Saturday, August 31, 2013

The Thrill - a review of the Stratford Festival play

The following blog article was originally published on August 14 on the Not Dead Yet blog.
Amy Hasbrouck & John Kelly
By Amy Hasbrouck - the founder of the disability rights group - Toujours Vivant/Not Dead Yet
I am not a theatre buff, so I won’t try to write a review of Judith Thompson’s play The Thrill, currently at the Stratford Festival in Ontario.  It is a “what if” play, taking its inspiration, starting point, and much of its material from a New York Times Magazine article by Harriet McBryde Johnson entitled “Unspeakable Conversations.”  The 2003 article describes Johnson’s exchanges with Princeton bioethicist Peter Singer between 2001 and 2002, when she spoke at Princeton on assisted suicide.
In her article Harriet Johnson made a throw-away comment about her “head being turned” by Singer’s polite, respectful and appropriate behavior on their meeting at Princeton.  The playwright spins out the scenario of “what if” the two fell in love.
In the first act, Thompson introduces Elora Dixon, a lawyer and disability rights activist with strong beliefs, smarts, southern style and the heart of a poet.  Her personal assistant, Francis, is a devoted friend and counselor who shares her earthy sense of humour.  Compared to Peter Singer, the character of Julian Summer is “more of a humble pop philosopher with one mega-hit book” who teaches at McGill University.  Elora and Julian meet when he stops in Charleston, South Carolina to promote his book and visit his aging mother, Hannah.  Julian’s book describes the short life of his youngest sister who died of a neuromuscular disease.  Julian’s mother Hannah has mild dementia and is living with her daughter.  Julian often uses the threat of sending her to a nursing home as a lever to force Hannah to behave.
Liz Carr
The actor playing Elora does a very good job, but she does not have a disability.  She is shown being spoon fed, having her hair brushed, and having her torso washed while clothed.  All the same, my companion Liz Carr said the mostly non-disabled audience seemed withdrawn into their seats as they watched.  Whether they were trying to avoid the subject of death, the frank talk about disability, or both, we couldn’t tell.  The heavier topics were offset by laugh-lines delivered mostly by Elora, Francis and Hannah.
As the second act opens, Elora has had to accept a feeding tube, which she believes is the “beginning of the end” for her.  Her doctors have told her she will lose her sight, her hearing then her mind before she dies; she does not question this.  Though she is in love with Julian she still mistrusts his motives, and rejects him when he returns after his book tour.  Meanwhile Julian decides his mother is a danger to herself and puts her in a nursing home, where she soon dies.

Afraid to face her worsening illness, Elora decides she wants to die.  She asks Julian to “put his money where his mouth is” and kill her, by kissing her until she suffocates.  Julian doesn’t want to do it but is eventually convinced because Elora claims it is “her choice.”  He tries, but can’t go through with it, saying he loves her too much to do it.  Elora decides to soldier on until the end with Francis at her side, sending Julian away for the last time.
In her essay about writing the play, Judith Thompson says she had a seizure disorder during adolescence, and wore the identity of “an epileptic.”  And while it’s clear she admires Harriet Johnson, the play seems like it was written by someone whose understanding of disability rights is skin deep.  We talked afterwards with someone involved with the production, who said that the group really struggled with the ending, and changed it many times.
Elora’s sudden desire to die seemed a truly bizarre choice (except when viewed from a non-disabled perspective), chock full of dangerous subtext.  It reinforces the view of non-disabled people that somewhere deep inside, disabled people really hate their lives and want to die.  Worse still, it suggests that disabled opponents of assisted suicide really think about assisted suicide exactly the way non-disabled people do.
I knew Harriet Johnson, who died in 2008, through phone meetings and her writings; I may have met her at one of the early Not Dead Yet actions, I’m not sure.  I can’t speak for her.  Like all people with disabilities who face constant oppression, she probably had moments of depression, frustration and rage which when turned inward, can become self-hatred and even a wish to be done with it all.  I know those feelings, we all do.  But it’s a long stretch between feeling worn out and defeated, and asking someone to kill you.
I also think that people who work against assisted suicide who become suicidal would kill themselves rather than asking someone else to do it for them.  The distinction between suicide and assisted suicide seems lost on the playwright, who opts to have Elora betray the cause as soon as the issue touches her personally.
While it’s good for non-disabled people to see a character based on Harriet Johnson, (even if she’s a little over-the-top and short on substance) make the disability arguments against assisted suicide, the plot twist in the second half undermines the credibility of those arguments.  In the end, it’s the non-disabled character’s unwillingness to go through with it that sets her straight, another tired plot device to show that people with disabilities can’t run their lives and need a non-disabled person to guide them.  The play leaves me very worried about its effect of the play on non-disabled audiences.
The author refers to Not Dead Yet several times during the play, with an NDY banner on the back of Elora’s wheelchair, even showing her assaulting Julian with the chair during a demonstration.  Ms. Thompson should have had the courtesy to contact NDY before borrowing the name and image, and to learn more about Harriet and NDY’s philosophy and tactics.  NDY uses non-violent tactics and NDY activists do not use their wheelchairs to threaten anyone.
The Thrill is part of a larger “forum” within this year’s festival that features performances and discussions on the “right to die.”  The only person with an identified disability involved in the forum is a workshop moderator.  Alex Bulmer is a playwright with a visual impairment who is leading a panel discussion on August 15 entitled “writing about the right to die.”  The forum is a perfect example of the problem with the debate on end-of-life issues – disabled people, whose lives are at stake, are not leading the discussion. – Amy Hasbrouck
Amy Hasbrouck is a member of the Board of Directors of Not Dead Yet and heads up Toujours Vivant/Not Dead Yet (Canada).

