Belgium doesn't kill killers but will kill the depresed.

Published by OneNewsNow on February 20, 2019.

By Charlie Butts

A study of Belgium prisoners, who were killed at their own request, has revealed tragic irony in a country with liberal euthanasia laws.

Research: Euthanasia of prisoners in Belgium.

Belgian euthanasia protest.

The study, published in magazine The Knack by Jan Lippens, followed 23 prisoners who requested euthanasia between 2011 and 2017.

Alex Schadenberg of the Euthanasia Prevention Coalition tells OneNewsNow that a majority of the prisoners were convicted of heinous crimes, such as murder, and were unlikely to ever be released. But only two of the 23 prisoners actually faced a terminal illness which, naturally, would be the expected reason to ask for a hastened death.

The remaining prisoners cited psychological reasons for asking to die, Schadenberg says, which is sadly ironic in Belgium where capital punishment is outlawed.

"So the concept is that it's wrong to kill a prisoner," he points out, "but then secondly it's okay to lethally inject them because they are experiencing psychological suffering."

Assisted death is already being done in some jurisdictions on that basis and Canada, which legalized terminating ill people in 2016, is considering expanding the list to those suffering psychologically.

Not Dead Yet and disability rights groups against assisted suicide are being blocked at public hearings.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Anita Cameron (center)

Not Dead Yet, and other disability rights groups have been a strong and effective voice against the legalization of assisted suicide. Recent public hearings on assisted suicide bills have been orchestrated to either reduce or eliminate the opportunity for disability rights groups from speaking against assisted suicide.

Not Dead Yet reported that many disability rights organizations were blocked from giving testimony at the New Jersey committee hearing earlier this month. More recently, Not Dead Yet reported that disability rights groups were forced to wait, before they could give testimony in Maryland. Anita Cameron, from Not Dead Yet, said that people with disabilities often experience complicated health and transportation issues. Sheryl Grossman, a Maryland resident with the National Council on Independent Living had to leave before she could offer testimony.

For many years the assisted suicide lobby has tried to neutralize or eliminate the effect of the disability rights groups opposition to assisted suicide. This may be a new strategy.

Truchon, Gladu and the euthanasia of people who are not terminally ill

This article was published on February 7, 2019.

By Dr Catherine Ferrier

President, Physicians Alliance Against Euthanasia

In recent issues of this Newsletter we have considered the dangers of different ongoing schemes for enlarging the qualifying criteria for euthanasia, to include people with dementia (by advance directive), “mature” minors (with or without parental consent or knowledge) and those for whom psychiatric illness is the sole underlying condition.

Unfortunately, by virtue of a challenge currently undertaken by Mr. Jean Truchon and Ms. Nicole Gladu before the Québec Superior Court, there is now something quantitatively much worse on the table: euthanasia for people who are not at the “end of life” (as required by the Quebec law) or for whom, contrary to what Canadian law requires, “natural death is not reasonably foreseeable”. In other words, doctors may soon be asked to “medically” kill people who are not dying.

It is evident that to permit this would allow the phenomenon to assume proportions many times that of the original context of “unbearable suffering at the end of life”. Therefore, whatever dangers were first invoked in that discussion must now be multiplied a hundredfold.

Unfortunately, the plaintiffs and their counsel do not admit that any such dangers exist. Increased suicide, for example, is impossible in their world because “Medical aid in dying” is never suicide, by definition (although any qualified and suicidal patient would have the absolute right to die using a compliant doctor in the place of poison or gun). Moreover, no matter how many “vulnerable” persons were to die for the wrong reasons, that too is irrelevant, because Mr. Truchon and Ms. Gladu are not vulnerable. And in the myopic priorities of the petitioners: if even one, single, non-vulnerable ill or disabled person wishes to die, then society has a sacred duty to provide that death, even if it means completely transforming medical culture, regardless of what mayhem may ensue.

The law, however, must not uncritically endorse the perspective of any one stakeholder. The law has a duty to balance competing interests.

Jean Truchon & Nicole Gladu

These conflicting interests and the balancing function of the law were sharply illustrated on the first day of hearings by the presence of two severely disabled individuals, vehemently opposed to the demands of Mr. Truchon and Ms. Gladu, and determined to defend their own rights: not the right to benefit from a discriminatory exception to our criminal code which would allow their deaths; but the right to an equal and non-discriminatory application of existing law to prevent those deaths.

