Holocaust Memorial Day – Let’s not forget the key role doctors played

Dr. Peter Saunders

The following article was written by Dr. Peter Saunders, the campaign director for the Care Not Killing Alliance in the UK. This article was published on his blog  on Holocaust Memorial Day under the title: Holocaust Memorial Day - Let's not forget the key role doctors played.

By Peter Saunders, January 27, 2013

The millions of Jews and others killed during the Holocaust have been remembered in services today across the UK, as part of Holocaust Memorial Day. 

Candles have been lit at ceremonies in London and Staffordshire's National Memorial Arboretum, 68 years after Auschwitz was liberated.


More than one million people, mostly Jews, died at the Nazi camp before it was liberated by allied troops in 1945.

Nazi Doctors at Nuremberg 

But the horrific genocide of six million Jews was only the final chapter in the story. 

What is far less well known is the role of doctors in the process. 

Twenty-three physicians were tried at the so-called Nuremberg Doctors' Trial in 1946 (picture), which gave birth to the Nuremberg Code of ethics regarding medical experiments. 

Many others including some of the very worst offenders never came to trial (see full list here). 

What ended in the 1940s in the gas chambers of Auschwitz, Dachau and Treblinka had much more humble beginnings in the 1930s in nursing homes, geriatric hospitals and psychiatric institutions all over Germany. 

When the Nazis arrived, the medical profession was ready and waiting.

Germany emerged from the First World War defeated, impoverished and demoralised. 

Into this vacuum in 1920 Karl Binding, a distinguished lawyer, and Alfred Hoche, a psychiatrist, published a book titled ‘The granting of permission for the destruction of worthless life. Its extent and form'. 

In it they coined the term ‘life unworthy of life’ and argued that in certain cases it was legally justified to kill those suffering from incurable and severely crippling handicaps and injuries. Hoche used the term ballastexistenzen (‘human ballast’) to describe people suffering from various forms of psychiatric disturbance, brain damage and retardation.

By the early 1930s a propaganda barrage had been launched against traditional compassionate 19th century attitudes to the terminally ill and when the Nazi Party came to power in 1933, 6% of doctors were already members of the Nazi Physicians League. 

In June of that year Deutsches Arzteblatt, today still the most respected and widely read platform for medical education and professional politics in Germany, declared on its title page that the medical profession had ‘unselfishly devoted its services and resources to the goal of protecting the German nation from biogenetic degeneration’.

From this eugenic platform, Professor Dr Ernst Rudin, Director of the Kaiser Wilhelm Institute of Psychiatry of Munich, became the principle architect of enforced sterilisation. The profession embarked on the campaign with such enthusiasm, that within four years almost 300,000 patients had been sterilised, at least 50% for failing scientifically designed ‘intelligence tests’.

By 1939 (the year the war started), the sterilisation programme was halted and the killing of adult and paediatric patients began. The Nazi regime had received requests for ‘mercy killing’ from the relatives of severely handicapped children, and in that year an infant with limb abnormalities and congenital blindness (named Knauer) became the first to be put to death, with Hitler’s personal authorisation and parental consent.

This ‘test-case’ paved the way for the registration of all children under three years of age with ‘serious hereditary diseases’. This information was then used by a panel of ‘experts’, including three medical professors (who never saw the patients), to authorise death by injection or starvation of some 6,000 children by the end of the war.

Adult euthanasia began in September 1939 when an organisation headed by Dr Karl Brandt and Philip Bouhler was set up at Tiergartenstrasse 4 (T4) (pictured right) The aim was to create 70,000 beds for war casualties and ethnic German repatriates by mid-1941. 

All state institutions were required to report on patients who had been ill for five years or more and were unable to work, by filling out questionnaires and chosen patients were gassed and incinerated at one of six institutions (Hadamar being the most famous). 

False death certificates were issued with diagnoses appropriate for age and previous symptoms, and payment for ‘treatment and burial’ was collected from surviving relatives.