Friday, August 30, 2013

Disabled - "Euthanasia Organ Donors"

This article was written by Wesley Smith and published on August 31, 2013 on his blog.

Wesley Smith
By Wesley Smith

Belgium is really gearing up its euthanasia followed by organ harvesting regime–and apparently the transplant medical community has no moral qualms. In fact, it has become so morally ho-hum, that it was the subject of discussion at the 21st European Conference on General Thoracic Surgery held in the UK in May.

It’s all just peachy keen. From the Abstract (0-099) of “Lung Transplantation with Grafts Recovered From Euthanasia Donors:
January 2007 and December 2012, 47/350 (13.4%) patients received pulmonary grafts from controlled DCDs [donation after cardiac death], including 6 (1.7%) after euthanasia in accordance with state legislation and approval by Ethics Committee. Patients suffered from an unbearable neuromuscular (n = 3) or neuropsychiatric (n = 3) disorder with explicit wish to donate organs. Euthanasia was executed by an independent physician in a room adjacent to the operating room in the absence of the retrieval team.
Did you get that? One set of doctors killed the patient, stepped out of the room, and another set of doctors entered for the harvest.

Now, the hunt is on for mentally ill and patients with disabling conditions such as MS to become “euthanasia organ donors.” 
Euthanasia donors accounted for 12.8% of all lung DCDs. Immediate post-transplant graft function and long-term outcome in recipients was excellent. More euthanasia donors are to be expected with more public awareness.
In a better world, increased public awareness would cause universal public revulsion.

I can think of nothing more dangerous than making mentally ill and despairing disabled people believe their deaths have greater value than their lives. Well one thing, perhaps: Having a society accept the idea that it can benefit at the expense of people in desperate need of care–and whose care is very expensive.

Links to other articles on the same topic:
- Altruistic assisted suicide, surely you can't be serious?
- Belgium becomes world leader in organ removal after euthanasia.
- Where euthanasia meets organ harvesting.
- Euthanasia and Organ Donation in Belgium.

Canadian docs say 'no' to euthanasia

The following article was originally printed by OneNewsNow on August 30, 2013.

Alex Schadenberg
Another group of medical professionals, this time in Canada, is standing firm against euthanasia.

The Canadian Medical Association met recently in Calgary and considered the issue of euthanasia and doctor assisted suicide.

Alex Schadenberg of the Euthanasia Prevention Coalition tells OneNewsNow the Association maintained its long standing stance against the practice.
In 2007 they wrote a new policy which maintained their opposition to both euthanasia and assisted suicide.” says Schadenberg 
He reports there were “major attempts” at this year’s meeting to make changes to the 2007 platform. 
“So what's really good is that they have continued to uphold their position,” Schadenberg says. “That's what's important here.”
Most of the delegates were discussing how to take better care of people who are dying, how to improve palliative, or pain relief, care.

The Euthanasia Prevention Coalition reported the CMA passed a resolution that called on the organization to
"support the right of any physician to seek conscientous objection when faced with a request for medical aid in dying." 
There is hope the outcome will have an influence on Quebec, where there is a strong push to legalize euthanasia.

Schadenberg explains: 
“The Quebec delegation was the only delegation in favor of legalizing euthanasia and assisted suicide, and they have the idea that they're simply different.” 
In Quebec there is a “strong group” of physicians who oppose euthanasia and assisted suicide, “and we would hope that they’re being listened to,” says Schadenberg.
Quebec will soon hold a hearing on a bill to legalize it.