For that is what the law against assisted suicide does: it prevents deaths. Before the Carter decision and Bill C-14, it provided this protection to everyone; and even since the law was adopted, it has still protected those who are not at the end of life; but if the Truchon-Gladu challenge prevails, the entire population of chronically ill and disabled individuals will be stripped of such protection. And that is horribly wrong.

It has been reported that Mr. Truchon and Ms. Gladu’s counsel summarily rejected any notion of lost protection, using what has so often been accepted as an unassailable argument: “each one may choose”. But if apparent choice were sufficient protection from the dangers of assisted suicide, why do we still have a law at all? Why do “normal” people still require protection? The answer is obvious: Because the existing law does in fact provide real protection for the general population. And non-suicidal people who are ill or disabled (whether “vulnerable” or not), naturally resent this attempt to deprive them of their right to equal treatment before the law.

This is not different from many regulations in existence, such as, for example, those requiring doors to close off open elevator shafts (in spite of the fact that people may simply “choose” not to jump). We recognize that people can fall down the shaft by accident; or that in a period of existential weakness they might regrettably decide to jump; and yes, they may even be pushed. Doors prevent such tragedies. And so do our laws against assisted suicide.

Here, then, fundamentally, are the two sides to this issue: There are people who seek an exceptional “right” to jump, with the help of the medical profession; and there are those, every bit as qualified for that proposed exemption, who wish to benefit from the same level of protection accorded to every other citizen.

How, then, can we decide between these two competing and mutually exclusive views?

1. The number of suicidal people like Mr. Truchon and Ms. Gladu is greatly inferior to those in similar circumstances who wish to continue living.
2. It is impossible that people with the intellectual resources and networking skills of the non-vulnerable Mr. Truchon and Ms. Gladu can be prevented from dying if they really want to. Many thousands of Canadians commit suicide each year, and it is estimated that hundreds are assisted to do so. What Mr. Truchon and Mme Gladu risk, then, is not a requirement to live, but simply that society will not arrange for their deaths.
3. Should Mr. Truchon and Ms. Gladu win, others, who will inevitably and regrettably succumb to the open elevator shaft of missing protection, will lose their lives. Our choice, therefore, is between providing a more convenient death for a few, or protection of ongoing life for many more.
4. Fair minded people must realize the reality of intimidation, coercion – or even mere suggestion – originating from overwrought family, overburdened caregivers, and yes, perhaps blatantly greedy heirs; recognize also the danger of passing self-doubt, or existential despair, translated into state-sanctioned, medicalized suicide. We believe that what the legislators considered an acceptable weight of tragedy, in a compromise involving only those wishing to die more quickly and less painfully at the very end of life, should certainly be considered unacceptable when applied to the much larger population of those with non-terminal illness and disability.
5. Law is a framework under which we live. The benefits of law should be maximized for those who are alive – and for those who wish to go on living.

From these several facts, we arrive naturally at the conclusion that the existing law (bad as it may be) should remain as it is without further expansion. Mr. Truchon and Ms. Gladu will die, as all people die, and probably much sooner, by their own hand or by the hand of others.

But when they leave this world, they must not be permitted to bequeath to us a framework that works to the detriment of those who have chosen to remain behind.

Make euthanasia unimaginable.

Sincerely,
Catherine Ferrier
President, Physician Alliance Against Euthanasia.

Euthanasia in Canada: CMA - Take off the rose-coloured glasses.

The following article was published in the British Medical Journal (BMJ) on February 8, 2019 in response to articles published by the BMJ Drs Buchman and Blackmer.

In June 2016, Canadian legislation came into effect with Bill C-14 that legalized Medical Assistance in Dying (MAiD), a euphemism for euthanasia and physician-assisted suicide. In Canada, most cases of MAiD are via euthanasia, where patients’ lives are ended through a lethal injection of drugs administered by a physician or a nurse practitioner. Many palliative care experts object to the term ‘assistance in dying’ because that is what palliative care physicians already do by helping people to die well, without hastening or causing death. Nevertheless, the term was formally adopted by the government, and continues to contribute to confusion regarding palliative care and MAiD.