The programme was stopped in 1941 when the necessary number of beds had been created. By this time the covert operation had become public knowledge. 

The staff from T4 and the six killing centres was then redeployed for the killing of Jews, Gypsies, Poles, Russians and disloyal Germans. By 1943 there were 24 main death camps (and 350 smaller ones) in operation.

Throughout this process doctors were involved from the earliest stage in reporting, selection, authorisation, execution, certification and research. They were not ordered, but rather empowered to participate. 

Leo Alexander, a psychiatrist with the Office of the Chief of Counsel for War Crimes at Nuremberg, described the process in his classic article 'Medical Science under Dictatorship' which was published in the New England Medical Journal in July 1949.

‘The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the attitude, basic in the euthanasia movement that there is such a thing as a life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans.’ 

Dr. Karl Brandt

The War Crimes Tribunal reported that ‘part of the medical profession co-operated consciously and even willingly’ with the ‘mass killing of sick Germans’. 

Among their numbers were some of the leading academics and scientists of the day; including professors of the stature of Hallervorden (neuropathology), Pernkopf (anatomy), Rudin (psychiatry/genetics), Schneider (psychiatry), von Verschuer (genetics) and Voss (anatomy). None of these men were ever prosecuted while of the 23 defendants at Nuremberg, only two were internationally recognised academics.

It is easy to distance ourselves from the holocaust and those doctors who were involved. However, images of SS butchers engaged in lethal experiments in prison camps don’t fit the historical facts; the whole process was orchestrated through the collaboration of internationally respected doctors and the State. 

With the advantage of hindsight we are understandably amazed that the German people and especially the German medical profession were fooled into accepting it. The judgement of the War Crimes Tribunal in 1949 as to how they were fooled was as follows. 

'Had the profession taken a strong stand against the mass killing of sick Germans before the war, it is conceivable that the entire idea and technique of death factories for genocide would not have materialized...but far from opposing the Nazi state militantly, part of the medical profession co-operated consciously and even willingly, while the remainder acquiesced in silence. Therefore our regretful but inevitable judgement must be that the responsibility for the inhumane perpetrations of Dr Brandt (pictured left)...and others, rests in large measure upon the bulk of the medical profession; because the profession without vigorous protest, permitted itself to be ruled by such men.' (War Crimes Tribunal. 'Doctors of Infamy'. 1948)

A 2010 article in American Medical News covered the United States Holocaust Memorial Museum’s exhibition on medicalised killings under the Nazis. It concluded:

“‘The misguided scientific ideas of physicians and scientists were integral to Nazis' crimes against humanity and should serve as a reminder to doctors to put patients before political ideology ... As evil as these actions appear in retrospect, they arose out of a highly sophisticated German medical culture... More than half of the Nobel Prizes that were awarded in science through the 1930s went to Germans ... 'These doctors became killers, not despite their training but in the name of their science and training… All doctors and medical professionals need to know and understand this material.'"

True Dignity Vermont overwhelms opposition at Senate committee hearing.

The following message is from True Dignity Vermont about the recent hearing on assisted suicide in Vermont.

Opponents of assisted suicide hugely outnumbered proponents at tonight's public hearing before the Vermont Senate Judiciary and Health and Welfare committees. 

Three board members of True dignity got two minutes each to speak, as did many other opponents. The common theme was that legalizing assisted suicide would have unintended consequences such as suicide contagion, elder abuse, the perception by sick people of a duty to die, expansion to euthanasia, expansion to the non terminally ill and the incompetent, and a fundamental and corrupting change in the way both patients and doctors view the practice of medicine.

The proponents did not even try to respond to these concerns. Some actually reinforced them by saying things such as "If I were facing Alzheimer's I would want to have the option of death with dignity.". This is either ignorance or a dead giveaway that the proponents will push for the expansion of assisted suicide to people who are either more than six months from death or incompetent, since that expansion would be necessary to include Alzheimer's patients, who become incompetent earlier than six months before death.

