide Legislation

The Virginia Joint Commission on Health Care has requested public comments by close of business on October 15 concerning several policy issues, including one option that would recommend the introduction of assisted suicide legislation. It’s called Policy Option 2, worded as follows:

Introduce legislation to amend the Code of Virginia to include a Medical Aid-in-Dying statute that mirrors California’s EOLOA statute, with the following additions: a. when informing patient of alternative to MAID, attending physician must include information about any possible treatments for the underlying disease, b. attending physician must attest that patient enrolled in hospice or was informed of EOL services, c. if patient is in nursing facility, one witness may be person designated by facility, d. adopt rules to facilitate collection of information regarding compliance, e. provide an online guidebook and establish training opportunities for medical community to learn about the MAID process and medications that may be used (NOTE: Language will be provided to members and placed on the JCHC website 5 business days prior to the November Decision Matrix meeting).

O n October 11, NDY President Diane Coleman submitted a comment (to jchcpubliccomments@jchc.virginia.gov) which began:

Diane Coleman

I am submitting this comment as a person with an advanced neuromuscular condition who uses breathing support 18-19 hours a day. I have personal experience with misdiagnosis and the uncertainty of terminal predictions by doctors. I am also the founder and President of Not Dead Yet, a national disability rights group, with members in Virginia, that opposes legalization of assisted suicide because it is discriminatory and poses unacceptable dangers to elders and people with disabilities with or without terminal diagnoses.

This comment uses the term “assisted suicide” for several reasons. Merriam Webster defines suicide as “The act or an instance of taking one’s own life voluntarily and intentionally.” As the AMA Council on Ethical and Judicial Affairs stated in its report on the issue this year, “The terms ‘aid in dying’ or ‘death with dignity’ could be used to describe euthanasia or palliative/hospice care at the end of life and this degree of ambiguity is unacceptable for providing ethical guidance.”[i] Assisted suicide proponents understandably prefer to call it “aid in dying” because it polls better. They attempt to justify the name change by asserting that the person is already dying. While some may be dying, others are not. More importantly, with assisted suicide, the cause of death is not a disease, but a lethal overdose.

My Personal Story of Mistaken Prognosis . . .

To continue reading the NDY comment, go here.

On October 12, Bruce Darling submitted a comment on behalf of ADAPT which stated:

Bruce Darling

As an organization working to ensure disabled people’s right to build our lives in the community, legislation making it legal for physicians to help end our lives is deeply troubling to ADAPT. While the proponents of this legislation will tell you that it is not about disabled people, only people with terminal illness, let me assure you that every single person who qualifies under that definition is a disabled person. Not every person with a disability is terminally ill, but every person who is terminally ill is or will eventually become a person with a disability. There is no person with a terminal prognosis who does not also have, or acquire, an impairment which significantly affects their ability to perform a major life function (such as eating, sleeping, toileting, or walking).

Accordingly, physician assisted suicide is only provided to people with disabilities, by definition. This is discrimination. People with disabilities have fought hard for the right to live as equals, to live and receive services in the community, to have equal access to housing and transportation and employment opportunities. In an ableist society, these rights are continually denied to us. Yet this same society wishes to extend to us the “right” to end our lives. Equal rights, means equal access to suicide prevention, not the false “compassion” of suicide assistance.

… Assisted suicide is not about relieving the suffering of the dying: it is an expression of the most toxic and deadly form of ableism, which holds that life with a disability is not worth living. The lives of people with disabilities, whether terminal or non-terminal, do matter, and are worth living. (Emphasis added.)  

To continue reading the ADAPT comment, go here.

If you would like to submit your own comment by October 15 at close of business (even just saying that you oppose Option 2), and/or support NDY’s and ADAPT’s comments, please email jchcpubliccomments@jchc.virginia.gov.

[i] REPORT OF THE COUNCIL ON ETHICAL AND JUDICIAL AFFAIRS 5-A-18, Page 2, https://www.ama-assn.org/sites/default/files/media-browser/public/hod/a18-ceja5.pdf

The assisted suicide bill was aimed at people like my husband.

