Choice is an Illusion President Margaret Dore States Hawaii Assisted Suicide/Euthanasia Act Must Be Rejected

GlobeNewswire • February 27, 2017

Honolulu, Feb. 27, 2017 (GLOBE NEWSWIRE) 

Attorney Margaret Dore, president of Choice is an Illusion, which is fighting assisted suicide and euthanasia legalization efforts throughout the United States, made the following statement in connection with an assisted suicide/euthanasia bill set for hearing tomorrow in the Hawaii State Senate Committee on Judiciary and Labor. The bill is SB 1129 S.D. 1.

“The bill seeks to pass a proposed act legalizing assisted suicide and allowing euthanasia,” said Dore. “If enacted, the act will apply to people with years or decades to live. The act is a recipe for elder abuse, especially for people with money, meaning the middle class and above in the inheritance situation.”

Margaret Dore

Dore said, "The proposed act allows the patient's heir, who will financially benefit from the patient's death, to actively participate in requesting the lethal dose. After that, no doctor, not even a witness, is required to be present at the death. Even if the patient struggled, who would know?"

"But, it gets worse," said Dore, "the death certificate is required to list a terminal disease as the cause of death, which prevents prosecution." Dore explained, "The official cause of death is a terminal disease (not murder) as a matter of law. For inheritance perpetrators, the death certificate is a 'stay out of jail free card.'”

Dore stated, “If enacted, the proposed act will legalize assisted suicide and euthanasia for people who are 'terminal,' which is defined as a doctor's prediction of less than six months to live. In real life, such persons may have years or decades to live."

"Doctors can be wrong about life expectancy, sometimes way wrong," said Dore. "This is due to mistakes and the fact that predicting life expectancy is not an exact science. A few years ago, I was met at the airport by a man who at age 18 or 19 had been diagnosed with ALS (Lou Gehrig's disease) and given 3 to 5 years to live, at which time he would die by paralysis. His diagnosis had been confirmed by the Mayo Clinic. When he met me at the airport, he was 74 years old. The disease progression had stopped on its own."

Dore stated, “The proposed act is based on a similar law in Oregon. In Oregon, a young adult with insulin dependent diabetes is ‘terminal’ because the six months to live is determined without treatment. A typical insulin dependent adult will live less than a month without insulin. Such persons are therefore ‘terminal’ for the purpose of assisted suicide.”

Dore added, “By contrast, with insulin, such persons may have decades to years or decades to live.”

Dore concluded, “The proposed act will create the perfect crime and encourage people with years or decades to live to throw away their lives. The act must be rejected.”

For more information, see “Dore Memo Opposing SB 1129 SD1,” which can be viewed at these links: memo and appendix.

American Psychiatric Association position on euthanasia.

Alex Schadenberg
Euthanasia Prevention Coalition

In the current edition of the Psychiatric Times, Dr Mark Komrad outlines the position of the American Psychiatric Association (APA) concerning euthanasia and assisted suicide. Dr Komrad explains:

Early in December 2016, the American Psychiatric Association (APA) Board of Trustees passed an historic Position Statement that originated in the Assembly and was unanimously supported by the APA Ethics Committee: 

The APA, in concert with the American Medical Association’s position on Medical Euthanasia, holds that a psychiatrist should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.

Some might be concerned that the position only prohibits euthanasia and assisted suicide for people who are not terminally ill. In fact, the APA statement has caused a stir in countries where euthanasia and/or assisted suicide have become legal. Dr Komrad states:

People with non-terminal illnesses have been legally euthanized at their own request in several countries for nearly 15 years. This has included certain eligible patients who have only psychiatric disorders. 

In 2002, Belgium, the Netherlands, and Luxembourg removed any distinctions between “terminal” and “non-terminal” conditions, and between physical suffering and mental suffering, for legally permitted PAS/E. That was when patients with psychiatric disorders became eligible for this “right” in these countries. Independent consultants have to declare their condition “untreatable,” and the patient needs to declare it to be “insufferable.”

Dr Mark Konrad

Dr Komrad then explains how people with non-terminal psychiatric conditions are approved for euthanasia in the Netherlands.

In the Netherlands, for example, for psychiatric-only cases, at least 1 consultant is required, but 3 are suggested. At least one should be a psychiatrist but does not have to be. 

However, the patient can weigh in regarding the “untreatable” criterion as well. It is not based solely on what physicians have to offer, but on what the patient wishes to accept. For example, though potentially effective treatments may be offered, such as ECT, MAOIs, residential treatment, transcranial magnetic stimulation, and vagus nerve stimulation, “competent” patients may refuse these offers. That choice could make their case “untreatable.” So patients can rule on both the “untreatable” and “insufferable” axes; physicians can only opine on the former. 