Peter Shumlin, the governor of Vermont, has been pushing for the legalization of assisted suicide throughout his political career. Vermont has faced continuous attempts to legalize assisted suicide over the past several years.

For more information go to: Vermont Governor commits to legalizing assisted suicide, again. 

Six lessons from euthanasia deaths in Belgium

By Michael Cook, January 28, 2013. Link to the original article.

They look at you with mild detachment. Not aggressive. Not friendly. Not happy. Not sad. Just detached. Two balding middle-aged Belgians with shaved heads, scruffy growth, and dark-rimmed oval glasses. The left ear of the man on the right juts out at a sharper angle. But otherwise the two faces are one face. They were the face of 45-year-old identical twins Marc and Eddy Verbessem.

Two weeks before Christmas, a doctor euthanased them at Brussels University Hospital. It was a perfectly legal procedure. All the boxes had been ticked and all the documents signed. The two men were deaf and slowly going blind as well. They had nothing to live for. They qualified.

But nearly everyone felt that there was something inhumanly cold about a society which failed these simple men when they could see and killed them when they couldn’t.

As a paradigm case of Belgian euthanasia, it pays to examine how it unfolded and what it reveals about a legalized right to die.

* * * * *

Marc and Eddy Verbessem were born deaf. They never married and they lived together, working as cobblers. When they discovered that they had another congenital disorder, a form of glaucoma, they asked for euthanasia. They could not bear the thought of never seeing each other again.

According to their local doctor, David Dufour, they had other medical problems as well, including debilitating back pain. "All that together made life unbearable,” he told the London Telegraph.

Their family opposed their decision. So did the local hospital. It took them nearly two years to find a doctor who was willing to administer a lethal injection under Belgium’s euthanasia law. This was Professor Wim Distelmans, a well-known euthanasia activist. He seems proud to have played a key role in "the first time in the world that a 'double euthanasia' has been performed on brothers”.

On December 14, dressed in new suits and shoes, reluctantly accompanied by their brother and their parents, they arrived for their appointment with Professor Distelmans. Dr Dufour described their final moments to the media: “They were very happy. It was a relief to see the end of their suffering. They had a cup of coffee in the hall, it went well and [they had] a rich conversation. The separation from their parents and brother was very serene and beautiful. At the last there was a little wave of their hands and then they were gone.”

But a fig leaf of smarmy words cannot hide the fact that the twins were killed by their own doctor. Even supporters of euthanasia felt uneasy. 

Lesson one: the expanding circle. 

Under Belgian law euthanasia is allowed if “the patient is in a medically futile condition of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident”.

But the Verbessem brothers were not terminally ill. A doctor at their local hospital said, “I do not think this was what the legislation meant by 'unbearable suffering’". Professor Distelmans was nonchalant: “One doctor will evaluate differently than the other."

In an email interview, Jacqueline Herremans, president of Belgium's Association for the Right to Die with Dignity, told me that euthanasia should be made available to many more people:

“When we opened the debate almost 15 years ago, the first thought was for people suffering from incurable cancers. And it is still cancer which is the origin of almost 80% of the cases of euthanasia. But we must admit that suffering may exist in other circumstances. MS, ALS, Parkinson’s are obvious. But what about psychiatric disorders without any possibility of cure? What about ageing persons with several medical affections losing their autonomy and seeing no more sense to their life, knowing that tomorrow is going to be worse than today? What about Alzheimer’s patients?”

Lesson two: euthanasia-minded doctors prefer easy deaths to complicated social work. 

Marc and Eddy Verbessem’s problems were complex. They were shy and withdrawn. Soon they would be not only deaf but deaf and blind. It was difficult for doctors to communicate with them. The easiest way to unravel their social problems was to end them forever.

However, as deaf communities pointed out, being deaf and blind is not a death sentence. After all, America’s best-known deafblind person, Helen Keller, travelled the world, wrote books and became an ardent propagandist for socialism.