The President-Elect of the Canadian Medical Association (CMA), Dr. Sandy Buchman, a palliative care physician and euthanasia provider, has exacerbated this confusion further. In his recent invited BMJ essay (2), Dr. Buchman describes providing euthanasia as the most patient- centered way to relieve suffering. Dr. Buchman’s views are not consistent with the official policy of the CMA regarding palliative care (3), or the position of the Canadian Society of Palliative Care Physicians (CSPCP) and the majority of palliative care physicians in Canada who do not view euthanasia as part of palliative care. In a recent survey, CSPCP members strongly agreed that euthanasia is not part of the provision of palliative care. The vast majority (92% of 213 respondents) do not provide euthanasia (4). The CSPCP position that palliative care strives to reduce suffering, not to end life (5), is consistent with international standards for palliative care, such as the World Health Organization definition (6). CMA Policy on Palliative Care also recognizes that palliative care and MAiD are distinct (3).

Dr. Buchman romanticizes euthanasia. He calls it “the most patient-centered service I could offer,” leading to “the most peaceful death I had ever witnessed.” Peer reviewed, published evidence demonstrates that most requests for euthanasia are motivated by a desire for control, or a fear of dying, not by uncontrolled symptoms such as pain or shortness of breath (7). The patient Dr. Buchman refers to in his essay illustrates the existential, not symptom-based, risk factors involved. These existential issues include fear of loss of control, questioning the meaning, purpose and value of life, fear of what comes after death, demoralization, and fear of being a burden to others (8). None of these issues are properly addressed by euthanasia, and hastening the death of a patient removes any further therapeutic opportunities. Simply bowing to “patient autonomy” and ending a life without working hard to alleviate the deeper total pain is hardly “patient centered” in the most robust sense of that term. As Chochinov and Mount beautifully express, “…to be clear, palliative care is not a panacea that can eliminate every instance and every facet of end-of life suffering. However, the physician-patient relationship is complex and profound. Preserving dignity for patients at the end of life is comprised of a steadfast commitment to non-abandonment and a tone of care marked by respect, kindness, and an unwavering affirmation of patient worth.” (9).

The other group of citizens ignored in Buchman’s account are those whose lives are made even more vulnerable by the very existence of euthanasia, including those with disabilities, mental illness, dementia, children, seniors, and those who lack resources including financial, social supports, or access to palliative care. The Vulnerable Persons Standard (VPS) has been developed to provide standards for safeguards needed in Canada to protect those who are most vulnerable to coercion, or who feel that they have no other option than to choose to have their lives ended (10). Sadly, these very practical, broadly supported and meticulously documented recommendations for true “patient-centered care” have been dismissed and ignored by supporters of euthanasia and all levels of government. The few regulations that have been implemented, such as the requirement for capacity – both at the time of request and at the time of delivery of euthanasia, and a ten day waiting period between formal request and death, have no standard system of oversight to ensure compliance, and enforcement is essentially non-existent. There are no standardized training requirements for capacity assessment or psychiatric consultation for MAiD. Individual physicians or nurse practitioners are solely responsible to determine eligibility and whether or not to waive the ten day interval. The assessments for receiving government supported workers’ compensation or home oxygen are often more lengthy and stringent than those done in preparation for MAiD!

Drs. Blackmer and Buchman assert that the CMA supports physicians who refuse to participate in euthanasia (1,2). They fail to note that some provincial medical regulators, including the largest one in Canada with over 40,000 physician members, demand strict physician participation through “effective referral” (11), and that physicians who refuse such participation could be forced to withdraw from practice or lose their licences altogether. Some of these physicians are fighting a lengthy and expensive court battle to resist this coercion (12). A number of medical groups have supported these physicians by requesting intervener status in the case. The CMA has not.

Two and a half years after its legalization in Canada, strong lobbies are intensifying their push for euthanasia as a response to mental illness, physical disability, cognitively incapacitated patients through advance directives, and children. In Toronto, the Hospital for Sick Children has already drafted policy on providing euthanasia to mature minors (children felt to be capable of making their own medical decisions, despite not yet reaching the age of majority), anticipating a change in legislation later this year that would make euthanasia permissible for these children (13).

These developments, and the ongoing jeopardy faced by objecting physicians in Canada, contradict the optimistic, rosy assessment offered by Drs. Blackmer and Buchman. Other jurisdictions need to take a hard look at the reality of the Canadian context before holding Canada up as an example to be emulated.