In the Netherlands, lethal injections are the most commonly used method to fulfill an approved patient’s death wish. This is often administered by the patient’s treating psychiatrist at home, in the office, or in specialized Levenseinde Klinieks (End of Life Clinics). Between 2008 and 2014, more than 200 psychiatric patients were euthanized by their own request in the Netherlands (1% of all euthanasia in that country): 52% had a diagnosis of personality disorder, 56% refused one or more offered treatments, and 20% had never even had an inpatient stay (one indication of previous treatment intensity). When asked the primary reason for seeking PAS/E, 66% cited “social isolation and loneliness.” Despite the legal requirement for agreement between outside consultants, for 24% of psychiatric patients euthanized, at least one outside consultant disagreed. 

Some remarkable stories have been profiled in the Dutch media. For example, a woman was granted euthanasia for chronic PTSD due to childhood sexual abuse. The arguments based on personal autonomy to justify such access to PAS/E are being pushed even further in the Netherlands. Ministers of Health and Justice have proposed to their Parliament that criteria not be limited to medical conditions, but be extended to average citizens who feel they have lived “completed lives.”

Dr Komrad then comments on euthanasia for psychiatric conditions in Belgium:

From 2014 to 2015, 124 patients in Belgium were euthanized at their own request for psychiatric disorders. These patients had a wide range of psychiatric disorders: 4% had schizophrenia; 6%, bipolar; 4%, autism; 23%, dementia; 31%, depression; and 32%, personality disorders (half of which were borderline disorder). In one Belgian series that covered 2007 to 2011, diagnoses also included substance abuse, autistic spectrum disorder, OCD, ADHD, dissociative disorder, and “complicated grief.” 

Prominent cases profiled in the Belgian media include a pair of deaf twins euthanized on request because they were going blind, a man with gender identity disorder who was unhappy with surgical results, and another man who sought euthanasia for ego-dystonic homosexuality.

Dr Komrad then comments on the new Canadian law that permits euthanasia for psychiatric conditions.

In the spring of 2016, at the instructions of their Supreme Court, the Canadian Parliament followed the course of these European countries. Physician-assisted suicide was legalized nationally, and terminal/non-terminal and physical/mental suffering distinctions were effaced. As in Europe, Canadian patients can refuse treatments that might forestall death —and still be eligible. However, thanks to the influence of the Prime Minister, Parliament stopped short of enacting its original intention to allow this for people with only psychiatric disorders. 

Not surprisingly, several cases of psychiatric patients are working their way through the Canadian courts, demanding that there be no such discrimination for psychiatric patients. One case that received particular attention was a woman with chronic conversion disorder, who successfully fought in the courts to overrule the proscription on PAS/E for psychiatric disorders in her case. Several psychiatrists supported her pursuit of this action. So that legal precedent is now in place in Canada.

Dr Komrad then explains how the new California assisted suicide regulations open the door to assisted suicide for psychiatric conditions.

Even with current laws, there are emerging regulations that directly affect psychiatric patients in those states that allow assisted suicide. The California Department of Mental Health has adopted a regulation that requires state psychiatric hospitals to provide assisted suicide services to committed patients, if terminally ill. Under this regulation, a court hearing must be held to determine whether the patient is qualified for release to obtain physician-assisted death, even over clinically based objections of the treating psychiatrist. If a patient is deemed eligible, and no outside physicians can be located, the facility must provide fatal care itself, within the hospital. Unlike refusing treatment for mental disorders, committed inpatients’ competent refusal of treatment for medical disorders (eg, diabetes) cannot be overridden, even if refusal may result in death —thus rendering their condition “terminal.”

Dr Komrad then explains how the APA position may lead effect euthanasia and assisted suicide statutes world-wide.

The APA position implies that, even where legal for the non-terminally ill, it is neither the duty of a psychiatrist to fulfill that right, nor is it ethically appropriate to do so. Some (in the Belgian press) have argued that an American association does not have a place in the discussion of medical and psychiatric practices, which make most sense when seen in the context of different cultures. However, there is an understanding in the domain of medical ethics that there are some principles that transcend cultures. 

The Ethics Committee of the World Psychiatric Association (WPA) has crafted a position similar to that of the APA, which will be submitted for a membership vote at the 2017 World Congress in Berlin. If endorsed, the WPA would be acknowledging that, on this particular issue, the ethical proscription against helping psychiatric patients to commit suicide may be so antithetical to the fundamental ethos of psychiatry that it should indeed be applied worldwide.

There was a significant reaction in the Belgian and Netherlands media after the publication of the APA position. Further to that, in Canada there is significant debate as to whether euthanasia should be permitted for psychiatric reasons alone.

Finally, the APA position protects psychiatrists who do not agree with killing their depressed or mentally ill patients. Thank you to the APA for creating a path that may lead to the end of killing people with psychiatric conditions. 