In fact, a Canadian deafblind activist was dumbfounded. “I wonder if the deafblind Verbessem twins know…  the education that was available, the Deafblind community in Belgium around them, the tools that were out there for them to keenly acquire so that their fears of going blind would be soothed with their own amazement and comfort?” Coco Roschaert wrote on her blog.

More to the point: did the doctors who euthanased them know? Did they care?

Lesson three: safeguards are meant to be hurdled. 

Supporters of legalised euthanasia insist that safeguards in the legislation restrict euthanasia to the most difficult cases. In fact, it is becoming easier and easier to be euthanased in Belgium. A report published late last year by the Brussels-based European Institute of Bioethics has claimed that euthanasia is being “trivialized” and that the law is being monitored by a toothless watchdog. After 10 years of legalised euthanasia and about 5,500 cases, not one case had ever been referred to the police.

The case of the Verbessem twins also shows that the procedure is far from transparent. If a prisoner dies in jail, all the facts are made available to the public. If a patient is euthanased, the public may never even find out that it happened. For example, little is known about the health of the twins, how they communicated with the doctors who killed them, whether their social support was adequate, why another hospital had turned down their request, how much counselling they had received.

Doctors naively – or is it arrogantly? – want the public to know as little as possible. “I have been very surprised [that] there is so much interest and debate about this,” Dr Dufour said.

Lesson four: if you’re disabled, you’re in trouble. 

Professor Chris Gastmans, of the Catholic University of Leuven, criticised the deaths as an impoverished response to disability. "Is this the only humane response that we can offer in such situations? I feel uncomfortable here as ethicist. Today it seems that euthanasia is the only right way to end life. And I think that's not a good thing. In a society as wealthy as ours, we must find another, caring way to deal with human frailty."

Lesson five: compassionate euthanasia has a price tag. 

Both Eddy and Marc were charged 180 Euros each for transporting their bodies back home. This macabre detail shouldn’t surprise us. China also charges the families of the people it executes. It's called a bullet fee.

Lesson six: not enough Belgians are being euthanased but the government has a plan. 

In 2011, the last year for which official figures are available, 1133 people were euthanized in Belgium. A few days after the Verbessem brothers died, the government announced that it would amend the law to allow minors and people with dementia to be euthanized as well.

Link to article: Belgium twins euthanized out of fear of blindness.

Assisted suicide would exacerbate the problem of elder abuse

The following article was written by Dr. Annie Bukacek from Kalispell Montana and published in the Missoulian in Montana under the title: Assisted Suicide would exacerbate problem of elder abuse in Montana.

For over 20 years, I have been an internal medicine physician with a high percentage of older patients. I have had the painful misfortune of personally observing countless instances of elder abuse. 

Elder abuse is horrific and on the rise. Perpetrators of the abuse include hired caregivers, neighbors and family members. In my experience, the motive is usually financial gain. This was true in the case of one of my patients, where a much younger man obtained financial control (became payee for Social Security and retirement benefits) by taking advantage of an elderly woman’s loneliness and dementia. He feigned romantic interest in her, flattering her to the point that she took his side against her family members. She became isolated and totally dependent on him. After many months, Adult Protective Services was able to provide a guardian. This same motive of greed could lead to coerced assisted suicide if there was anticipated financial gain, and death could occur quickly if assisted suicide was legal – before protection could be put in place. 

In Oregon and Washington, where assisted suicide is legal, portions of those states’ statutes lend themselves to elder abuse, such as the fact that no witness is required at the time of death. An elderly patient of mine recently died peacefully and of natural causes in his home, surrounded by family. His daughter was devastated when a family member visiting from Oregon asked if they had given him pills to end his life, as they would have done in her state. 

Elder abuse is already a huge problem in Montana. I hope Montana’s legislators will have the courage to stop legalization of assisted suicide here and thereby protect the elderly and disabled. 

For more information, including a summary of this important issue, see: www.montanansagainstassistedsuicide.org. 

Annie Bukacek, Kalispell Montana

Depressed patient died by assisted suicide in Oregon

The following letter was printed in the Montana Standard newspaper on January 27, 2013 under the title: Oregon doctor could not save patient from assisted suicide.