Nancy Elliott

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Nancy Elliott is a former three-term elected representative from New Hampshire. As an elected representative she fought against the assisted suicide bills in her state. Nancy is now actively opposing assisted suicide bills throughout the USA.

Nancy explains why she opposes assisted suicide:

This is about state sanctioned suicide. This is about giving the government the right to decide who is deserving of death and who isn't.

 It was at the same time this bill came that my husband was very critically ill. He had heart disease, diabetes, Parkinson's, kidney disease, numerous diseases.

One of the reps had put in this bill the reasons why you might want to do this (assisted suicide). They had loss of autonomy, loss of dignity, loss of bodily control. And so I asked him, "What are you talking about?"

It was really pretty clear that they were aimed at people like my husband, who, in their opinion, shouldn't be living.

He would have been so hurt. It would be like saying:

"Your a piece of junk, you need to get out of the way, your taking up space, go kill yourself."

Join EPC USA and help Nancy defeat assisted suicide in your state.

This film clip was taken from the film - Fatal Flaws. Order Fatal Flaws today.

Canadian Physicians attend World Medical Association General Assembly

This report was published by the Physicians Alliance Against Euthansia on October 15, 2018.

Reykjavik, Iceland, October 3-6, 2018

A number of concerned Canadian doctors became Associate Members of the World Medical Association (WMA) and attended the October 2018 General Assembly (GA) of the WMA in Reykjavik, Iceland. This informal report summarizes some activities and experiences of the group.

1. We were at the GA because we wished to contribute to the discussion of a draft resolution entitled Proposed WMA Reconsideration of the Statement on Euthanasia and Physician Assisted Dying which was to be brought forward to the Ethics Committee of the WMA by the Canadian Medical Association (CMA) and the Royal Dutch Medical Association (RDMA). It was proposed as a replacement for the WMA Resolution on Euthanasia (2002), the WMA Declaration on Euthanasia, (1987) and the WMA Statement on Physician Assisted Suicide (1992, confirmed 2015). The proposal sought to move the WMA away from condemning euthanasia and physician assisted suicide (E/PAS) as unethical. It also moved away from the term physician assisted suicide, using instead either physician assisted death or assisted dying. We felt that this policy would facilitate legalization of E/PAS around the world and involvement of physicians in these procedures. We wished to uphold the WMA opposition to E/PAS and encourage a life-affirming approach.

2. Delegates from more than 50 national medical associations around the world were present at this GA. Many of the more experienced participants at the meeting provided us with good advice regarding WMA processes and how to ensure our effective participation. Others sought clarification about an article some of us had co-authored in the September 2018 World Medical Journal, entitled Euthanasia in Canada: a Cautionary Tale (French and Spanish translations available at: bit.ly/WMACanada). It was written to counterbalance the optimistic view of the introduction of euthanasia and physician assisted suicide (E/PAS) into Canada that the current representatives of the Canadian Medical Association (CMA) generally promulgate. While the CMA spokesperson at this meeting asserted that our article is a misrepresentation, many participants acknowledged that the extensive references provided would permit them to access primary sources and reach their own conclusions about our analysis of the Canadian situation.

3. At the meeting of Associate Members, a resolution was proposed that aimed at a greater consistency between policies of WMA and its National Medical Associations (NMAs). Our group argued that two paragraphs in that policy would weaken the role of WMA as a promoter of the highest standards of medical ethics, because WMA would be expected to “accommodate” NMA policies inconsistent with WMA policies. Our motion to remove the problematic paragraphs was carried.

