Tuesday, March 31, 2015

Always Care, Never Kill: How Physician-Assisted Suicide Endangers the Weak, Corrupts Medicine, Compromises the Family, and Violates Human Dignity and Equality

This research article was published by the Heritage Foundation on March 24, 2015.

Ryan Anderson
By Ryan T Anderson PhD

Allowing physician-assisted suicide would be a grave mistake for four reasons. First, it would endanger the weak and vulnerable. Second, it would corrupt the practice of medicine and the doctor–patient relationship. Third, it would compromise the family and intergenerational commitments. And fourth, it would betray human dignity and equality before the law. Instead of helping people to kill themselves, we should offer them appropriate medical care and human presence. We should respond to suffering with true compassion and solidarity. Doctors should help their patients to die a dignified death of natural causes, not assist in killing. Physicians are always to care, never to kill.
The Hippocratic Oath proclaims: “I will keep [the sick] from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.”[1] This is an essential precept for a flourishing civil society. No one, especially a doctor, should be permitted to kill intentionally, or assist in killing intentionally, an innocent neighbor.

Human life need not be extended by every medical means possible, but a person should never be intentionally killed. Doctors may help their patients to die a dignified death from natural causes, but they should not kill their patients or help them to kill themselves. This is the reality that such euphemisms as “death with dignity” and “aid in dying” seek to conceal.

In 2015, at least 18 state legislatures and the District of Columbia are considering whether to allow physician-assisted suicide (PAS).[2] Legalizing physician-assisted suicide, however, would be a grave mistake because it would:
  • Endanger the weak and vulnerable,
  • Corrupt the practice of medicine and the doctor–patient relationship,
  • Compromise the family and intergenerational commitments, and
  • Betray human dignity and equality before the law.
First, PAS endangers the weak and marginalized in society. Where it has been allowed, safeguards purporting to minimize this risk have proved to be inadequate and have often been watered down or eliminated over time. People who deserve society’s assistance are instead offered accelerated death.

Second, PAS changes the culture in which medicine is practiced. It corrupts the profession of medicine by permitting the tools of healing to be used as techniques for killing. By the same token, PAS threatens to fundamentally distort the doctor–patient relationship because it reduces patients’ trust of doctors and doctors’ undivided commitment to the life and health of their patients. Moreover, the option of PAS would provide perverse incentives for insurance providers and the public and private financing of health care. Physician-assisted suicide offers a cheap, quick fix in a world of increasingly scarce health care resources.

Third, PAS would harm our entire culture, especially our family and intergenerational obligations. The temptation to view elderly or disabled family members as burdens will increase, as will the temptation for those family members to internalize this attitude and view themselves as burdens. Physician-assisted suicide undermines social solidarity and true compassion.

Fourth, PAS’s most profound injustice is that it violates human dignity and denies equality before the law. Every human being has intrinsic dignity and immeasurable worth. For our legal system to be coherent and just, the law must respect this dignity in everyone. It does so by taking all reasonable steps to prevent the innocent, of any age or condition, from being devalued and killed. Classifying a subgroup of people as legally eligible to be killed violates our nation’s commitment to equality before the law—showing profound disrespect for and callousness to those who will be judged to have lives no longer “worth living,” not least the frail elderly, the demented, and the disabled. No natural right to PAS exists, and arguments for such a right are incoherent: A legal system that allows assisted suicide abandons the natural right to life of all its citizens.

Instead of embracing PAS, we should respond to suffering with true compassion and solidarity. People seeking PAS typically suffer from depression or other mental illnesses, as well as simply from loneliness. Instead of helping them to kill themselves, we should offer them appropriate medical care and human presence. For those in physical pain, pain management and other palliative medicine can manage their symptoms effectively. For those for whom death is imminent, hospice care and fellowship can accompany them in their last days. Anything less falls short of what human dignity requires. The real challenge facing society is to make quality end-of-life care available to all.

Doctors should help their patients to die a dignified death of natural causes, not assist in killing. Physicians are always to care, never to kill. They properly seek to alleviate suffering, and it is reasonable to withhold or withdraw medical interventions that are not worthwhile. However, to judge that a patient’s life is not worthwhile and deliberately hasten his or her end is another thing altogether.

Citizens and policymakers need to resist the push by pressure groups, academic elites, and the media to sanction PAS. Recent experience with PAS both in the United States and in Europe suggests how problematic it is.

Endangering the Weak and Marginalized

To understand how PAS endangers the weak and marginalized, one must understand what PAS entails and where it leads. With PAS, a doctor prescribes the deadly drug, but the patient self-administers it. While most activists in the United States publicly call only for PAS, they have historically advocated not only PAS, but also euthanasia: the intentional killing of the patient by a doctor.