I am a doctor in Oregon, where assisted suicide is legal. A few years ago, I was caring for a 76-year-old man who presented to my office a sore on his arm, eventually diagnosed as melanoma. I referred him to specialists for evaluation and therapy.

I had known this patient and his wife for more than a decade. He was an avid hiker, a popular hobby here in Oregon. As his disease progressed, he was less able to do this activity, becoming depressed, which was documented in his chart.

During this time, my patient expressed a wish for assisted suicide to one of the specialists. Rather than take the time to address his depression, or ask me as his primary care physician to talk with him, she called me and asked me to be the “second opinion” for his suicide. She told me that barbiturate overdoses “work very well” for patients like this, and that she had done this many times before.

I told her that assisted suicide was not appropriate for this patient and that I did not concur. I was very concerned about my patient’s mental state, and told her that addressing his underlying issues would be better than simply giving him a lethal prescription. Unfortunately, my concerns were ignored, and two weeks later my depressed patient was dead from an overdose prescribed by this doctor.

Under Oregon’s law, I was not able to protect my depressed patient. If assisted suicide becomes legal in Montana, you may not be able to protect your friends or family members.

I urge you to contact your legislators to tell them to keep assisted suicide out of Montana. Don’t make Oregon’s mistake.

Dr. Charles J. Bentz
Portland, Oregon

For further information read: Oregon 2012 Assisted Suicide update.

Oregon 2012 Assisted Suicide statistics - an analysis

By Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

The number of assisted suicide prescriptions and deaths have, once again, increased in the State of Oregon in 2012.

The number assisted suicide deaths were: 77 in 2012, 71 in 2011, 65 in 2010 and 59 in 2009. There has been a 30% increase in the number of assisted suicide deaths in Oregon since 2009.

The number of prescriptions for assisted suicide were 115 in 2012, 114 in 2011, 97 in 2010 and 95 in 2009. There has been a 21% increase in the number of prescriptions for assisted suicide in Oregon since 2009.

The Oregon assisted suicide law does not prevent elder abuse.

Margaret Dore, the President of Choice is an Illusion and a lawyer from Seattle noted that the Oregon assisted suicide statistics are consistent with elder abuse.

Dore stated in her article that:

Oregon's assisted suicide law, itself, allows the lethal dose to be administered without oversight. This creates the opportunity for an heir, or someone else who will benefit from the patient's death, to administer the lethal dose to the patient without the patient's consent. Even if he struggled, who would know? 

The new report provides the following demographics: "Of the 77 DWDA deaths during 2012, most (67.5%) were aged 65 years or older; the median age was 69 years.  As in previous years, most were white (97.4%), [and] well-educated (42.9% had at least a baccalaureate degree) . . . ." Most (51.4%) had private health insurance. 

Typically persons with these attributes are seniors with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation. 

Oregon's law is written so as to allow such abuse to occur without anyone knowing. The new report is statistically consistent with elder abuse. 

The report indicated that the physician or another healthcare provider was present at the time of death in 11 of the 77 deaths.

The Oregon assisted suicide law does not prevent undue influence.

The Oregon report makes it appear that there is no undue influence to pressure people to assisted suicide. In Oregon, patients desiring treatment under the Oregon Health Plan have been offered assisted suicide instead.

Barbara Wagner

The most well known cases involve Barbara Wagner and Randy Stroup. Each wanted treatment. The Plan denied their requests and steered them to suicide by offering to pay for their suicides. Neither Wagner nor Stroup saw this scenario as a celebration of their "choice." Wagner said: "I'm not ready to die." Stroup said: "This is my life they’re playing with."

It is important to note that only 2 of the 77 people who died by assisted suicide in Oregon in 2012 were referred for a psychiatric evaluation. This is significant because a study conducted by Oregon researcher, Linda 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 Oregon study, who had asked for assisted suicide, 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.