• Dr. Leonie Herx, Division Chair & Associate Professor of Palliative Medicine, Connell Chair in Palliative Medicine, Queen's University, Kingston, Ontario, Canada
• Dr. Srini Chary, Associate Professor, Division of Palliative Medicine, University of Calgary, Calgary, Alberta Canada 
• Dr. Ed Dubland, Palliative Medicine Consultant, Burnaby, British Columbia, Canada
• Dr. Robin Fainsinger, Professor, Division of Palliative Care Medicine Medicine, Edmonton, Alberta, Canada 
• Dr. David Henderson Palliative Medicine Consultant, Truro, Nova Scotia, Canada 
• Dr. Bernard Lapointe, Associate Professor, Departments of Oncology & Family Medicine, Director of Palliative Care, McGill University, Montreal, Quebec, Canada 
• Dr. Valerie Schulz, Professor, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada 

1. Blackmer J. Commentary: How the Canadian Medical Association found a third way to support all its members on assisted dying. BMJ. 2019 Jan 30;364:l415.
2. Buchman S. Why I decided to provide assisted dying: it is truly patient centred care. BMJ. 2019 Jan 30;364:l412.
3. Palliative Care (Policy). Canadian Medical Association. 2016. Accessed on February 6, 2019: (Link)
4. Medical Assistance in Dying Member Survey (October 2017). Canadian Society of Palliative Care Physicians (CSPCP) 2018 February. Accessed on February 6, 2019: (Link)
5. Key Messages: Physician-Hastened Death. Canadian Society of Palliative Care Physicians (CSPCP) 2015, October. Accessed on February 6, 2019: (Link)
6. WHO Definition of Palliative Care. Accessed on February 6, 2019: (Link)
7. Palliative Care (Policy). Canadian Medical Association. 2016. Accessed on February 6, 2019: (Link)
8. Rodríguez-Prat A et al. Understanding patients' experiences of the wish to hasten death: an updated and expanded systematic review and meta-ethnography. BMJ Open. 2017 Sep 29;7(9):e016659. Accessed on February 6, 2019: (Link)
9. Chochinov, H. Dying, Dignity, and New Horizons in Palliative End‐of‐Life Care. CA: A Cancer Journal for Clinicians. 2006; 56: 84-103. doi:10.3322/canjclin.56.2.84
10. Chochinov H, Mount B. Physician Hastened Death: Awaiting a Verdict. CMAJ Blog. 2014 October, 14. Accessed on February 6, 2019: (Link)
11. Vulnerable Persons Standard. Accessed on February 6, 2019: http://www.vps-npv.ca/
12. Medical Assistance in Dying (Policy). College of Physicians and Surgeon of Ontario. 2016 Accessed on February 6, 2019: (Link)
13. Leiva, R et al. Euthanasia in Canada: a cautionary tale. World Medical Journal. 2018 64(3):17 Accessed on February 6, 2019: (Link)
14. DeMichelis C, Zlotnik Shaul R, Rapoport A. Medical Assistance in Dying at a paediatric hospital. J Med Ethics. 2019 Jan;45(1):60-67.

Montana Bill prohibiting assisted suicide passes in committee.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition.

Great news: Montana House Bill 284 (HB 284) passed in the Judiciary House ensuring that it will be debated and voted in the Montana Senate. The debate on the bill may happen later this week.

It is interesting that the media have been silent on the success of HB 284.

Montanans have faced a confusing situation concerning assisted suicide. In 2009, the Baxter court decision declared that Montana citizens had a right to assisted suicide. The Baxter decision was appealed to the Montana Supreme Court where it was decided that Montana citizens do not have a right to assisted suicide but even but the Court granted a tightly worded defense of consent, if a physician was prosecuted for assisted suicide.

* Physician-Assisted Suicide is not legal in Montana.

Since the Montana Supreme Court decision, the assisted suicide lobby has claimed that assisted suicide is legal in Montana, while in fact assisted suicide is technically prohibited.

HB 284 reverses the Montana Supreme Court Baxter decision by clarifying that consent is not a defense for homicide or assisted suicide.

The assisted suicide lobby sent out an emergency appeal today calling HB 284 the physician imprisonment act. The assisted suicide lobby is confirming that assisted suicide is not legal in Montana.

Assisted suicide abandons people at their time of greatest human need.

Care Not Killing poll: public are aware of the dangers of assisted suicide

The Care Not Killing Alliance UK recently conducted a poll that indicates that the public are aware of the dangers of legalizing assisted suicide.