This is not surprising: The arguments for PAS are equally arguments for euthanasia. Neil Gorsuch, currently a federal judge, points out that some contemporary activists fault the movement for not being honest about where its arguments lead. He notes that legal theorist and New York University School of Law Professor Richard Epstein “has charged his fellow assisted suicide advocates who fail to endorse the legalization of euthanasia openly and explicitly with a ‘certain lack of courage.’”[3]

The logic of assisted suicide leads to euthanasia because if “compassion” demands that some patients be helped to kill themselves, it makes little sense to claim that only those who are capable of self-administering the deadly drugs be given this option. Should not those who are too disabled to kill themselves have their suffering ended by a lethal injection?

And what of those who are too disabled to request that their suffering be ended, such as infants or the demented? Why should they be denied the “benefit” of a hastened death? Does not “compassion” provide an even more compelling reason for a doctor to provide this release from suffering and indignity?[4] As Professor John Keown points out:

If compassion justified us in giving a lethal prescription to a terminally ill patient on request to end their suffering, it would equally justify us in giving them a lethal injection, particularly if they were physically unable to commit suicide. It would also justify us in giving a lethal injection to a terminally ill patient who was incapable of making a request.[5]
Judge Gorsuch notes that for the Dutch, “it is the physician’s assessment of the patient’s quality of life as ‘degrading’ or ‘deteriorating’ or ‘hopeless’ that stands as the ultimate justification for killing.”[6]

Although the Supreme Court of the United States has ruled in two unanimous decisions that there is no constitutional right to PAS, three states permit it by statute: Oregon, Washington, and Vermont.[7] Physician-assisted suicide and euthanasia are allowed in three European countries—the Netherlands, Belgium, and Luxembourg—and Switzerland allows assisted suicide.[8]

The evidence from these jurisdictions, particularly the Netherlands, which has over 30 years of experience, suggests that safeguards to ensure effective control have proved inadequate. In the Netherlands, several official, government-sponsored surveys have disclosed both that in thousands of cases, doctors have intentionally administered lethal injections to patients without a request and that in thousands of cases, they have failed to report cases to the authorities.[9]

The Cruelty of Terri Schiavo’s Death.

This article was published by Wesley Smith on his blog on March 31, 2015.

Wesley Smith
By Wesley Smith

During the Terri Schiavo debacle, I would often debate bioethicists and others who claimed that Terri’s death would be gentle. 

These advocates either intentionally or ignorantly conflated two different circumstances.
  1. The first, taking food and water from someone whose body readily assimilated sustenance. That is an agonizing death. 
  2. The second, people dying naturally whose bodies are shutting down. In such circumstances, people stop eating and drinking on their own as part of the process of passing on. That does not cause suffering, and indeed, it is medically inappropriate–and can be cruel–to force sustenance into their bodies.
Terri was a number 1, and the advocates pretended she was a number 2.

Now Terri’s brother frankly discusses the terrible circumstances of his sister’s slow death by dehydration. He had an artist depict what she actually looked like. From, “I Will Never Forget the Look of Horror…” 
These are the hard facts my family and I will have to live with for the rest of my life:  
After almost two weeks without food or water, my sister’s lips were horribly cracked, to the point where they were blistering.  
Her skin became jaundiced with areas that turned different shades of blue. Her skin became markedly dehydrated from the lack of water. Terri’s breathing became rapid and uncontrollable, as if she was outside sprinting.  
Her moaning, at times, was raucous, which indicated to us the insufferable pain she was experiencing. Terri’s face became skeletal, with blood pooling in her deeply sunken eyes and her teeth protruding forward.  
Even as I write this, I can never properly describe the nightmare of having to watch my sister have to die this way. What will be forever seared in my memory is the look of utter horror on my sister’s face when my family visited her just after she died. 
The process Bobby describes is exactly what the late, pro-dehydration neurologist Dr. Ron Cranford testified happens to those being dehydrated in the Robert Wendland case. From my, “A Painless Death?” in the Weekly Standard quoting a court transcript: 

Directives from Supreme Court must be enforced.

This article was published by Advocate Daily on March 31, 2015.
Hugh Scher

Many Canadians do not recognize the full extent to which existing rules around end-of-life decision-making are not serving as appropriate barriers to inappropriate conduct, says Toronto health and human rights lawyer Hugh Scher.

Concerning cases around end-of-life care decisions continue to crop up across Canada, says Scher, noting it is unclear whether directives from prior court rulings are being respected and enforced.