The Oregon assisted suicide law does not prevent depressed people from dying by assisted suicide.

It is also noted that 14 of the people who received a prescription and died, have not submitted documentation and their ingestion status is unknown.

Assisted Suicide in Oregon is not limited to people who are terminally ill.

A recent letter from Jeanette Hall from King City Oregon stated:

In 2000, I was diagnosed with cancer and told that I had six months to a year to live. I knew that our law had passed, but I didn’t know exactly how to go about doing it. I did not want to suffer, and I did not want to do radiation. I wanted Stevens to help me, but he didn’t really answer me.

Instead, he encouraged me to not give up and ultimately I decided to fight the cancer. I had both chemotherapy and radiation. I am so happy to be alive!

It is now 12 years later. If Stevens had believed in assisted suicide, I would be dead. I thank him and all my doctors for helping me choose “life with dignity.”

The assisted suicide law in Oregon is not safe.

A recent letter written by Oregon attorney, Isaac Jackson, titled: The Oregon Assisted Suicide law is unsafe stated:

I write to inform your readers that Oregon’s assisted suicide law lacks transparency. Even law enforcement is denied access to information collected by the State. Moreover, this is official state policy. 

In 2010, I was retained by a client whose father had died under our assisted-suicide act. Unlike other deaths I have investigated, it was difficult to get basic information. 

After I wrote the state epidemiologist, I received a letter from the Attorney General’s Office that the agency charged with collecting assisted-suicide data, the Oregon Health Authority, “may only make public annual statistical information.” The letter also referred me to the Oregon Medical Board and law enforcement. 

The Board wrote me that there could be no investigation without an allegation of misconduct against a physician. At my request, a police officer was assigned to the case. Per his confidential report, the Oregon Health Authority would neither confirm nor deny that my client’s father had died under our act. Per the report, the officer did, however, talk to the doctor signing the death certificate who said that he did not know that the death had involved assisted-suicide. The death certificate listed the immediate cause of death as “cancer” and the manner of death as “natural.” 

Per the report, the officer also spoke with potential perpetrators who assured him that the death had been voluntary. He closed the case. 

This is a link to Oregon’s data release policy as of Jan. 1, that it “will not confirm on a case-by-case basis whether an individual has used, or a provider has been involved, with Death with Dignity.” 

Without transparency our law is not safe.

A recent letter from Kathryn Judson in Oregon confirms that the assisted suicide is not safe. She wrote:

When my husband was seriously ill several years ago, I collapsed in a half-exhausted heap in a chair once I got him into the doctor's office, relieved that we were going to get badly needed help (or so I thought). 

To my surprise and horror, during the exam I overheard the doctor giving my husband a sales pitch for assisted suicide. 'Think of what it will spare your wife, we need to think of her' he said, as a clincher. 

Now, if the doctor had wanted to say 'I don't see any way I can help you, knowing what I know, and having the skills I have' that would have been one thing. If he'd wanted to opine that certain treatments weren't worth it as far as he could see, that would be one thing. But he was tempting my husband to commit suicide. And that is something different. 

I was indignant that the doctor was not only trying to decide what was best for David, but also what was supposedly best for me (without even consulting me, no less). 

We got a different doctor, and David lived another five years or so. But after that nightmare in the first doctor's office, and encounters with a 'death with dignity' inclined nurse, I was afraid to leave my husband alone again with doctors and nurses, for fear they'd morph from care providers to enemies, with no one around to stop them. 

The Oregon assisted suicide law is controlled by a few insiders.

In 2009, Compassion & Choices, the assisted suicide lobby group that were formerly known as the Hemlock Society, facilitated 57 of 59 assistedsuicide deaths.

In 2008 the Oregonian newspaper urged Washington State citizens not to legalize assisted suicide. The Oregonian stated that the law was operated by: 

“a coterie of insiders run the [assisted suicide] program, with a handful of doctors and others deciding what the public may know.”  