Links to articles concerning this topic:

• Netherlands: euthanasia for alcoholism.
• Belgium: Euthanizing the mentally ill.
• Mentally ill OK'd for assisted suicide in California hospitals.
• Killing the mentally ill in the Netherlands.
• 74% of Belgian assisted deaths for mental suffering are women.
• Study uncovers concern with the practise of euthanasia and assisted suicide.

Assisted suicide can be a slow and painful death.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

In October 2012, Ezekiel Emanuel wrote an article titled Four Myths About Doctor-Assisted Suicide that was published in the New York Times. In the article, Emanuel explains why assisted suicide is not necessarily a "Good Death." Emanuel wrote:

The last misconception about assisted suicide is that it is a quick, painless and guaranteed way to die. But nothing in medicine—not even simple blood draws—is without complications. It turns out that many things can go wrong during an assisted suicide. Patients vomit up the pills they take. They don’t take enough pills. They wake up instead of dying. Patients in the Dutch study vomited up their medications in 7 percent of cases; in 15 percent of cases, patients either did not die or took a very long time to die—hours, even days; in 18 percent, doctors had to intervene to administer a lethal medication themselves, converting a physician-assisted suicide into euthanasia.

Recently Kaiser Health News published an article promoting a new assisted suicide drug cocktail. The article outlines a few of the horrific details associated with current assisted suicide drugs.

The first Seconal alternative turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, used 67 times, has led to deaths that stretched out hours in some patients—and up to 31 hours in one case.

In other words, in the past few years some assisted suicide deaths have been horrific. Dr. Carol Parrot, a doctor who does assisted suicide in Washington State explains:

Concerns about the overly long deaths surfaced last summer. Nearly all of the problems occurred in patients already taking high doses of opiates. 

“We run into patients who are so tolerant or dependent on narcotics that even the astronomically high doses of oral narcotics in our prescription do not stop them from breathing,” she said. 

If patients have diseases that slow or alter normal organ function, it can affect the speed and amount of drugs absorbed in the small intestine, metabolized in the liver and sent to the rest of the body. Very large patients, too, may require larger doses. 

Deaths aren’t required to be supervised, and no doctor was present with the unidentified patient who took 31 hours to die, so doctors would only be speculating about the reason, Parrot said.

The article concluded by informing that reader that:

KHN’s coverage of end-of-life and serious illness issues is supported by The Gordon and Betty Moore Foundation.

We need society to be committed to caring for, not killing people.

Canadian doctors are asking to have their name removed from the "euthanasia list."

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

An article by Sharon Kirkey published in the National Post states that as of February 17 there were 137 Ontario doctors who were on the list of doctors who will do euthanasia, but there were also 24 doctors who asked to be removed from the list and another 30 doctors who have asked to be temporarily off the list.

Euthanasia was officially legalized on June 17, 2016 in Canada. In 8 months, 24 Ontario doctors who agreed to lethally inject patients changed their mind while another 30 doctors are now unsure about participating in euthanasia.

• Canadian doctors are struggling with euthanasia.

Jeff Blackmer, the Canadian Medical Association's VP of medical professionalism stated:

For some doctors, the act is simply too distressing. 

“... we’re seeing doctors who go through one experience and it’s just overwhelming, it’s too difficult, and those are the ones who say, ‘take my name off the list. I can’t do any more.’ ” 

Meanwhile, the Ontario College of Physicians and Surgeons have ordered physicians who not willing to do euthanasia that they are required to do an "effective referral" to a doctor who will kill their patient. 

Doctors who are unwilling to kill their patients are also unwilling to refer their patient to the executioner.

The Coalition for HealthCare and Conscience is challenging the College of Physicians and Surgeons to protect conscience rights for all medical professionals.

I believe that it is natural that doctors are uncomfortable with killing their patients. Killing another human being is counter-intuitive to our human nature.

It is incumbent upon our culture to reject killing and commit ourselves to caring for people.

Death with dignity is not attained by a lethal injection, death with dignity is attained by dying comfortably within a community of caring and supportive people.

Euthanasia and Alzheimers in Canada.

This article was published by Mercatornet on February 27, 2017.

By Aubert Martin

The euthanasia machine has once again become activated, following the “compassionate” murder of a woman with advanced stage Alzheimer’s. Although the details are not yet known, it appears that her exhausted spouse may have “cracked”. The despair into which this poor man plunged demonstrates well the harsh reality that caregivers can endure when providing for a relative with Alzheimer’s disease.

However, instead of questioning the support offered to the sick and their loved ones, the debate was immediately channeled towards euthanasia, conveniently called “medical aid in dying”.

Murder of woman with dementia in Montréal leads to demand for more euthanasia.

Thus, while the first year of euthanasia has just ended – with 21 cases of abuse which will not lead to any disciplinary action – supporters of euthanasia are crying out for an expansion of the law which they denounce as cruel because it is too restrictive. They hope that the justice system – which today accuses this man of murder – will revise its position so that in the future a doctor can perform the same act with impunity.