4. At this GA, summarizing reports were presented by representatives of German, Nigerian, Japanese and Brazilian medical associations on the recent WMA Regional meetings, all opposing involvement of physicians in E/PAS. These consultations on E/PAS conducted by the WMA clearly underscored continued firm opposition to these acts by most member nations. Perhaps because of this, the CMA/RDMA proposal was withdrawn on short notice prior to the Ethics Committee meeting in Reykjavik. It was replaced by a compromise document, brought forward by the German Medical Association, which affirms the WMA’s opposition to E/PAS, but avoids altogether the use of the word unethical and substitutes the phrase physician assisted suicide with physician assisted dying. It was apparent, during the remainder of the meeting, that many at the WMA have serious concerns about these possible changes. Some reiterated that the WMA was founded, in large part, to refute the idea that making something legal also makes it ethical. The proposed substitute document will undergo study in the months ahead by all delegates and their written opinions are to be reviewed at the April 2019 meeting of the WMA in Chile.

5. Toward the end of the General Assembly, to everyone’s surprise, the CMA delegation accused the incoming president of the WMA, Dr. Leonid Eidelman, of plagiarism in his inaugural speech and moved that the WMA demand his resignation. This motion failed, not being supported by any other delegates. Subsequently, the CMA announced its withdrawal from membership in the WMA. Eidelman offered an explanation and apologized to the Council and the GA of the WMA, and his explanation and apology were accepted.

Sheila Rutledge Harding, MD, MA, FRCPC
Crossmount, Saskatchewan

P.S. Any physician or medical student may become an Associate Member, upon application to the WMA: https://www.wma.net/sign-up/. Associate Members are apprised of documents under consideration, given opportunity for input, and may attend WMA meetings to voice their opinions.

Canadian woman abandoned to death. Has euthanasia become the only option for some?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

I spoke to a woman, today, about the sad story of the death of her only daughter. Her daughter was dying with cancer and her care was so substandard that she decided that euthanasia was her only option.

Shortage of palliative care is pushing people to euthanasia.

She said, my daughter wanted to be cared for at home, but the home care was minimal and not good. Her daughter was dying from cancer but she was living with neglect.

Her daughter decided the euthanasia was her only option. She signed the forms for euthanasia and waited to be killed.

Her mother, who had cared for her parents when they died, was trying to care for her daughter, but she lived one hour away. She tried but failed to find good home care in the community.

In the end, her daughter died before the lethal injection was done. 

Her mother repeated that she only wanted to be cared for at home, she only wanted her pain controlled, instead she died a horrible death.

The Euthanasia Prevention Coalition supports excellent care. A recent news article indicates that Canada is not providing good end-of-life care, but euthanasia is available. 

No one should be abandoned to death by euthanasia or to dying a bad death.

Caring not Killing is the answer.

If you need to speak to someone about your experience with euthanasia or assisted suicide please call Compassionate Community Care at: 1-855-675-8749.

• Euthanasia in Canada: A cautionary tale.

The deadly advocacy of assisted suicide in Washington DC

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Dr G Kevin Donovan 

The Washington Times published an excellent analysis of the assisted suicide legislation in Washington DC by G. Kevin Donovan, a physician and director of the Pellegrino Center for Clinical Bioethics and professor at Georgetown University Medical Center.

Donovan is responding to public service announcements in Washington DC promoting assisted suicide. Donovan states:

It is no wonder that the assisted-suicide lobby has resorted to such tactics — this dangerous public policy is so unpopular here that in the first year after the District of Columbia enacted a law to allow assisted suicide, not one person killed themselves with a doctor’s help, as the new law sanctions. In fact, during that time only two out of nearly 11,000 licensed D.C. physicians were willing to participate, and just one hospital cleared doctors to be involved.

People in Washington DC clearly do not want assisted suicide. Donovan then explains how legalizing assisted suicide leads to discrimination for people in vulnerable conditions.

Despite so-called safeguards, the D.C. assisted-suicide bill fails to adequately protect the most vulnerable in society. The poor, people of advanced years, persons with disabilities, both physical and developmental, and people who experience depression all find themselves at a much higher risk of being placed, even against their will, in that “second class” of people who do not receive the equal protection of suicide prevention. 

This type of discrimination is a reality in places where assisted suicide is legal. We know because in Oregon (oregon.gov), where assisted suicide was legalized 20 years ago, feeling like a burden is among the top end-of-life concerns of people who asked for lethal drugs. Making suicide available to people who require significant care and resources conveys that dependency and the need for care is burdensome, perhaps even revolting.