The Oregon 2012 Assisted Suicide statistics and recent articles from Oregon confirm that there are significant problems with the assisted suicide law in Oregon, that no amount of control will keep hidden, forever, from its citizens. 

Oregon 2012 Assisted Suicide Statistics.

Margaret Dore

By Margaret Dore, Esq.

Oregon's assisted suicide statistics are out for 2012.[1]

This annual report is similar to prior years.  The preamble implies that the deaths were voluntary (self-administered), but the information reported does not address that subject.[2]

Oregon's assisted suicide law, itself, allows the lethal dose to be administered without oversight.[3]  This creates the opportunity for an heir, or someone else who will benefit from the patient's death, to administer the lethal dose to the patient without the patient's consent.  Even if he struggled, who would know?

The new report provides the following demographics:

"Of the 77 DWDA deaths during 2012, most (67.5%) were aged 65 years or older; the median age was 69 years.  As in previous years, most were white (97.4%), [and] well-educated (42.9% had at least a baccalaureate degree) . . . ."[4]  Most (51.4%) had private health insurance.[5]

Typically persons with these attributes are seniors with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation.[6]

Oregon's law is written so as to allow such abuse to occur without anyone knowing.  The new report is statistically consistent with elder abuse.

For more information: Assisted Suicide in Oregon, Evidence of missed evaluation for depression.

Footnotes:
[1]  The new report can be viewed here: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year15.pdf and
http://choiceisanillusion.files.wordpress.com/2013/01/year-15-2012.pdf 
[2]  Id.
[3]  Oregon's law can be viewed here:  http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx
[4]  Report cited at note 1.
[5]  Id.
[6]  Educated persons are generally financially better off than non-educated persons; persons with private insurance are generally well off; seniors generally are well off.  See " Broken Trust:  Elders, Family, and Finances, a Study on Elder Financial Abuse Prevention, by the MetLife Mature Market Institute, the National Committee for the Prevention of Elder Abuse, and the Center for Gerontology at Virginia Polytechnic Institute, March 2009, Executive Summary, page 4 ("Elders’ vulnerabilities and larger net worth make them a prime target for financial abuse").

Euthanasia: let's look at the bigger picture

The following article was written by Craig Wallace and published on Abc.net.au on the Ramp Up page on January 21, 2013 under the title: Euthanasia: let's look at the bigger picture.

Craig Wallace is the President of People with Disability Australia.

Media coverage of suicide and euthanasia often looks very different, depending on whether or not disability is a factor, writes Craig Wallace.

Euthanasia: lets look at the bigger picture.

Craig Wallace

By Craig Wallace, Ramp Up, January 21, 2013

Like many people, I was struck by last week's story about 45 year old deaf twin brothers killed by "legal euthanasia" in Belgium. According to reports, they were both going blind and were frightened of losing their independence and had "nothing to live for".

An excellent piece by Leah Hobson published on Ramp Up last week makes the case against stacking judgments on brothers Marc and Eddy. However our view on legalising euthanasia here in Australia needs to weigh personal rights, disability rights, financial, emotional and other pressures which we may experience to take our own lives.

It is significant that the focus of articles about euthanasia and end of life planning like this one in The Australian hastily drift into how much it costs the community to keep people with intensive support needs going. How quickly compassion dies and the calculators come out.

In the current world of rationed care and economic rationalism, it is not hard to imagine a situation where the availability of euthanasia becomes seen as a cheaper, easier, 'rational' option to providing intensive support, community living and care for those most vulnerable. Instead of having the support to make well-considered choices, the services that make life bearable could fall away and people with disabilities could be levered into taking their lives as the default option.

Euthanasia can become a euphemism which sanitises what is, essentially, suicide. It is hard to see what separated euthanasia from suicide for Mark and Eddy, except they had a disability.

Suicide is not a lifestyle option. It's the end of any choice, good or bad. It's choice denying. Also, suicide is handled in a very careful way by the media - it is often unreported to discourage copycat deaths and published articles usually carry warnings.