In one recent case, a Toronto physician and hospital were sued by a family who alleged a “do not resuscitate” (DNR) order was unilaterally placed on an elderly patient at Toronto East General Hospital against their wishes, reports the Toronto Star.

The Star reports the statement of claim, which seeks $1.2 million in damages for four of Canh Luong’s family members, alleges Dr. Alvin Chang and Toronto East General committed “wrongful death, abuse of power, negligence and breach of fiduciary duties.”

The statement of claim, says the Star, alleges Chang was negligent in preferring “his own opinion over that of the plaintiffs with respect to the code status of Luong,” for failing to consult them before making the change, and for failing “to provide Luong with the necessaries of life.”

Scher, who is not involved in the Luong case but who has been involved in other such cases, says clear rules and meaningful consequences for those who go against the established guidelines are needed.
“If we are not able to stop the most basic abuses relative to DNR orders or end-of-life care measures now, expanding those practices presents serious dangers,” says Scher. “The Supreme Court of Canada made it clear in Rasouli that doctors should not be acting unilaterally with regard to the withholding and withdrawal of treatment including end-of-life decision-making measures and that consent to treatment or refusing treatment – particularly where it forms part of an ongoing treatment plan – is required from the patient or substitute decision-maker.”
Scher says, 
“Doctors who act against that consent or without it are acting without lawful authority and in my view, are running afoul of the law as established by the Supreme Court of Canada.”

In Carter, released in February, the Supreme Court struck down the ban on doctor-assisted suicide in specific cases. The court gave the federal government 12 months to craft legislation to respond to the ruling, with the ban on doctor-assisted suicide standing until then.

The Carter decision risks creating a culture of permissiveness with regard to all end-of-life matters, says Scher, and real consequences are required for those that break or ignore the law. Without them, all Canadians are put at serious risk in health care settings across the country, Scher states.

For more information contact:
Hugh Scher, EPC legal counsel (Toronto): 416-816-6115 or hugh@sdlaw.ca

Scher, has acted as counsel to The Euthanasia Prevention Coalition in several high-profile end-of-life files including Rasouli v. Sunnybrook Health Sciences Centre, 2011 ONCA 482 (CanLII); Cuthbertson v. Rasouli, 2013 SCC 53, [2013] 3 S.C.R. 341; Bentley v. Maplewood Seniors Care Society, 2014 BCSC 165 (CanLII); Bentley v. Maplewood Seniors Care Society 2015 BCCA 91; Carter v. Canada (Attorney General), 2012 BCSC 886 (CanLII); Carter v. Canada (Attorney General) 2013 BCCA 435 (CanLII); and Carter v. Canada (Attorney General), 2015 SCC 5.

The 2015 HOPE International Symposium on Euthanasia and Assisted Suicide.

The Fourth International Symposium on Euthanasia and Assisted Suicide is hosted by HOPE Australia on May 22 - 23, 2015 at the Rydges Hotel South Park in Adelaide South Australia.

Register for the 2015 HOPE International Symposium.

The 2015 HOPE International Symposium is hosted by HOPE Australia, and co-sponsored by the Euthanasia Prevention Coalition - International, Euthanasia-Free New Zealand, the disability rights group - Lives Worth Living, and Doctors Opposed to Euthanasia.

Renee Joubert
The speakers include:

  • Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition (EPC) and Chair, EPC - International,
  • Paul Russell, Director, HOPE Australia and Vice Chair, EPC - International,
  • Renee Joubert, Director, Euthanasia-Free New Zealand,
  • Craig Wallace, Convenor, Lives Worth Living, a network of people with disabilities,
  • Nic Steenhout, Director, Vivre dans la dignité Quebec.
  • Nic Steenhout
    Henk Reitsma, Board member, EPC - International and an expert on the Netherlands Euthanasia statistics.
  • Tom Mortier, Chemistry professor in Belgium. His depresed mother died by euthanasia in 2012. 
  • Professor Theo Boer, former member of a Dutch Euthanasia Regional Review Committee.
  • Nancy Elliott, Board member, EPC - International and a past three term New Hampshire state representative.
  • Sue Hanson, co-chair NSW Agency for Clinical Innovation - Palliative Care Network
  • Dr Paul Dunne, a leading Palliative Care Medical Specialist in Australia.
  • Brendan Malone, from New Zealand, is a dynamic speaker on youth, culture and media.
This is the first International Symposium hosted in the southern hemisphere by EPC - International. Previous symposia were held in Toronto, Washington, Vancouver, Edinburgh.

Monday, March 30, 2015

Clear rules and consequences needed concerning the right to receive food and water.