Donovan continues by outlining the other negative effects associated with assisted suicide.

Assisted suicide also breaks down the patient-physician relationship. With these laws, a doctor is legally forbidden from listing suicide as the cause of death on the death certificate. Not only does that require a falsehood, it makes oversight nearly impossible and accurate disease data a thing of the past. These laws do precious little for patients, but they do ensure that doctors cannot be sued or subjected to criminal penalties when acting “in good faith” within this law. 

For centuries, a physician’s primary focus has been to cure and comfort. Assisted suicide is an aberration that distorts that focus, medicalizing suicide. The result is a breach of trust between physician and patient — and the real risk that normalizing suicide will lead to “suicide contagion” in others. There is no mystery behind why physicians in Washington are not lining up to participate: It undermines their credibility and runs contrary to their role as healer. And physicians should be wary of promoting suicide for any reason among their patients. More doctors themselves die of suicide than in any other profession.

Donovan concludes by challenging the suicide lobby from promoting assisted suicide rather than suicide prevention, patient's rights and protection of the vulnerable.

• NO DC assisted suicide deaths in the first year after legalization. DC doctors don't support assisted suicide.

Euthanasia versus Plagiarism at the World Medical Association

Last week, the Canadian Medical Association (CMA) decided to withdraw its membership from the World Medical Association after a controversy related to euthanasia and plagiarism.

Dr Mark Komrad

Dr Mark Komrad, a psychiatrist and professor at John's Hopkins University, wrote a commentary on the drama titled: Euthanasia vs Plagiarism published in the Psychiatric Times on October 10, 2018. The Psychiatric Times considered the commentary as a follow-up to Komrad's article published online on October 3, 2018: An Open Letter to Representatives of the World Medical Association.

Komrad wrote: 

A remarkable drama occurred at the World Medical Association (WMA) last week. The events were not just dramatic; they took a bizarre turn. I am an Associate Member of the WMA. As I shared with you in an earlier commentary, an initiative was mounted by the Canadian Medical Association (CMA) and the Royal Dutch Medical Association at the WMA’s semi-annual meeting in Reykjavik to dilute the WMA’s strong language against assisted suicide and euthanasia in their ethics code. This language currently reads:

Physician-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically.1

These two national delegations, representing countries where medical euthanasia is legal, appear to have attempted to move the WMA towards a more neutral position. In Canada, euthanasia is a legal option for some patients whose death is “in the reasonably foreseeable future”—which is undefined. In Ontario Province, there have been maneuvers both by government and medical societies to condemn and make illegal refusing to refer patients for euthanasia by physician conscientious objectors. In the Netherlands, even non-terminal chronic conditions like psychiatric disorders, could be eligible, and there is even political pressure to remove medical criteria and open euthanasia by physicians for those who feel “tired of living” or that their life is “complete.” Both countries were looking to the WMA to begin normalizing their remarkably advancing moral wavefronts by moving the fulcrum of world medical ethics.2

At the meeting, Dutch and Canadian delegations withdrew their aggressive proposals at the last minute. However, the German delegation instead proposed a potential compromise in the code’s language. This includes changing the term “physician-assisted suicide” to “physician-assisted death” and changing “unethical and must be condemned” to “physicians should not engage” in these activities. Yet, they also proposed language protecting “conscience rights” for conscientious objectors. However, there was apparently overwhelming opposition to even this “compromise” change in language among the majority of national delegations to the WMA. (Curiously, the Belgian delegation was silent and did not stand up with the Dutch on their initiative, even though their laws and practices are very similar to those in the Netherlands.) Now, the WMA has agreed to call for written opinions from all delegates on this “compromise” proposal of the Germans, to be assembled for their Spring 2019 meeting.