Suicide is something society discourages for every group of people. Except when they are talking about people with disabilities. No suggestions to call Lifeline or get help in articles like this one - instead we are told "they were very happy" and "it was a relief". The doctor who helped the twins take their lives reportedly described their end as a "gift".

What does it say about the perceived value of people with disabilities when our deaths are described in clinical terms and counted as a blessing?

People take their lives for all sorts of reasons - they might be bankrupt, old, ill, lonely, overworked, trapped in poverty, abused, addicted, confused about their sexuality, at the sharp edge of family breakdown, in shame or at the end of a long set of bad life experiences.

If suicide is a gift for one group of people who feel their lives have become unbearable, then why not for everyone who feels like this? Imagine the reaction if someone wrote about the tragic, senseless death of UK nurse Jacintha Saldanha and described it as a "relief".

In a world with total empathy and certainty - where we all understood what each other meant all of the time - I might support voluntary suicide in extremis on medical grounds.

But we don't live in such a world of crystal clarity, so my concerns are about definitions of words like 'voluntary' and 'unbearable' and how they will be interpreted by mortals, including doctors.

Let's look at the term 'unbearable', for example. Most lives involve periods of discomfort and pain - physical, emotional, mental. Unrequited love or grief can be a kind of incurable pain. Depression or arthritis another. Major life changes can cause pain. Some forms of pain may be fixed within people's lifetimes and others not. Each period of pain may seem unbearable at the time.

I have known many people with disabilities who have gone through stages of grief and loss, including suicidal feelings, and came through the other side with joy and a love of life. Everyone - with or without a disability - can make new choices over a lifetime. Or reach an acceptance of life. But there is no 'undo' button for death.

In Belgium legislators are now proposing amending the law to accommodate suicide for minors. If euthanasia is a right, then where do these rights stop and for whom? How can they be granted to one group of people and not another? This, it seems to me, is why it's simply not within the capacity of the State or the medical profession to decide who stays and who goes. This, I think, is also how the clientele for euthanasia can easily move from people in pain from cancer, to people in pain because of quadriplegia or paraplegia or chronic depression.

Discussions on these issues sometimes turn to religion and the sanctity of life. That's fine for others but my position is drawn from Article 10 of the UN Convention of the Rights of Persons with Disabilities, which affirms that every human being has the inherent right to life.

While I doubt there is a heaven, we have seen that hell can be created right here on earth. There are doors that call us there and should not be opened. 'Legal euthanasia' for people with disability is one of them.

If this article brings up any issues for you, support and information about suicide prevention is available by calling Lifeline Australia on 13 11 14.

Quebec Euthanasia: Thin Edge of the Wedge

The following letter was written by Alex Schadenberg and published on January 23, 2013 in the Calgary Herald (I did not choose the title for the letter) under the title: Thin Edge of the Wedge.

Re: "Quebec can be a model on assisted suicide law," Naomi Lakritz, Opinion, Jan. 22. 

Naomi Lakritz has written an interesting column concerning the proposal to legalize euthanasia in Quebec. 

There is a difference between euthanasia and assisted suicide, but when reading the Menard report, it is clear that Quebec intends to legalize euthanasia under the term "assisted dying," and that the media have wrongly referred to it as assisted suicide. 

Euthanasia is an intentional act of directly causing death, usually by lethal injection. Euthanasia is defined by the intention of the person doing the act, and not whether the act was with or without explicit request. 

That is why a recent study from Belgium found that 32 per cent of the euthanasia deaths were without explicit request. 

Finally, Quebec is defining the act of "assisted dying" (euthanasia) as medical treatment. This is very concerning since Canada recognizes a right to universal health care. 

Even if the law begins with tight restrictions, logically the courts will extend its practice based on the equality provision of our Charter of Rights and Freedoms. This was an intentional decision by the Quebec government to legalize a limited form of euthanasia that would soon become available to nearly everyone. 

Alex Schadenberg, London, Ont. Alex Schadenberg is executive director of the Euthanasia Prevention Coalition.