This article was published by Advocate Daily on March 30, 2015.
Hugh Scher
Top British Columbia courts have made it clear that oral nutrition should not be considered health care or medical treatment and instead be seen as basic personal care and support. But, how the directive will be applied and enforced across Canada remains to be seen, says Toronto health and human rights lawyer Hugh Scher.
In Bentley v. Maplewood Seniors Care Society 2015 BCCA 91, the British Columbia Court of Appeal dismissed a request from the family of an 83-year-old woman that their mother no longer be given nourishment or liquids by staff members at the nursing home where she resides.
Justice Mary Newbury agreed with a lower court judge, ruling that the woman, who has advanced Alzheimer’s disease, is exercising her consent when she opens her mouth to accept food and water, despite her family’s position that it was her wish while she was mentally capable that she not be fed in her current condition.
The Euthanasia Prevention Coalition and the Euthanasia Prevention Coalition – BC, represented by Scher and Geoff Cowper QC, were intervenors in the case at trial and on appeal.
“I recognize the terribly difficult situation in which Mrs. Bentley’s family find themselves and I appreciate the disappointment they must feel in being unable to comply with what they believe to have been her wishes and what they believe still to be her wishes,” writes Newbury. 
“It is a grave thing, however, to ask or instruct caregivers to stand by and watch a patient starve to death. It should come as no surprise that a court of law will be assiduous in seeking to ascertain and give effect to the wishes of the patient in the ‘here and now’, even in the face of prior directives, whether clear or not," says the decision.
The coalition also advanced its position at the Supreme Court of British Columbia, which previously ruled that oral nutrition should not be considered health care or medical treatment, but rather seen as basic personal care and support. The court found the woman is capable of making the decision to accept oral nutrition and hydration and is “providing her consent through her behaviour when she accepts nourishment and liquids.”
The case has seen national media attention, with Scher appearing on outlets including Global NewsCTV and Lawyers Weekly, and he says with the appeal concluded, it’s time to look forward at how the ruling will take shape across the country.
“The first step is going to be to determine how the ruling in Bentley, which determines that regular feeding and regular hydration represent basic personal support and not health care or medical treatment, is applied across the country,” says Scher. 
We know there are people in nursing homes across the land, including Ontario, where it’s an open question whether doctors are following that protocol. Families may be making requests of doctors to stop these measures of basic food and drink in a way that may be contrary to the law.”
There are a number of international policies and provisions in places such as the U.S. and Scotland, says Scher, that also consider foods and fluids to be personal support and not health care, but the issue now is how to determine whether the rules are being respected.

Friday, March 27, 2015

John Kelly and Alex Schadenberg on Radio Sputnik's “Brave New World”

John Kelly
This article was published by Not Dead Yet on March 27 2015.

Alex Schadenberg
At the end of February, John Kelly, the New England Regional Director of Not Yet Dead and Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, were guests on “Brave New World,” a show on Radio Sputnik. Also on the show was Gert Huysmans, the President of the Federation of Palliative care of Flanders (Belgium). John Harrison is the host of the show.

According to John Kelly, this show was better venue than he is used to – venues in which news hosts are often openly hostile to any opponent of legalized assisted suicide and euthanasia. John said (and the show recording and transcript confirm this) “he (Harrison) gave each of the participants a chance to describe the situation in our own country, thereby giving us a chance to make our points without being asked the “what do you say to Brittany Maynard” type of gotcha question. When he asked me the devils advocate question it was about a person with a disability, not someone “about to die in pain” or some such nonsense.”

Here are a couple of excerpts:
Gert Huysmans: What you mentioned in Flanders and in Belgium, euthanasia is not a right. You have the right to request for euthanasia, and that’s a world of difference. So it’s not that you have the right to choose your moment of dying with euthanasia. You have to follow certain conditions that are mentioned in the law. You have to have unbearable suffering caused by a disease or an accident, and the physician you request your euthanasia [from] should have the internal persuasion that euthanasia is the only proper solution for your problems and in some cases and in some circumstances euthanasia is acceptable, but it is not a right as such.
And, as news of the law’s actual application has shown, practice is only as narrow as the broadest comfort zone of any given individual physician.

John talks about the long-term resistance to “right to die” laws from the disability community:

JK: We in the United States, the disability rights movement have fought [for] a generation against the arrogance being displayed by the doctor, where the doctors can presume to judge the quality of life, and when it is correct to end it. We have a history of being judged to not have high quality of lives, and whenever suffering is the subjective criterion for deciding who gets to die, people with disabilities will always be the ones who are targeted.
This show is an excellent one. I encourage readers to listen to the show or to read the transcript.

Safeguards do little to control euthanasia in Belgium.

This article was published on March 27 by OneNewsNow.