Now for the bizarre part. One can assume that having seen their initiative miss the mark, the CMA delegation discovered that incoming WMA President Dr Leonid Eidelman’s inaugural speech had some passages identical to a previous inaugural speech and some material on the web. They called for his resignation. Dr Eidelman, himself surprised, apologized and said that English was his 4th language and that he had actually hired a speechwriter to draft the speech. So, he was unaware of this sloppy preparation by the speechwriter. The CMA delegates declared this to be the “apex” of unethical behavior and called for his resignation. Not a single country’s delegation supported that call (including the Netherlands) and so they promptly walked out, and resigned Canada from the WMA.

Psychiatrists are familiar with the phenomenon of projection. Could the CMA be projecting a shadow of guilt regarding the remarkable and undoubtedly difficult practice of their members who are euthanizing patients? This shadow seems cast onto such a comparatively puny ethical misstep (inadvertent plagiarism), which is a mere “tempest in a teapot” by comparison.. Yet, the CMA leadership supporting their country’s euthanasia practices feel that their position on euthanasia is ethically justified.3 So, from their vantage point, where they may feel they are on higher moral ground than the WMA which condemns euthanasia, the CMA condemns the WMA President’s sloppiness as the very “apex” of unethical behavior.4 The “primary gain?” The CMA can feel more “comfortable“ not abiding by the WMA’s ethics code, since they no longer belong.

What does the resignation of the CMA from the WMA teach us? “Doctors killing patients is OK. But copying small parts of speeches is real evil—so evil in fact that it merits leaving the international community of medicine.” 

References: 

1. World Medical Association. WMA Statement on Physician-Assisted Suicide. https://www.wma.net/policies-post/wma-resolution-on-euthanasia. Accessed October 10, 2018.
2. Schadenberg A. Canadian and Dutch Medical Associations pressure World Medical Association to change policy opposing euthanasia. Euthanasia Prevention Coalition. September 6, 2018. http://alexschadenberg.blogspot.com/2018/09/canadian-and-dutch-medical-associations.html. Accessed October 10, 2018.
3. Blackmer J. Dr. Blackmer blog response. April 30, 2018. Physicians’ Alliance against Euthanasia. https://collectifmedecins.org/en/dr-blackmer-blog-response. Accessed October 10, 2018.
4. Rizza A. Canadian Medical Association resigns from world body amid plagiarism accusations. The Toronto Star. October 6, 2018. https://www.thestar.com/news/canada/2018/10/06/canadian-medical-association-resigns-from-world-body-amid-plagiarism-accusations.html. Accessed October 10, 2018.

Dr Mark Komrad has published several excellent articles on euthanasia and assisted suicide. Previous article by Dr Komrad:

Canadian Association of Retired Persons is pressuring governments to force medical institutions to kill.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Canadian Association of Retired Persons (CARP) released its policy platform for the 2019 Federal election. 

CARP is focusing on 19 areas for action including pressuring the government to force every medical institution that receives government funding to provide euthanasia, also known as Medical Assistance in Dying (MAiD).

The CARP "Exceptional Health Care" policy includes to:  Make Accessible End-of-Life Care a Right (page 21 of the platform). 

This platform statement first demands palliative care for everyone:

Make access to palliative care a right so that all Canadians can access it regardless of where they live or receive care, including rural, remote and indigenous communities.

The platform then demands that all publicly funded medical institutions provide euthanasia:

Ensure access to medical assistance in dying (euthanasia) is provided at publicly-funded institutions and available to Canadians regardless of where they live or receive care.

By demanding that every funded medical institution provide euthanasia they are then demanding that every religiously affiliated, every palliative care and every long-term care medical institution provide euthanasia.

Promoting euthanasia is not new for CARP.

Wanda Morris

CARP officially became a pro-euthanasia advocacy group in January 2016 when CARP fired Susan Eng, the long-time Executive VP of CARP. Moses Znaimer, the President of CARP, disagreed with Eng's neutral position on euthanasia. Znaimer then hired Wanda Morris, the CEO of the euthanasia lobby group - Dying with Dignity to replace Eng.

In July 2018, Wanda Morris, the current Executive VP of CARP, published an article attacking palliative care institutions and services refusing to provide euthanasia. Morris argued that euthanasia respects the Hippocratic tradition and argued that refusing to do euthanasia causes harm to patients.