In the United States, assisted suicide is legal only in Washington State, Oregon and Vermont. 

Thursday, August 29, 2013

Top 20 blog articles on issues related to euthanasia and assisted suicide.

3. Declaration of Hope – January 17, 2013.

20. Euthanasia is out-of-control in Belgium – August 26, 2011.

Other important articles:

Mild stroke led to mother's forced death by dehydration - September 27, 2011.

For more information contact the Euthanasia Prevention Coalition.

Wednesday, August 28, 2013

Palliative care not assisted suicide.

The Sudbury Star published an interesting article on August 26 examining assisted suicide and concluding that Comfort care should be urged over assisted suicide.

Elaine Klym
The article interviews Elaine Klym, a veteran palliative care nurse in Sudbury. Klym stated in the article that she:
understands the medical profession needs to do more to mitigate the suffering of terminally ill patients, but she says hastening death is not the way to go. 
"I think the topic of physician-assisted suicide comes up because there's not enough palliative care available," she says. 
Her recommendation is "comfort care," which means better universal access to pain and symptom management, which could include nausea, anxiety, shortness of breath, as well as other symptoms related to chronic illness. The hospice does not advocate for doctor-assisted dying. 
"It's not just pain management and it's not just the physical things," she says. "We forget about the whole person. It's a holistic approach to care." 
Klym, also spoke about the importance of the Shared care team, an interdisciplinary team that brings the hospice philosophy into the community.
"Our role is to promote comfort, not to hasten death," she says. "It's such an anxious time for families. It's a question (medically assisted dying) that at times has been asked, and then it's often sitting down with the family and asking, 'what is the concern? What is the fear?' A lot of times, after some education and discussion, the concern has been alleviated." 
Klym says the proper management and control of symptoms is her priority. 
"The hospice is about finding the best in every day," she says. "Palliative care is about living the best of every day. It is not about hastening death." 
Fear and confusion may play roles in knee-jerk reactions to terminal illness. 
She points out the dying process need not be entirely negative.

The Sudbury Star article also looked at the position of the Council of Canadians with Disabilities, Canada's national disability advocacy organization. The article reported:
The Council of Canadians with Disabilities opposes assisted dying and euthanasia. In a policy statement dating back to 1996, it says it opposes actions that may "further devalue the lives of people with disabilities in Canada or promote the negative stereotypes about people with disabilities as suffering individuals in need of state-regulated assistance to end our lives." The Council of Canadians with Disabilities believes doctor-assisted dying is unconstitutional.  
Amy Hasbrouck & John Kelly
Its policy statement continues, "The (council) opposes government action to decriminalize assisted suicide because of the serious potential for abuse and the negative image of people with disabilities that would be produced if people with disabilities are killed with state sanction."
The Council of Canadians with Disabilities (CCD) intervened at the BC Court of Appeal in the Carter case, a court case that seeks to legalize euthanasia and assisted suicide in Canada and Amy Hasbrouck with Toujours Vivant - Not Dead Yet is also working with CCD.

Tuesday, August 27, 2013

Requests for euthanasia in Belgium are rarely refused.

By Alex Schadenberg

A study published in the Journal of Pain and Symptom Management – November 2011 titled: Process and Outcomes of Euthanasia Requests Under the Belgian Act on Euthanasia: A Nationwide Survey found that only 5% of requests for euthanasia in Belgium are refused.

The Belgian study on the process and outcomes of euthanasia requests was part of the “Monitoring Quality of End-of-Life Care Study.” 

The researchers sent an anonymous self-administered questionnaire to 3006 Belgian physicians by mail in March 2009. Euthanasia was legalized in Belgium in 2002. 

The data in the study is based on 914 returned questionnaires. The 34% response rate was based on the fact that only 2726 questionnaires were applicable to the study.

This data in the study found that only 5% of the 363 most recent requests for euthanasia were refused.

The study states:
"We found that only 5% of all requests are actually rejected, which is considerably fewer than in The Netherlands (12%)."
The study then states:
"Unfortunately we have no information on the reasons why the attending physicians from our study refused to grant requests. ... 
When a psychiatric disorder is the primary diagnosis, the requests were never granted. Although the Belgian euthanasia law specifically mentions psychological suffering as grounds for requesting euthanasia."
But since March 2009, when the study was done, it appears there is now a greater acceptance of euthanasia for people with depression or psychiatric conditions in Belgium.

This January it was reported that Belgian identical twins, Marc and Eddy Verbessem, were euthanized in Belgium because they feared becoming blind. 