A ComRes poll concerning attitudes to assisted suicide, commissioned by CNK, found that:

● 51% 'would be concerned that some people would feel pressurised into accepting help to take their own life so as not to be a burden on others' if assisted suicide were legal (with only 25% disagreeing) 

● 48% say that giving GPs 'the power to help patients commit suicide' would 'fundamentally change the relationship between a doctor and patient, since GPs are currently under a duty to protect and preserve the lives of patients' (with only 23% disagreeing).

Gordon MacDonald

Dr Gordon MacDonald, a spokesman for Care Not Killing commented:

'This poll shows a greater level of understanding of the difficulties with assisted suicide than most so-called experts think possible. Usually the public are only asked a simple rights based question that is heavily framed, but these questions reveal significant unease around the removing universal protections to allow doctors to kill their patients.'

The poll found that most (51 per cent) of those surveyed were concerned that some people might feel pressured into accepting help to take their own life 'so as not to be a burden on others', while half that proportion (25 per cent) disagreed. These figures reflect what is happening in the US states of Oregon and Washington where a majority of those ending their lives in 2017 said that not wanting to be a burden was a motivation for their decision. This compared to just one in five (21 per cent) in those states who were concerned about the possibility of inadequate pain control, or experiencing discomfort.

Murder trial of Michel Cadotte or "Mercy Killing"

The following update was part of the webcast produced by the disability rights group, Toujours Vivant - Not Dead Yet. You can watch the full webcast here (Link).

In Québec, the trial of Michel Cadotte in the homicide of his wife Jocelyne Lizotte two years ago is wrapping up. Mr. Cadotte is accused of second degree murder after he admitted to smothering his wife who had dementia; he claims he wanted to end her suffering.

Québec man uses "mercy killing" defense in wife's murder.

Psychologist Gilles Chamberland testified that Cadotte’s actions were not related to depression. Nor was he overwhelmed with caring for his wife, since she was in a long-term care facility. Mr. Cadotte had asked for euthanasia on his wife’s behalf but been refused.

Evidence presented at trial showed that Ms. Lizotte’s condition was no better or worse than it had been in some time, but that Mr. Cadotte had been drinking heavily over the weekend leading up to the homicide.

Mr. Cadotte claims he killed Ms. Lizotte “out of compassion,” but a report filed by Dr. Chamberland said Cadotte wanted “end her suffering,” to stop his own pain.

Intimate partner violence among elders is neither rare nor new. A 2007 study of murder-suicides from the Clinical Interventions in Aging journal found that life-ending violence is often explained away as “altruistic,” especially in cases where one party is ill. This distortion prevents “proper investigation into the specifics of the case, especially with regard to victim consent.” In one incident, a husband “claimed his wife had terminal cancer, but the autopsy found she had no evidence of any illness.”

These murders may be inspired by the perpetrator’s “strong need to control [the spouse’s] fate.” Some even thought death was preferable over sending their partners to a nursing home.
The study rightly concludes that “[domestic] violence events should never be viewed as romantic or altruistic as it is often erroneously reported in the news media.”

Disabled girls and women are also at a higher risk for abuse, including at the hands of their partners. In a 2017 submission to the United Nations, Women Enabled International explained that “women with disabilities worldwide experience domestic violence – including physical, sexual, emotional, psychological, and financial abuse – at twice the rate of other women.”

These women must also rely on the abuser “to meet personal needs; indeed, when the abuser is also a caregiver, it is frequently impossible for women with disabilities to get help.” Women may be unable to leave a dangerous living situation because they don’t have transportation or can’t find an accessible shelter. The longer women stay in abusive environments, the higher the risk that violence will escalate to homicide.

Can doctors be neutral on euthanasia and assisted suicide?

This article was published by Mercatornet on February 14, 2019. 

By Margaret Somerville

Margaret Somerville

The BMJ has recently published two articles, one by Dr Sandy Buchman, a palliative care physician and the incoming president of the Canadian Medical Association (CMA), the other by Dr Jeff Blackmer, a physician and vice president of international health at CMA presenting a very positive and benign picture of the implementation of legalized physician-assisted suicide and euthanasia in Canada, euphemistically called “Medical Aid in Dying” (MAiD).

Canadian Medical Association exaggerates its support for conscience rights.