By this very fact, they confirm the existence of the famous slippery slope that opens the ever-enlarging door to “emotionally acceptable reasons” to expand the scope of euthanasia. In fact, this kind of reasoning that trivializes such acts has recently resulted in a bill in the Netherlands which would permit euthanasia for elderly people in good health who feel they have lived their lives to completion.

There are inherent contradictions in this poisonous logic – such as hearing, in the same breath, that compassionate murder is an “inexcusable act”, but that people should have access to medical suicide under the guise of “health care”. But the emotional picture of the drama that took place on Monday at a nursing home hits hard enough on the public imagination to such a point that we are hearing demands to formalize the marriage between “love” and “murder” by a certificate of advance consent.

However, wanting to broaden the law to give advanced consent to suicide – through an advance directive – raises many ethical and moral questions.

What is the status of people with dementia such as Alzheimer’s? Are we talking about a subcategory of human beings that could be eliminated if their “old self” asked for it? Or is it a group of people that society considers henceforth unworthy but tolerated if it is a personal choice – as already implied in our laws on euthanasia and assisted suicide with respect to people with disabilities? Are there categories of “unworthy” people?

Is it really this condescending look that we want to give to people weakened by disease? Recently, the Netherlands provided us with a concrete example of how such logic was achieved: a woman with dementia was euthanized against her will.

Indeed, despite her dementia, she had clearly expressed that she no longer wanted to die; but she was trapped by her advanced directive. She even struggled to resist the doctor who was injecting the deadly poison. The doctor had to resort to having the woman’s family members forcefully restrain her to ensure that the verdict of her paper, signed in the prime of her life, was respected. Her refusal to die was not taken into account, merely because of her mental state; as if this woman was only identified with her illness.

The tragedy that is making headlines now in Quebec should be a wake-up call to prevent our society from taking another step in the wrong direction. There is still time to change our perspective on people made vulnerable by sickness, old age, or disability.

Someone I know took care of his mother who had Alzheimer’s for several years. There is no doubt that being welcomed by his own mother with a “good morning dear sir” sometimes felt like a dagger in his heart. Yet this worthy man, putting aside the fact that his mother no longer recognized him, kept honouring her because he, on the other hand, remembered that she was his mother.

Aubert Martin is the Executive Director of Vivre dans la Dignité (Living with Dignity), a Quebec-based organisation.

Murder of woman with dementia leads to demand for more euthanasia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The alleged murder of a Montreal woman with dementia has led to renewed pressure by the euthanasia lobby to extend "MAID" to incompetent people.

Michel Cadotte allegedly killed his wife, Jocelyne Lizette, because they were refused an assisted death. Cadotte has been charged with second degree murder.

In response to the death, the euthanasia lobby is pressuring the government to extend euthanasia to people who are incompetent, such as those with Alzheimer's or dementia, if the person previously stated a wish to die by euthanasia. The media is also using this tragic story to promote the extension of euthanasia.

If euthanasia (death by lethal injection) is extended to incompetent people, how would it be possible to determine whether or not someone has changed their mind?

Recently a woman in the Netherlands who stated, while competent, that she wanted euthanasia died by euthanasia without consent. According to the article in the Daily Mail:

The doctor secretly placed a soporific in her coffee to calm her, and then had started to give her a lethal injection. 

Yet while injecting the woman she woke up, and fought the doctor. The paperwork showed that the only way the doctor could complete the injection was by getting family members to help restrain her. 

It (the paperwork) also revealed that the patient said several times 'I don't want to die' in the days before she was put to death, and that the doctor had not spoken to her about what was planned because she did not want to cause unnecessary extra distress. She also did not tell her about what was in her coffee as it was also likely to cause further disruptions to the planned euthanasia process.

The Alzheimer Society of Canada disagrees with extending euthanasia to incompetent people. According to the CBC news report the Alzheimer Society of Canada stated that they do not support euthanasia for incompetent people. According to the Statement:

people can live with dementia for longer than ten years, and in that time, they may change their mind on doctor-assisted death. 

The statement says it's difficult or impossible for caregivers "to know what the person with dementia comes to value over time, especially if those values are at odds with previously expressed desires." 

Instead of calling for a broadening of the laws, the organization is calling for better palliative care in Canada.

Legalizing euthanasia gives the power to kill to physicians. No one should have the legal power to kill.

Anita Cameron (Not Dead Yet): The Disability Perspective

This article was published by Not Dead Yet on February 22, 2017.

In this desperate fight against assisted suicide, it is vitally important that people, especially lawmakers, speak with disability organizations such as Not Dead Yet.

Anita Cameron

By Anita Cameron

A few weeks ago, I went to Albany, the New York state capital, to meet with members of the Senate Minority Caucus to urge them not to support any forthcoming assisted suicide legislation.