Alex Schadenberg
Promised safeguards and controls for euthanasia and doctor assisted-suicide in Belgium apparently aren't working, according to the latest study.

In 2007, a study was conducted in Belgium, and figures released in the most recent examination of the practice from 2013 show it is problematic. Alex Schadenberg of the Euthanasia Prevention Coalition tells OneNewsNow experts researched over 3,700 deaths.

“And in that data they learned that 4.6 percent of all the deaths were euthanasia, which is significant and huge,” he explains. “On top of that, they found that 1.7 percent of all deaths were what they call 'hastened deaths without request.'”
In other words, doctors or nurses decided to kill an ailing person who had not requested euthanasia.

According to Schadenberg, the absence of estimates on unreported cases is glaringly apparent. He says the practice is so out of control that even people suffering depression are assisted to die.

“So the fact is that there is a serious problem, and the Belgium government needs to stop it,” he tells OneNewsNow. “The problem with euthanasia right off the bat is once you allow someone else to cause your death, once you allow in law that someone else can kill you, the one question remaining is for what reason? And when they are promoting this to people they always say, Oh, but we will have safeguards.”
But Schadenberg says the regulations are neither safe nor do they guard against abuse. He says that's also true in states in America where assisted suicide has been legalized.

Thursday, March 26, 2015

Feeding Tubes and Futility in Texas.

We Can End the End-of-Life Impasse in the Texas Legislature.
Dr Jacqueline Harvey
By Jacqueline C. Harvey, Ph.D . 

After five consecutive sessions of bitter battles over end-of-life bills, the Texas Legislature is finally poised to pass the first reform to the Texas Advance Directives Act (TADA) in twelve years. An issue that created uncanny adversaries out of natural allies and equally odd bedfellows has finally found common ground in H.B. 3074: an act that simply prohibits doctor-imposed euthanasia by starvation and dehydration. Since H.B. 3074 includes only those provisions and language that all major organizations are on record as having deemed acceptable in previous legislative sessions, there is finally hope of ending the end-of-life impasse in the Texas Capitol.

Many people are surprised to learn that Texas law allows physicians to forcibly remove a feeding tube against the will of the patient and their family. In fact, there is a greater legal penalty for failing to feed or water an animal than for a hospital to deny a human being food and water through a tube. This is because there is no penalty whatsoever for a healthcare provider who wishes to deny artificially administered nutrition and hydration (ANH). According to Texas Health and Safety Code, “every living dumb creature” is legally entitled to access to suitable food and water. Denying an animal food and water, such as a case this January in San Antonio, is punishable by civil fines up to $10,000 and criminal penalties up to two years in jail per offense. Yet Texas law allows health care providers to forcibly deny food and water from human beings - what they would not be able to legally do to their pet cat. And healthcare providers are immune from civil and criminal penalties deny of food and water to human beings as long as they follow the current statutory process which is sorely lacking in safeguards. Therefore while it is surprising that Texas is the only state law that explicitly mentions food and water delivered artificially for the purpose of completely permitting its forced denial (six other states mention ANH explicitly for the opposite purpose, to limit or prohibit its refusal), it is not at all surprising that the issue of protecting a patient’s right to food and water is perhaps the one point of consensus across all major stakeholders.

H.B. 3074 is the first TADA reform bill to include only this provision that is agreed upon across all major players in previous legislative sessions. Texas Alliance for Life and Texas Right to Life have each previously sponsored broad and ambitious bills to either preserve but reform the current law (Texas Alliance for Life’s position) or overturn it altogether as Texas Right to Life aims to do. Prior to H.B. 3074, bills filed by major advocacy organizations have often included ANH, but also a host of other provisions that were so contentious and unacceptable to other organizations each bill ultimately died, and this mutually-agreed-upon and vital reform always died along with it. The 2011 and 2013 sessions present a prime example where both organizations filed complicated, contentious opposing bills, both of which would have protected a patient’s right to food and water but each bill also included provisions that other groups saw as contrary to their goals. Both bills were ultimately defeated and neither group was able to achieve protections for patients at risk of forced starvation and dehydration- a mutual goal that could have been met through a third, narrow bill like H.B. 3074. H.B. 3074 focuses on what unites the organizations involved rather than what divides them.

H.B. 3074 is progress that is pre-negotiated and pre-approved. It is not a fertile springboard for negotiations on an area of mutual agreement. Rather it is the culmination of years of previous negotiations on bill that all came too late, either due to the complex nature of rival bills, the controversy involved or even both. On the contrary, H.B. 3074 is not just simple and an area of agreement, moreover, it is has already been negotiated. since Texas Alliance for Life and Texas Right to Life (along with their allies) were able to agree on language in 2007 with C.S.S.B. 439. 