As an academic medical ethicist at McGill University in Montreal for nearly four decades and now living and working in Australia, I am concerned that Australian legislatures, which are currently considering whether to legalize physician-assisted suicide and euthanasia, might accept the picture presented in these articles, without identifying their deficiencies.

In focusing only on respect for the autonomy and relief of the suffering, of an individual, personally identified, educated, mentally competent patient who requests and gives informed consent to MAiD, Dr Buchman makes the strongest case possible for the ethical acceptability of euthanasia and its legalisation. But, apart from other concerns, generalizing even these justifications beyond Dr Buchman’s patient and his specific characteristics and circumstances raises problems. In reality, how many people requesting euthanasia or assisted suicide (MAiD) will have the intensive attention, medical and family support Dr Buchman describes, or be as informed, articulate and highly educated as this patient, who himself was a doctor?

Respect for individual autonomy is used, as Dr Buchman does, by pro euthanasia advocates as a justification for legalizing MAiD. But it is far from the only consideration which needs to be taken into account, even if one does not object to MAiD on the most fundamental basis that we should not authorise anyone, let alone doctors, to intentionally inflict death on other human beings.

Dr Buchman makes no mention of any such considerations, in particular, risks and harms to the “common good” and society. These include breaches of the value of respect for human life at both the individual and societal levels, and serious physical and existential risks and harms to vulnerable people, especially those who are disabled and fragile elderly people.

Whether we agree or disagree with MAiD, we can all agree with Dr Buchman’s goal of relief of suffering, but we must kill the pain and suffering, not the person with the pain and suffering.

Dr Blackmer’s article raises a wide range of important issues, which he does not identify. They include: Is MAiD medical treatment? It can be argued that it is not. Likewise, MAiD is not, as its promoters argue, just a legitimate incremental extension of “good palliative care”. The informing philosophies of MAiD and palliative care are in conflict. Palliative care is based on a commitment to help people to live as fully as possible until they die a natural death. The informing principle of MAiD is that it is ethical to intentionally inflict death to relieve suffering or even the fear of future suffering.

Whether to legalize MAiD is a societal and political decision, not primarily a medical one and it’s suggested that if a society wants it to be available and legalizes it, for many reasons, it should be kept out of medicine. I call this “taking the white coat off euthanasia”.

By embracing euthanasia and assisted suicide as medical treatment the CMA made physician participation an expectation and refusing to provide them became an exception requiring justification. Despite assurances from the CMA leadership, Canadian doctors who object to participation in “therapeutic homicide” now risk discipline and even expulsion from the medical profession.

Euthanasia has been rapidly normalized and routinized in Canada at a rate that even one of its strongest advocates, Dr Yves Robert, registrar of the College of Physicians of Quebec, has found alarming, in that it has quickly become just another choice of how to die.

Not everything that is legal is ethical. So, the Canadian Medical Association could have maintained its long-established stance -- which reflects almost 2,500 years of medical ethics wisdom -- that it is unethical for physicians to participate in MAiD, even though it is now legal in Canada. When the cloak of medical approval is absent, the public are much more likely to question the wisdom of legalizing it.

Finally, while the CMA might be neutral with respect to who may be a member, in that it accepts as members both physicians who are pro-MAiD and those who are anti-MAiD, there is not, as Dr Blackmer claims, any “neutral stance” on the ethical acceptability of MAiD. In not continuing to oppose physicians’ involvement in it as unethical, the CMA is unavoidably supporting it in some or other form, which is not a neutral position. In fact, we can see precisely that outcome in the use of CMA statements by Canadian courts, legislatures and regulators in promulgating and implementing the law legalizing MAiD in Canada.

In short, there is no neutral stance on the ethics of MAiD but a clear choice to be made as to whether one is for or against it, as the present conflict among Canadian physicians so clearly demonstrates, despite the CMA’s and Dr Blackmer’s desire to whitewash the situation.

Margaret Somerville is professor of bioethics in the school of medicine at the University of Notre Dame Australia. This article was originally published in the BMJ Rapid Responses online.

Canada's Justice Minister says that he will not change the euthanasia law before the October 2019 election.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Hon. David Lametti

Canada's new Justice Minister, David Lametti, who voted against Canada's euthanasia law because it didn't go far enough, told Tonda MacCharles from the Toronto Star that he will not push to change the euthanasia law before the next election. Lametti said:

Any changes would have to wait until the conclusion of a five-year parliamentary review about how the new regime is working.