In February it was reported that a woman with Anorexia Nervosa died by euthanasia in Belgium. 

Also in February, Tom Mortier wrote an article about the euthanasia death of his depressed mother in Belgium. Mortier stated:
My mother suffered from chronic depression. ... In April 2012 she was euthanased at the hospital of Vrije Universiteit Brussel (the Free University of Brussels). 
The death of my mother has triggered a lot of questions. How is it possible that people can be euthanised in Belgium without close family or friends being contacted? Why does my country give medical doctors the exclusive power to decide over life and death? ... What are the criteria to decide what “unbearable suffering” is? Can we rely on such a judgment for a mentally ill person?
Netherlands study that was published in 2005 examined euthanasia and depression in relation to cancer patients found that almost half of all the requests for euthanasia were made by patients who were depressed and 44% of the patients who were depressed requested euthanasia, which represented a 4.1 times greater risk factor for requesting euthanasia.

similar study in Oregon published in 2008 found that 26% of those who had requested assisted suicide were depressed or experiencing feelings of hopelessness.

The book Exposing Vulnerable People to Euthanasia and Assisted Suicide, is a book that I wrote to examine the recent studies concerning the practice of euthanasia and assisted suicide in Belgium and the Netherlands.

Exposing Vulnerable People uncovered data proving that in Belgium:
 • 32% of the assisted deaths are done without request in the Flanders region;
 • 47% of the assisted deaths go unreported in the Flanders region; 
 • nurses are euthanizing patients even though the law prohibits nurses from doing euthanasia. 

There has never been an attempted prosecution for abuses of the Belgian euthanasia law.

The fact that this study found that only 5% of the requests for euthanasia were denied, indicates that doctors in Belgium are not carefully administering the euthanasia law and the  safeguards in the law are not being followed.

The Springtime March in Quebec
The Belgian people should be very concerned that those who are incompetent and/or depressed are dying by euthanasia and very few requests for euthanasia are rejected.

The Quebec government needs to reject Bill 52, the Quebec government bill to legalize euthanasia that is based on the Belgian euthanasia law. Bill 52 is dangerous.

Legalizing euthanasia and assisted suicide are not safe.

Saturday, August 24, 2013

On the Natural Death of Brooke Hopkins

This article was written by Wesley Smith and published on August 24, 2013 on his blog.

Wesley Smith
By Wesley Smith

I have long known of the tragedy that struck vocal assisted suicide advocate Margaret Pabst Battin and her husband Brooke Hopkins. Hopkins was catastrophically injured in an accident and has spent years under Battin’s very good care. There were several prominent articles written about the situation over the years, most recently, a cover story in the New York Times Magazine.

I never commented publicly. Absent a compelling reason, I try not to personalize these things when people are going through very tough times.

Now Hopkins died after ordering that his respirator be turned off, that is, he refused unwanted medical treatment. From the New York Times story:
The hospice physician gave Brooke a sedative, and Brooke sat in his wheelchair for a while with his stepchildren, his friends, a few of his favorite caregivers and his wife. He said he was getting sleepy, and he was put into bed. Peggy got in beside him. A gospel song he had chosen for the occasion, Marion Williams’s “My Soul Looks Back,” played on the stereo… 
Later, Peggy told the Tribune reporter, Peggy Fletcher Stack, that “it was peaceful and painless, just as he wanted it” — close to the kind of ending he described to me earlier as a “generous death.”
Battin and Hopkins made his circumstance a very public matter, so with the denouement, I think it is acceptable for me to comment.

Note, that–contrary to the propaganda of some assisted suicide advocates–no one forced Hopkins to receive invasive medical treatment he no longer wanted. As a result, he died naturally, from his underlying condition, and was given proper medical care to ease the passing by hospice.

There is a bright line ethical (and usually) legal separation between dying naturally after refusing treatment and being killed by an intentional overdose of drugs. There is the factual distinction, of course. But as policy, the differences are profound, providing a dramatically contrasting impact on greater society and our perceived value of the lives of people going through terminal and disabling illnesses and injuries.

My sympathies to Battin and good on her for taking such good and loving care of her beloved.

Friday, August 23, 2013

Legalizing Euthanasia and Assisted Suicide is not safe. Patient Safety must come first.

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Official studies from the Netherlands and Belgium indicate euthanasia deaths are occurring without request and abuse of the law is common.

When researching statistics on euthanasia and assisted suicide it is interesting how the euthanasia lobby have created their own studies to cover up the truth concerning "assisted death" in the countries where it is legal.