During the meetings, each legislator and/or staffer was asked had he or she heard stances against assisted suicide from the perspective of disabled people. With one exception, no one said they had heard why many in our community are against it.

As I spoke with other folks with disabilities around the country, the same theme arose — they were speaking out against assisted suicide and they weren’t really being heard.

It is an uphill battle because those of us directly affected by such legislation are either being dismissed by Compassion and Choices or our voices are being drowned out by other powerful groups whose reasons for opposition to assisted suicide differ from ours.

I find it disturbing, to say the least, that the disability perspective has not been sought out, since our community will suffer the effects, unintended or not, of assisted suicide laws. This doesn’t come as any surprise when our lives are devalued by doctors and society in general. Why bother with the ramifications for us when, to most, being disabled is considered a fate worse than death?

So, what does the disability community think about assisted suicide? While our community isn’t monolithic, the vast majority of us, including all of the major disability organizations that have taken a position, feel that the legalization of assisted suicide is dangerous. It is inherently discriminatory, it opens the way for insurance companies to choose assisted suicide as an option because it is cheaper than paying for life-saving drugs and treatments, it allows doctors to be gatekeepers to decide whose lives are worthy, and makes it possible for unscrupulous and abusive family members and heirs to coerce their relative into choosing assisted suicide even if it isn’t what they want.

Proponents of assisted suicide such as Compassion and Choices pooh-pooh the disability perspective, saying that our community won’t be affected because this is for people with six months or less to live, who are in excruciating pain. The fact is, doctors can, and do, make mistakes about how long someone has to live. Also, while they and others talk about pain as the main reason that people want assisted suicide, the truth is that people seeking the suicide drugs in Oregon cited loss of autonomy, feelings of being a burden, loss of the ability to engage in activities, loss of the ability to control bodily functions and loss of dignity as the top reasons for wanting to die. All of these are issues that many of us disabled face every day and live meaningful lives despite this.

In this desperate fight against assisted suicide, it is vitally important that people, especially lawmakers, speak with disability organizations such as Not Dead Yet, Disability Rights Education and Defense Fund (DREDF), ADAPT, National Council on Independent Living (NCIL) and Autistic Self Advocacy Network (ASAN) before supporting, sponsoring or co-sponsoring assisted suicide legislation. While other opponents may have moral or philosophical reasons for opposing this deadly trend, disabled people live with the cold, hard reality of what has happened, and what can happen, to us. We can give you actual facts of how our lives are affected, rather than philosophical musings or moral admonitions.

Reach out to us for our perspective and don’t dismiss us when we tell you the real truth about what assisted suicide legislation will do to disabled people. Listen to us because this is literally a matter of life and death!

Lessons from indigenous wisdom in the euthanasia debate.

This article was published by ABC News Australia on February 16, 2017.

How a person dies affects others, not just in the present but in the future.

Margaret Somerville

By Margaret Somerville

This Some time ago, I was a member of an ethics committee set up as part of the Nuclear Waste Management Organization established by the Canadian Government to advise it on how it should deal with the complex issue of the disposal of nuclear waste.

At the first meeting of the committee, the chairperson asked us each to introduce ourselves and to make some brief remarks relevant to the disposal issue.

George Erasmus, who was the national chief of the Assembly of First Nations from 1985 to 1991, was a committee member. When it came to his turn, after a long moment of silence, George said softly, 

“Well if it had been up to us, we would never have been in this position, because we would never have allowed the technology that results in nuclear waste. We would have looked back seven generations for lessons from our ancestors and looked forward seven generations to its risks and harms to future generations and decided against its use.”

George’s words came to mind as wise advice for those of us engaging in the legalization of euthanasia debate currently raging in Australia. They struck me as especially apropos in light of the fact that Aboriginal and Torres Strait Island and First Nations communities in Australia and Canada, respectively, are, in my anecdotal experience, uniformly and adamantly opposed to euthanasia. What might these indigenous communities be perceiving that pro-euthanasia advocates are not?

Looking back: Hippocrates and ‘do not kill’

Looking back seven generations is to consult history or, as John Ralston Saul evocatively calls it, “human memory”.

Since the time of Hippocrates 2,400 years ago, medicine has a history of the absolute prohibition of physicians intentionally killing their patients. Why now do some people want to abandon this foundational value guiding the practice of medicine?

We have always been faced with death and suffering and have never seen euthanasia as ethically acceptable medical treatment or, indeed, as medical treatment. Why then, when there is so much more we can do to relieve suffering, might our society suddenly think it is a good idea to allow doctors to inflict death? The contributing factors are multiple and complex, but at base the cause is a sole focus on upholding the individual’s absolute right to autonomy and “choice”, to the exclusion of other balancing considerations that should be taken into account.

