Expert in Irish Assisted Suicide case claims that no abuse of vulnerable people occurs.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Marie Fleming, the wife of Exit International leader Tom Curran, is challenging the Irish law that protects people from assisted suicide.

Fleming, who lives with MS, is arguing that the ban on assisted suicide will force her to die an undignified death. She is asking the court to allow her husband, Tom Curran, the right to assist her suicide without fear of prosecution.

Similar to the Carter and Leblanc cases in Canada Fleming is basing her case on the concept that the law discriminates against people with disabilities who are unable to commit suicide without assistance.

An article published in the RTE News in Ireland on December 11, 2012 stated that Professor Margaret Battin, from the University of Utah, claimed that: 

"there was no evidence from studies in the US and the Netherlands that legalised assisted suicide led to abuse of vulnerable people such as the elderly, poor or disabled."

Margaret Battin

A similar article published in the Independent on December 12 stated that Margaret Battin stated that: 

"laws providing for assisted suicide did not lead to unlawful practices affecting vulnerable people. 

In areas where assisted suicide was permitted, a range of conditions and safeguards were applied, said Prof Battin of the University of Utah. 

She agreed there had been objections to her findings but did not believe any of those "hold adequate water".

Margaret Battin has been promoting euthanasia and assisted suicide for at least 30 years. She is not a neutral expert but a euthanasia apologist.

Battin bases her data on the reported cases of euthanasia and assisted suicide in jurisdictions where it is legal and she ignores the data concerning the unreported euthanasia deaths in the Netherlands and Belgium.

By analysing the data from three studies on the practice of euthanasia in Belgium (Physician-assisted deaths under the euthanasia law in Belgium: a population-based survey - CMAJ June 15, 2010, The role of nurses in physician-assisted deaths in Belgium - CMAJ June 15, 2010,Reporting of euthanasia in medical practice in Flanders Belgium: cross sectional analysis of reported and unreported cases - BMJ November, 2010) and the most recent major study on the practice of euthanasia and assisted suicide in the Netherlands (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 - Lancet July 2012) we learn that the practice of euthanasia is often abused and the euthanasia law is often ignored.

These four studies indicate that:

1. 32% of the euthanasia deaths are done without explicit request in the Flanders region of Belgium. 

2. We learn that nurses are carrying-out euthanasia deaths in Belgium, even though it is illegal for nurses to do euthanasia. 

3. 47% of the euthanasia deaths in the Flanders region of Belgium are not reported and 23% of the euthanasia deaths in the Netherlands are not reported as euthanasia.

A further analysis of these four peer reviewed studies indicates that:

1. When a physician reports a euthanasia death, as euthanasia, the physician usually follows the rules that are outlined by the law.

2. When a physician does not report a euthanasia death, the physician usually does not follow the rules that are outlined by the law.

3. The reasons for not reporting a euthanasia death, include the following: to avoid the administrative burden, the legal due requirements were not met or to avoid possible legal consequences. Often the physician never intended to report the death as euthanasia.

4. When a euthanasia death is not reported in Belgium, or done without explicit request the patient is more likely to be over the age of 80, die in a hospital, and is often incompetent to consent to the act. The same demographic is also over represented when a euthanasia death is done by a nurse in Belgium. Euthanasia deaths that are done without explicit request, that are unreported, or that are done by nurses fit the same demographic group. 

This demographic group "fits the description of a 'vulnerable' patient group" who have died by euthanasia without request.

5. Euthanasia deaths that are done by nurses in Belgium are not legal but occur. These deaths are usually done by order of a physician, but sometimes they are done without consulting a physician. These deaths are usually done by intentional opioid overdose, even though sometimes they are done by neuromuscular relaxants. Nurses who had previously been involved with a euthanasia death and male nurses were far more likely to carry-out euthanasia in Belgium.

Battin did agree that some studies may indicate that depressed people are dying by assisted suicide in Oregon. Battin stated: 

Oregon Death With Dignity Act may not adequately protect patients with mental illness or depression which in some cases may be missed or overlooked.

However she said she noted the word "may".

Battin may have forgotten about a study by her friend, Oregon researcher Linda Ganzini, that was published in 2008. Ganzini studied 58 people who requested assisted suicide in Oregon. Ganzini found that 15 of 58 participants in her study were either depressed or experiencing feelings of extreme hopelessness. Of the 58 participants in her study, 18 died by assisted suicide with 3 of the assisted suicide deaths being persons who Ganzini found had questionable competency due to their depression/feelings of hopelessness.

A similar study from the Netherlands that was published in 2005 found that people who showed signs of depression or exhibited "extreme feelings of hopelessness" were 4.1 times more likely to request euthanasia.

Margaret Battin needs to answer the question, whose findings do not "hold adequate water?"

Meanwhile the Irish government argued that there is no "right to suicide" in Ireland and legalizing assisted suicide will negatively effect certain vulnerable groups.

A similar court case was recently heard in the UK concerning Tony Nicklinson who was living with Locked-in-Syndrome. The three judges on the High Court in the UK decided in the Nicklinson/Martin case that the issues of euthanasia and assisted suicide should be decided by parliament and not the courts.