Recent studies on the Belgian euthanasia law indicate that a significant number of “assisted deaths” occur without request. A study published in the CMAJ - June 2010 found that 32% of all assisted deaths in the Flanders region of Belgium were done without request.

Another study published in the BMJ – Nov 2010 found that 47% of the assisted deaths in the Flanders region of Belgium were not reported.

The meta-analysis study of the practice of euthanasia in the Netherlands, in 2010, that was published in the Lancet – July 2012 found that 23% of the assisted deaths in the Netherlands were not reported and 192 assisted deaths were done without request.

A study published in the CMAJ – June 2010 examining the role of nurses with euthanasia in Belgium found that nurses were euthanizing patients, even thought the law limits euthanasia to doctors. Two nurses admitted to euthanizing a patient without a doctor even being present. 

The data from these studies prove that the assisted deaths that are done without request and the assisted deaths that are done by nurses are usually not reported.

Since the studies on euthanasia that are done by the proponents of euthanasia are limited to the "assisted deaths" that are officially reported, these studies create a false sense of security.

The deaths without request and the abuses of the law are not reported.

The fact is that legalizing euthanasia and/or assisted suicide is unsafe and the studies from the jurisdictions that examine all deaths, prove it.

Giving doctors the power to directly and intentionally cause your death assumes that all doctors are ethical and all acts will be done within the law. This is a big assumption.

Euthanasia and assisted suicide must remain prohibited out of a concern for patient safety.

For more information about the practice of euthanasia and assisted suicide in the Netherlands and Belgium order the book: Exposing Vulnerable People to Euthanasia and Assisted Suicide.

Thursday, August 22, 2013

Canadian Medical Association (CMA) delegates opposed euthanasia and assisted suicide

By Alex Schadenberg

The CMA rejected a proposal to support euthanasia and/or assisted suicide at its 146th Annual meeting that was held in Calgary Alberta (August 21 - 23).

Many media articles falsely suggested that the CMA fear debating the issues of euthanasia and assisted suicide, and yet the CMA delegates debated the issues and they voted against changing the language of the debate and they did not change their position.

Dr. Louis Hugo Francescutti
post media news article quoted incoming CMA president Dr. Louis Hugo Francescutti as saying: 
doctors are not ducking the issue. "What physicians do when they're not sure is pause and reflect and ask for consultation."
Doctors voted to reject having a: 
“large-scale public consultation to regard medical aid in dying as appropriate end-of-life care”
When reading the media reports and the publication from the CMA it appears that they rejected the consultation based on the "loaded language" within the resolution.

For the same reason, the delegates at the CMA annual meeting rejected a resolution calling for them to: 
replace the term “physician-assisted suicide” with “physician-assisted death” in all its official documents. 
The euthanasia lobby must have realized that they didn't have enough support to change the CMA policy so they focused on changing the language of the debate.

The CMA meeting passed a motion to: 
support the right of any physician to exercise conscientious objection when faced with a request for medical aid in dying.
The CMA also passed the following palliative care resolutions:
  • making palliative care services at home available to every person nearing the end of life
  • integration of palliative care services into community and chronic care service delivery
  • support for implementation of a collaborative palliative care model
  • creation of a curriculum for training in palliative care.
It is interesting that some media articles falsely report that the CMA is unwilling to debate "assisted death" after an annual meeting where the CMA focused on the issues related to "assisted death." This is probably because the CMA remains opposed to euthanasia and assisted suicide.

The same tactic is used by some media when they claim that the federal government refuses to debate the issues of euthanasia and assisted suicide after they had a thorough debate on the issues in 2010 and rejected Bill C-384 by an overwhelming vote of 228 to 59.

I challenge the media to allow an open debate on the issues of euthanasia and assisted suicide rather than writing one-sided articles that only quote the leaders of the euthanasia lobby while ignoring the facts of the issues and the studies that prove that legalizing euthanasia is not safe.

The media need to be willing to report the facts that were published in 2012 from the 5 year meta-analysis of the Dutch euthanasia law that found 23% of all assisted deaths were not reported? The media needs to stop ignoring the study that found 47% of all assisted deaths in the Flanders region of Belgium were not reported?
The media needs to be concerned that a 2010 study found that 32% of assisted deaths in the Flanders region of Belgium were done without request.

Capital Punishment was outlawed to ensure that no Canadian is executed after a wrong conviction.

We cannot turn a blind eye to the case of the Italian man, with a botched diagnosis who was killed by assisted suicide in Switzerland or that the Netherlands have approved eugenic euthanasia for newborns with disabilities.

Canadians and especially Quebekers need to know why legalizing euthanasia is not safe. Patient safety must be paramount in our medical system.