These other considerations include what approach is needed to protect the common good, that is the wellbeing of the community as a whole, not just the wishes and claims of an individual person, important as these are. The cultures of indigenous peoples are more cognisant of this need to protect the community and attuned to it, which could be one reason they reject euthanasia.

Pro-euthanasia advocates adamantly reject that the history of the Nazi horrors has anything to teach us and scorn anyone who dares to suggest that, when judiciously examined, it might provide insights and warnings. It’s true that we will not see a Holocaust resulting from the legalization of euthanasia, but the origins of the Holocaust in German doctors’ involvement in small, allegedly well-motivated and compassionate medical acts and the justifications used to validate these acts carry serious warnings that deserve attention in the current debate.

Looking forward: what we do now affects our great-grandchildren

In using their imaginations to look forward seven generations in order to be warned of future harms and risks to their descendants, indigenous communities are again seeking to protect not only individuals, but also the community. How a person dies, when death is caused by euthanasia, affects not only that person, but also unavoidably affects others and the community, and not just in the present but also in the future.

To summarize: the strongest case for legalizing euthanasia is based in radical individualism and “presentism”. It focuses on a suffering, competent adult individual who asks for and gives informed consent to euthanasia to the exclusion of the impact on the community of allowing euthanasia, and ignores what we could learn from considering it in the context of both the past and the future.

So in deciding about legalizing euthanasia we should learn an important lesson from indigenous wisdom and ask ourselves questions which include: How do we not want our great-great-grandchildren to die? What must we not do now if we are to leave to future generations a society in which reasonable people would want to live? Would an Australian society in which euthanasia had become a norm be such a society?

In thinking about that last question, further realities can be brought to light. If, as Andrew Denton claims, Australia will have the same rate of deaths by euthanasia as the Netherlands and Belgium, around 4 percent of all deaths, that will result in around 6000 euthanasia deaths annually, which would make euthanasia the sixth leading cause of death in Australia. It would fall between respiratory diseases and diabetes on the Australian Bureau of Statistics “Causes of Death 2015” list, and there would be 25 percent more deaths by euthanasia than from diabetes, five times the number of deaths from road accidents (1200 per annum) and twice the number of deaths from suicide (3000 per annum). Could we accept that?

The population of the Victorian town of Lakes Entrance is just under 6000. Would we be comfortable with wiping out with euthanasia each year the same number of people who presently live in that town?

Margaret Somerville was Samuel Gale Professor of Law, Professor in the Faculty of Medicine, and Founding Director of the Centre for Medicine, Ethics and Law at McGill University, Montreal.  Margaret Somerville is now a Professor of Bioethics in the School of Medicine at the University of Notre Dame Australia. Her most recent book is Bird on an Ethics Wire: Battles about Values in the Culture Wars.

Oregon 2016 assisted suicide report. Under-reporting of assisted suicide deaths?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The 2016 Oregon annual assisted suicide report is similar to prior years. The report implies that the deaths were voluntary (self-administered), but the information in the report does not address that subject.

According to the 2016 Oregon assisted suicide report.

• There were 133 reported assisted suicide deaths.
• There were 204 lethal prescriptions obtained.
• There were 8 deaths from "other illnesses" which included illnesses such as diabetes, hepatitis and alcoholic liver disease.

There may be more assisted suicide deaths.

According to the 2016 Oregon report, the ingestion status was unknown in 10 of the deaths, up from 5 in 2015. 

The report states that numbers are excluded when the ingestion status is unknown since they do not know whether or not the person died by assisted suicide. It is possible that some or all of the 10 unknown deaths were assisted suicide deaths. These deaths could represent unreported assisted suicide deaths.

Oregon's assisted suicide law lacks effective oversight. 

The Oregon law enables two doctors to approve death by assisted suicide. There is no further oversight once the prescribing physician writes the lethal prescription. The prescribing physician was present at the assisted death in only 13 of 133 reported deaths in 2015, creating the opportunity for an heir, or someone else who will benefit from the patient's death, to administer the lethal dose. "Even if he struggled, who would know?"

After the person dies by assisted suicide, the physician who prescribed the lethal dose is required to submit a report. The information in the annual reports are based on the data self-reported by the doctors who prescribe the lethal dose. The physician is rarely at the death, and the physician is required to self-report. This means the system enables abuses of the law to be covered-up. Doctors will not self-report abuse of the law. 

• Oregon 2015 assisted suicide report.
• Oregon assisted suicide reports substantiate critics' concerns.
• Oregon doctor: My personal story - The importance of trust between doctor and patient.

Legalizing assisted suicide gives physicians the power over life and death. It is the physician who decides, it is the physician who prescribes the lethal dose, and it is the physician who is required to self-report the act to the Oregon Health Authority.

What should further concern you is the fact that the assisted suicide lobby is now promoting assisted suicide laws that further lack safeguards.