The language from C.S.S.B. 439 is strikingly similar to H.B. 3074 which states, “except that artificially administered nutrition and hydration must be provided unless, based on reasonable medical judgment, providing artificially administered nutrition and hydration would: 
  1. hasten the patient's death; 
  2. seriously exacerbate other major medical problems not outweighed by the benefit of the provision of the treatment; 
  3. result in substantial irremediable physical pain, suffering, or discomfort not outweighed by the benefit of the provision of the treatment; 
  4. be medically ineffective; or 
  5. be contrary to the patient's clearly stated desire not to receive artificially administered nutrition or hydration.” 

Doctor Death Nightmare

Published on March 24.

By Deborah Rankin

Margaret Somerville
A law professor at McGill University says that a recent decision of the Supreme Court of Canada overturning the ban on assisted-suicide and euthanasia is a "nightmare" and "full of errors". Margaret Somerville, the Founding Director of the Centre for Medicine, Ethics and Law at McGill made these remarks recently to a rapt audience at a public forum organized by the Newman Centre for Catholic students and faculty.

She said that the SCC decision goes farther than simply striking down the ban against aiding someone to commit suicide, permitting euthanasia by physicians in certain circumstances, while cautioning that the ruling is unclear in this regard.

In physician assisted-suicide the doctor prescribes drugs that the patient takes, whereas in euthanasia the doctor administers a lethal injection - in either scenario, ostensibly at the patient's request. However, in jurisdictions where assisted-suicide has been legalized, there are multiple examples of abuse with people being euthanized without their consent.

This is especially true in the case of children and incompetent adults who can't give informed-consent: for example, the Groningen Protocol of the Netherlands permits so-called "voluntary euthanasia" of babies at the parents' request. Pro-euthanasia advocates refer to this gruesome practice as "post-birth abortion" while opponents say that it is really a form of "closet eugenics" - if the child is born with congenital defects the parents can request euthanasia on the pretext of preventing the child from suffering.

Wednesday, March 25, 2015

The Atlantic - Pushing Killing for Organs

This article was published on Wesley Smith's blog on March 24, 2015.
Wesley Smith
By Wesley Smith

I have repeatedly warned about articles published in medical and bioethics journals advocating killing the profoundly disabled or dying for their organs. 

The assault on the “dead donor rule” has now filtered down to the popular media. The Atlantic has an article advocating that dying patients be killed for their organs rather than having to actually, you know, die first. From, “As They Lay Dying:” 
A more useful ethical standard could involve the idea of “imminent death.” Once a person with a terminal disease reaches a point when only extraordinary measures will delay death; when use (or continued use) of these measures is incompatible with what he considers a reasonable quality of life; and when he therefore decides to stop aggressive care, knowing that this will, in relatively short order, mean the end of his life, we might say that death is “imminent.”  
If medical guidelines could be revised to let people facing imminent death donate vital organs under general anesthesia, we could provide patients and families a middle ground—a way of avoiding futile medical care, while also honoring life by preventing the deaths of other critically ill people.  
Moreover, healthy people could incorporate this imminent-death standard into advance directives for their end-of-life care. They could determine the conditions under which they would want care withdrawn, and whether they were willing to have it withdrawn in an operating room, under anesthesia, with subsequent removal of their organs. 

There’s a name for that: Homicide. Doctors should never be killers, even for a “beneficial” purpose.

Monday, March 23, 2015

More than 40% of Belgian euthanasia deaths were not reported in 2013.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

The New England Journal of Medicine (NEJM) published  a new study concerning the Belgium euthanasia experience titled: Recent Trends in Euthanasia and Other End-of-Life Practices in Belgium.

Similar to previous studies, researchers sent a questionnaire to 6188 physicians who had certified death certificates in the first six months of 2013 in Flanders. There were 
3751 returned questionnaires representing a 60.6% response rate. The data represents about 6% of all deaths in 2013.

The data in the study indicates that:

1. 4.6% of all deaths were euthanasia. There were 61,621 total death in 2013.
2. .05% of all deaths were assisted suicide.
3. 76.8% of the requests for euthanasia or assisted suicide were granted.
4. 1.7% of all deaths were hastened without explicit request.
With help from a Belgian researcher I learned that in 2013 there were 61,621 total deaths in Flanders Belgium. Since the data from the study indicated that 4.6% of all deaths were euthanasia, therefore there were approximately 2834 assisted deaths in Flanders in 2013.

The data did not include information concerning the number of unreported euthanasia deaths.

Since the official Belgian euthanasia report states that there were 1807 reported assisted deaths in Belgium, of which, 1454 were in the Flanders region, therefore approximately 1380 assisted deaths were not reported in Flanders Belgium in 2013.