“the parliamentary process struck “an important balance” that he respects, and a five-year review would be able to assess “data” and “evidence” about the impact the law is having.

Lametti told MacCharles that Canada's euthanasia is only the first step:

“I think the bill as it stands is an important marker, an important first step in a moral and ethical debate, as well as health-law debate, a policy debate,”

“And so the balance that was struck was appropriate in terms of that first step; I think it’s too early to do anything else.”

Clearly, Lametti is distancing himself, for now, from extending Canada's euthanasia law.

Canada's parliament will debate conscience rights for health care professionals before the election. 

David Anderson MP introduced Bill C-418 to uphold conscience rights for healthcare professionals. Conscience rights were not protected by Canada's euthanasia law.

• Canada's new Justice Minister is radically pro-euthanasia.

Barbara Kay: Canada, euthanasia and the slippery slope.

Alex Schadenberg

Executive Director - Euthanasia Prevention Coalition

Barbara Kay

The National Post recently published an excellent article by columnist Barbara Kay concerning the incremental extensions to euthanasia that are occurring in Canada.

Kay refers to the fact that the Supreme Court euthanasia decision was promulgated four years ago with the prediction that there would be no "slippery slope" toward abuses of the future law. She quotes Andrew Coyne, the former editor of the National Post who then stated:

“When the subject is as priceless as a human life, it is not enough that consent usually be obtained. It must be in every case. It will not suffice if the safeguards are adequate. They must be perfect.”

Kay continues:

But since the right to be killed by medical practitioners paid by the state has now been normalized, individuals are stepping forward, as any student of human nature (and observer of the euthanasia histories of Belgium and the Netherlands) might have predicted, to demand custom-tailoring of that right.

Case in point, Kay writes about the Audrey Parker campaign to extend euthanasia to incompetent people who made a previous request:

Audrey Parker, a Halifax woman with terminal cancer who was assisted to death on Nov. 1, weeks earlier than she wished, left a video, released last week by Dying with Dignity Canada. In it, she said she would have preferred to stay alive until Christmas, but worried that her cancer, creeping to the lining of her brain, would render her unfit by then to invoke MAID. She asked for a “Parker’s amendment” to the law, allowing for a proxy to facilitate a previously sworn request in such circumstances. 

It sounds reasonable. All safeguard abrogations do when they are attached to sympathetic protagonists with a black-and-white narrative. They are less palatable, though, when attached to muddier stories, like the case of a Dutch woman with dementia who’d signed a living will endorsing euthanasia when of sound mind, but then, when the time came, struggling against the needle, had to be held down by relatives as the doctor killed her. 

In fact, the Canadian government already asked the Council of Canadian Academics to study advance consent, as well as euthanasia in cases of mature minors and advanced dementia. On Dec. 13 the council submitted a report including what it saw as the pros and cons of each proposal, but without recommendations. 

Federal Justice Minister David Lametti has said the government will continue to review the practice of MAID. He looks forward to “speaking with Canadians about how the (MAID) regime is working for them.”

Kay then examines the issue of conscience rights in Ontario. She states:

The College of Physicians and Surgeons of Ontario (CPSO), considered by many stakeholders to be the most aggressive association of its kind in the country on this file, took a conscience-hostile stance on physicians who refuse to perform or refer for euthanasia (or abortion) a decade ago, and hasn’t softened up since. 

According to Dr. Ryan Wilson, president of Canadian Physicians for Life (CPL), “Ontario is the only (physicians’ association) that says you have to either participate in or refer to someone who will participate.” 

CPL and other advocacy groups had hoped that Premier Doug Ford’s new administration would end the political shunning they were accustomed to under the Liberals, especially since in November, the province of Ontario dropped its intervention on CPSO’s behalf in a court case brought against the association by five doctors of conscience. But at the Nov. 16-18 Ontario PC party Toronto convention, Ford’s promise to legislate conscience rights did not make it through the policy committee. 

The five physicians’ case was heard at the Court of Appeal on Jan. 21-22, with judgment pending. If they lose, as is likely, they are determined to take it to the Supreme Court.

Kay brings up several significant concerns with the application of Canada's euthanasia law. But there are more.

• Canadian woman seeks euthanasia from pelvic mesh pain.
• Mother upset after doctor pressured her to approve assisted death for her disabled daughter.
• Woman who dies by euthanasia may only have had a bladder infection.