We believe in Caring for people, not killing.

Dutch nursing home death – more excuses, more killing

This article was originally published on January 29, 2017 on the HOPE Australia website.

Paul Russell

By Paul Russell, the director of HOPE Australia.

Once you create a situation at law where killing of another person is allowed in certain circumstances, not only will the circumstances in which such killing is endorsed or allowed change over time, but the boundaries, however originally drawn, will be entirely ineffective in providing moral, legal and ethical guidance and restraint.

In Belgium and The Netherlands in the thousands of euthanasia deaths since their laws came into being in 2002 few cases have ever been referred by the review systems to justice for further scrutiny. In Belgium that number is one; one case only. …

According to a multiplicity of reports, an un-named woman–an octogenarian living in a nursing home and experiencing dementia– was euthanized against her will. She had made a comment in her advanced directive that she would like euthanasia “when I myself find it the right time.”

The woman had been a resident in the nursing home for only seven weeks. During that time she was noted as being ‘frightened and angry’ wandering the halls of the facility at night and missing her family. This, the nursing home doctor concluded, meant that she was suffering unbearably. She assessed that the woman was no longer mentally competent and accepted that the written declaration she had made earlier in her advanced directive was an acceptable request for euthanasia.

The Dutch Law allows for a request for euthanasia in an advanced directive to be acted upon after the satisfaction of all the other qualifying criteria. The law considers such a written statement as a ‘well considered request for euthanasia’. How it can be known for certain that, at the time the request was written down, that the person understood fully the nature of their request is never explained.

Compounding the problem, the woman’s expression of intent in her directive was not clear and should not have been accepted as an advance request according to the Dutch Euthanasia Commission. She had written, concerning euthanasia, that she wanted it, “when I myself find it the right time.” At the very least, this expression suggests that the woman wanted to approach the matter when she thought it was appropriate, implying that her own capacity to make a contemporary decision was important to her. Paradoxically, the doctor’s determination that capacity had been lost should have rendered her statement null.

Various media reports point out that the woman was provided with a sedative in her coffee ‘to calm the woman down’. She was unaware that the sedative had been provided. The Trouw newspaper’s editorial discussed the issue of the provision of a pre-euthanasia sedative without the person’s knowledge, pointing to a recent case where a similar sedative was provided without consent in a bowl of apple sauce. They note that the Dutch Euthanasia Review Commission rightly considers such behavior as ‘deceptive’.

The Trouw editor concluded that the problem was really that the coffee-carried dose was too low. Why? Because the woman resisted when later the doctor moved to apply the lethal dose via syringe. The NLTimes described it this way:

‘But when the infusion was inserted she “pulled back”, and while the doctor injected the euthanasia agent, she moved as if to get up. The doctor decided to continue while family members held the patient down. The woman died shortly afterwards.’

According to the UK Mirror, this story came to light via a report prepared by a Dutch Coroner for review by the Dutch Euthanasia Regional Review Committee. The Mirror says that the woman had said clearly several times “I don’t want to die” in the days before her death.

The Euthanasia Review Committee is charged with reviewing the file and making a recommendation that would need to be endorsed by a second review committee.

The Mirror concludes:

“The committee concluded though the doctor had acted in good faith, she should have stopped when the patient resisted. 

“Committee spokesman Jacob Kohnstamm added he was in favour of the case going to court: “Not to punish the doctor, but to get judicial clarity over what powers a doctor has when it comes to the euthanasia of patients suffering from severe dementia.” 

“The committee’s recommendations are now reportedly being considered by prosecutors and health officials.” …

Euthanasia or assisted suicide laws create an exception to the laws prohibiting homicide if certain criteria are observed. They were not observed in these cases, therefore the exception should not be applied. In Holland it would seem that ‘good faith’ is enough to be let off with a little less than a slap on the wrist. But deciding what is and is not an act in ‘good faith’ is a tricky business. A wrongful death – even in ‘good faith’ is still a homicide and not simply a misdemeanor.

It may be that this situation is being used deliberately to further the current debate on euthanasia and dementia and euthanasia and ‘tired of life’. It may be that the doctor was lax in her application to the paperwork; a simple mistake. But it just may be about a death outside of the confines set by the parliament – deliberately or otherwise – a homicide.

Whatever the outcome, what is abundantly clear is that once we create legal excuses for killing there will be more excuses and more killing.

• Netherlands euthanasia review committee says euthanasia without consent on woman with dementia was done in 'good faith.'

Oregon Senate Bill 494 will starve and dehydrate incompetent people to death.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

In Oregon, the Senate is debating a deceptive bill (SB 494) that appears to simply replace the current advanced directives legislation, but in fact it promotes the withholding or withdrawal of nutrition and hydration (food and water) from people who are incompetent and not dying.

