Friday, October 26, 2012

Legalizing euthanasia does not stop the abuse.

I was debating one of the leaders of the euthanasia lobby yesterday and she stated that - where euthanasia is legal, it is regulated, therefore there is less abuse. I reacted by presenting the information from the studies in Belgium and the Netherlands that prove that even though euthanasia is legal, abuse remains prevalent.

Then I was reminded of the recent email that I received from a person seeking information after her husband died after being intentionally dehydrated to death. She also thought that legalization would lead to greater controls. This is how I responded: 

In jurisdictions where euthanasia has been legalized, such as Belgium and the Netherlands, deaths by dehydration have not stopped and in fact have substantially increased. Studies from Belgium and the Netherlands prove that deaths by Deep Continuous Sedation, have increased after euthanasia was legalized. Deep Continuous Sedation is done by sedating a person and then withdrawing fluids and food. Deep Continuous Sedation or Terminal Sedation must be differentiated from Palliative Sedation which is done to kill pain and not patients.

Belgium euthanasia was legalized in 2002. An article entitled: Medical End-of-Life Practices under the Euthanasia Law in Belgium that was published in the New England Journal of Medicine (Sept 10, 2009) found that after legalization the rate of euthanasia increased, the rate of euthanasia without explicit request decreased but remained very high (1.8% of all deaths) and the rate of people who died by Continuous and Deep Continuous Sedation increased from 8.2% of all deaths in 2001 to 14.5% of all deaths in 2007. 

The article concluded: "We found that the enactment of the Belgium euthanasia law was followed by an increase in all types of medical end-of-life practices, with the exception of the use of lethal drugs without the patients explicit request."

A further examination of the facts indicates that in Belgium, 32% of all euthanasia deaths are done without explicit request. This statistic was determined by a study entitled: Physician-assisted deaths under the euthanasia law in Belgium: a population-based survey that was published in the Canadian Medical Association Journal (June 15, 2010). Even though the number of euthanasia deaths without explicit request decreased, and even though these euthanasia deaths did not follow the legal requirements for euthanasia, the number of these deaths remained "out-of-control," after legalizing euthanasia in Belgium.

In the Netherlands euthanasia was officially legalized in 2001. When examining the statistics in the Netherlands the recent study that was published (July 11, 2012) in the Lancet entitled:Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey found that deaths by Deep Continuous Sedation increased from 5.6% of all deaths in 2001 to 8.2% of all deaths in 2005 to 12.3% of all deaths in 2010. Deaths by euthanasia without request have decreased but in 2005 there were still 550 deaths without explicit request and in 2010 there were still 310 deaths without explicit request.

You suggested that once euthanasia is legal it would be "under the microscope." A study that was published in the British Medical Journal (November 2010) entitled: Reporting of euthanasia in medical practice in Flanders, Belgium: cross sectional analysis of reported and unreported cases found that 47.2% of the euthanasia deaths were unreported. The recent study that was published in the Lancet concerning end-of-life practices in the Netherlands found that 23% of the euthanasia deaths were unreported. The practice of euthanasia is not "under the microscope."

The theory that legalizing euthanasia will lead to greater control and fewer abuses is not true. The studies from jurisdictions where euthanasia has been legalized indicate that legalizing euthanasia and assisted suicide is not safe.


rob jonquiere said...

Dear Alex,
This post leaves me with a couple of questions.
1. why not mention who and where you debated about the issue of euthanasia?
2. why do you not follow up on the answer this leader of the euthanasia lobby gave?
By including these answers in your blog, you might strengthen your arguments? Or does leaving those out means that this leader had strong points weakening your argument??

Alex Schadenberg said...

Dear Rob:

Because of the nature of the debate, (on the radio) she actually didn't get a chance to respond.

The argument that there is less abuse where it is legal only works when you discount the unreported euthanasia deaths or when you ignore deaths without explicit request.

The fact is once euthanasia is legalized the studies prove that there is an increase in all types of assisted deaths and abuse is not eliminated, but in fact, remains prevalent.

In the Netherlands, euthanasia was legalized by the courts and in 2001 it was officially legalized by parliament. Therefore the Netherlands statistics are different than Belgium.

rob said...

Dear Alex, So it was not a debate at all? No exchange of arguments? Yours are known, I was curious to her's.