Last year, Dr Marc Cosyns, a Belgian euthanasia doctor, admitted that he does not report his euthanasia deaths.

This means that more than 40% of all euthanasia deaths were not reported in Flanders in 2013.

The study also found that 1.7% of all deaths were hastened without explicit request. Since there were 61,621 deaths in Flanders, therefore approximately 1047 deaths may have been hastened without explicit request in Flanders Belgium in 2013.

The recent Supreme Court of Canada assisted death decision suggested that abuse of euthanasia laws in other jurisdictions was only anecdotal. Canada needs a Royal Commission to set the record straight. 

Euthanasia is out-of-control in Belgium.

To learn more about the abuse and extension of euthanasia in the Netherlands and Belgium purchase my book: Exposing Vulnerable People to Euthanasia and Assisted Suicide.

Chilean girl who asked for euthanasia, changes her mind.

Alex Schadenberg
Euthanasia Prevention Coalition

Valentina Maureira
A 14-year-old Chilean girl, who asked the Chilean President, to allow her to die by euthanasia, has now changed her mind and wants to live.

Valentina Maureira, who lives with Cystic Fibrosis, created a youtube video last month asking the Chilean President, Michelle Bachelet, to allow her to die by euthanasia. Valentina got the idea from the Brittany Maynard assisted suicide campaign.

On February 28 President Bachelet met with Valentina. Presidential spokesman Alvaro Elizalde stated that 'it's impossible not to be overcome by emotion with the girl's request, it's impossible to grant her wish,' because it's not allowed under Chilean law.

Valentina has changed her mind after meeting with a family from Argentina.

Maribel Oviedo
Valentina's father said that his daughter was moved by a visit from a Argentina family, whose children also have Cystic Fibrosis.

He said Valentina was given hope by meeting someone who had survived beyond age 20 with the disease.

Maribel Oviedo and her father Ernesto traveled to Santiago to 'convey a message of hope.'

Maribel, 22, watched her sister Marisol die of cystic fibrosis in 2013. Mirabel received a lung transplant in 2012 and told Valentina that she now lives a normal life.

Mirabel offered to go to a doctor's appointment with her because she wanted to encourage her to live.

Valentina's story is emotionally charged. If Valentina had died by euthanasia, her options, potential treatment and opportunity to change her mind would have ended.

Now Valentina has hope.

Saturday, March 21, 2015

Belgian doctor justifies euthanasia for depressed people.

By Alex Schadenberg
International Chair - Euthanasia Prevention Coalition

Godelieva De Troyer died by euthanasia in 2012.
An interview with Wim Distelmans, the chairman for the federal euthanasia commission in Belgium, was published in HLN.BE   (google translated) on March 15. where Distelmans explains that there were 50 - 60 psychiatric patients who died by euthanasia in 2013 - 2014. Distelmans states:

"It is a small group, 50 to 60 patients. But it is not a negligible number:. 2 to 3 percent of the 1,924 people who were euthanized last year."
Distelmans then states:
"usually they are not old, but they suffer long. They do not belong in this world, they think.."
Distelmans promotes euthanasia for depressed people. He states (google translated):
"Manic-depressive patients are in their manic moments capable of the most improbable things, They spend their bank loot, for weeks at a five-star lodge, buy several cars one day. At that stage they are not competent. But in moments of depression they by their exhaustion come back to the baseline and are indeed competent. Then they can for instance say, "I live for thirty years crazy highs and lows, I've tried everything to break that infernal cycle Now that I'm back on the baseline, and I know that I have a couple of weeks left, back I for a dip in the depth or a jump in height. " These are people who are eligible for euthanasia."
Once euthanasia has become an acceptable solution to human suffering the only question that remains is what conditions will death become the solution for life.

Lethal injections for people with psychiatric conditions is based on a false compassion. Distelmans appears to be reacting to his fear of living with chronic depression.

New Euthanasia Bill in Tasmania

This article was published on the HOPE Australia website on March 20.

Paul Russell and
Alex Schadenberg
in Tasmania.
By Paul Russell, the director of HOPE Australia.

The Tasmanian MPs who tabled and pushed the last Euthanasia bill defeated in 2013, have said that they will try again later this year.

The then Premier, Lara Giddings MP and her then deputy, Nick McKim MP, now on the opposition benches made the announcement in The Examiner Newspaper on the 14th of March.

But bringing the issue to a vote in this new bill will not be as easy as it was when the then Premier and her Deputy were in control of the parliamentary debate from the treasury benches.

Moreover, whereas the vote in 2013 was resolved by 13 votes to 11, a cursory look at the chamber post the 2014 election suggests that the numbers are at least at that level if not more strongly against.

When Giddings and McKim had the privilege of office behind them, a faux discussion paper arising out of the Premier's Office and full control of the timing of the debate, they still could not find a majority on the chamber.

It is always possible that votes change and we must ever be vigilant, but I cannot help but observe that this seems more like grandstanding than it does about anything else.

Thursday, March 19, 2015

More than 1000 Belgian deaths were hastened without explicit request in 2013.

By Alex Schadenberg
Alex Schdenberg
Executive Director Euthanasia Prevention Coalition.

Contrary to the Supreme Court decision that struck down Canada's laws that protect people from assisted death, in Belgium, where euthanasia has been legal since 2002, a significant number people are dying by euthanasia without request.

Yesterday I wrote an article about the study published in the NEJM on March 19, 2015 on the experience with euthanasia in Flanders Belgium.  The study sent 6188 questionnaires to the physician who certified death certificates in the first half of 2013. The researchers received 3751 responses representing a 60.6% rate of return. The data indicated that 4.6% of all deaths were euthanasia and .05% of all deaths were assisted suicide.

This study found that 1.7% of deaths in the Flanders region of Belgium, in 2013, were intentionally hastened without explicit request. A similar study in 2007 found that 1.8% of deaths in the Flanders region of Belgium were hastened without explicit request, meaning that the problem continues.

Since there are 61,621 deaths in Flanders in 2013 and since the study found that 1.7% of all deaths were hastened without explicit request, therefore more than 1000 deaths were hastened without explicit request in 2013 in Flanders.

The Supreme Court of Canada assisted dying decision stated that abuse of euthanasia laws are anecdotal. A previous Belgian study in 2007 found that 1.8% of all deaths were hastened without explicit consent and this new Belgian study (2013) found that 1.7% of all deaths were hastened without explicit consent representing no statistical change in Belgium.

The Associated Press article interviewed Belgian ethicist Freddy Mortier. The article stated:
Mortier was not happy, however, that the 'hastening of death without explicit request from patients,' which can happen when a patient slumbers into unconsciousness or has lost the capacity for rational judgment, stood at 1.7 percent of cases in 2013. In the Netherlands, that figure was 0.2 percent.
People need to recognize that euthanasia or assisted suicide laws will be abused. Will assisted death be your choice or will it be imposed on you?

Study: Euthanasia represents 4.6% of all deaths in Flanders Belgium in 2013, deaths without patient request continues

By Alex Schadenberg
Executive Director and International Chair - Euthanasia Prevention Coalition

The New England Journal of Medicine (NEJM) (March 19, 2015) published the basic statistics related to a new study titled: Recent Trends in Euthanasia and Other End-of-Life Practices in Belgium.

Similar to previous studies, this study 6188 questionnaires to physicians in Flanders Belgium in the first half of 2013. The study received a 60.6% response rate by receiving 3751 returned questionnaires.

The data indicates that:
1. The percentage of euthanasia deaths increased from 1.9% of all deaths in 2007 to 4.6% of all deaths in 2013 representing a 242% increase in 6 years. 
2. The percentage of assisted suicide deaths decreased from .07% of all deaths in 2007 to .05% of all deaths in 2013 representing no statistical difference. 
3. The percentage of requests for euthanasia or assisted suicide increased from 3.5% of all deaths in 2007 to 6.0% of all deaths in 2013
4. The percentage of requests for euthanasia or assisted suicide that were granted increased from 56.3% in 2007 to 76.8% in 2013.
A significant and continuous problem in Belgium is the number of hastened deaths without explicit request from the patient.
In 2007, 1.8% of all deaths were hastened deaths without explicit request while in 2013, 1.7% of all deaths were hastened deaths without explicit request.
Since there were 61,621 deaths in 2013 in Flanders Belgium and since 1.7% of all deaths are hastened without explicit request, therefore approximately 1047 deaths are hastened each year without request in Flanders Belgium.

Further research needs to be done concerning these deaths without explicit request. In 2007, approximately 1 in 3 hastened deaths without explicit request were euthanasia.

The study also indicates that the use of continuous deep sedation until death decreased from 14.5% of all deaths in 2007 to 12% of all deaths in 2013. It is possible that the increase in euthanasia deaths accounts for much of the decrease in deaths by continuous deep sedation.

Continuous deep sedation until death is known as "slow euthanasia" when the physician sedates a patient, who is not otherwise dying and withdraws water and food to cause death by dehydration.

The issue of continuous deep sedation has become very important now that France is debating a bill to widen the application of continuous deep sedation.