In 2006, I attended the World Federation of Right to Die Societies Conference. One of the topics discussed at the conference was death by voluntary stopping of eating and drinking (VSED). I remember the leader of the Dying in Dignity group (UK) stating that they do not promote VSED because, in their experience, it can be a terrible way to die.

Even though Oregon legalized assisted suicide 20 years ago, euthanasia is a prohibited. Euthanasia is an act whereby one person directly and intentionally causes the death of another person, whereas assisted suicide is an act whereby one person directly and intentionally assists another person in causing their own death. SB 494 opens the door to euthanasia of incompetent people in Oregon.

• Oregon 2015 assisted suicide report. Another 26% increase in assisted deaths.

SB 494 is deceptive and dangerous piece legislation because it is sold as a bill to update current legislation but in fact it changes current legislation to ensure that incompetent people, who may or may not be otherwise dying, can be intentionally killed by dehydration.

Advanced directives are only relevant when a person is incompetent to make decision for themselves. Therefore SB 494, by definition, does not ensure that competent people can die by dehydration, but rather that incompetent people can be dehydrated to death.

SB 494 states:

____ I do not want my life to be prolonged by life support. I also do not want tube feeding as life support. I want my health care provider to allow me to die naturally if my health care provider and another knowledgeable health care provider confirm that I am in any of the medical conditions listed below.

So what are the conditions that are listed below?

a. Close to Death.   

b. Permanently Unconscious. 

c. Advanced Progressive Illness.

d. Extraordinary Suffering.

If a person is nearing death, based on the actual condition of the person, withholding or withdrawing fluids may be appropriate. But this decision should be based on a factual assessment that providing food and water has ceased to benefit and may be harming the person. We do not oppose withholding or withdrawing fluids from a person, when providing it has become useless, burdensome or without benefit.

If a person is incompetent then the person cannot consent to death by dehydration. To withhold fluids, even if the person while competent expressed this desire, is in fact dehumanizing the person by denying that person the basic necessaries of life. Withholding or withdrawing fluids from a person, who is not otherwise dying, will cause the person to die by dehydration. This is often a terrible death, even when the symptoms are masked by morphine and other analgesics. It is also a form of abandonment to deny a person the basic necessaries of life.

• The Life-Protecting Power of Attorney for Personal Care will protect your life.

SB 494 opens the door to euthanasia of incompetent people in Oregon because death by lethal injection is more compassionate than dehydrating a person to death.

It is simply not necessary to change the current Oregon Advanced Directives legislation in order to specifically promote death by dehydration. SB 494 must be defeated.

Tell the Hawaii Legislature to Vote “No” on assisted suicide Bill SB 1129

This article was published on February 15, 2017 by Choice is an Illusion Hawaii.

By Margaret Dore, Esq., MBA

SB 1129 legalizes physician-assisted suicide and allows euthanasia as long as actions are taken in “accordance” with the act.

The proposed Oregon style act applies to people with years or decades to live. The act is a recipe for elder abuse.

To view a legal analysis opposing the bill, with supporting documentation, click here. To view the analysis without the supporting documentation, click here.

Tell the Hawaii legislature to vote “No” on SB 1129. Contact info.

Highlights:

• Passing the proposed act will encourage people with years, even decades, to live, to throw away their lives. 

• The proposed act is sold as completely voluntary, but does not even have a provision requiring administration of the lethal dose to be voluntary. 

• Administration of the lethal dose is allowed to occur in private without a doctor or witness present. If the patient objected or struggled, who would know? 

• Elder abuse is already a not well controlled problem. Passing the proposed act will make the situation worse, to effectively allow legal murder. 

• Assisted suicide, even when apparently voluntary, can be traumatic for patients and families.

• Passage will create a risk of suicide contagion.

• The proposed Oregon-style “oversight” is a sham and will create the opportunity for a non-governmental entity to displace the proper role of government.

Tell the Hawaii legislature to vote “No” on SB 1129. Contact info.

Margaret Dore, Esq., MBA
Choice is an Illusion
President
206 697 1217

Not Dead Yet leader, Anita Cameron, submits testimony against Hawaii assisted suicide bill.

The testimony by Anita Cameron was posted on the Not Dead Yet website on Feb 14, 2017

Testimony in Opposition to SB 1129

Tuesday, February 14, 2017

Good day. Thank you very much for allowing me to offer my thoughts to you today.

M

Anita Cameron

y name is Anita Cameron. I am a 51-year-old with multiple disabilities, two of which are degenerative, and one which will take my life. I am writing in opposition to SB 1129, the Death with Dignity Act.

I will not use the euphemism that is the name of this bill, but will refer to it by exactly what it is – physician assisted suicide. It is very important to be up front, clear and honest about what this is. Couching it in pretty language and hiding the truth is disingenuous at best, and dangerous, at worst.

I am Director of Minority Outreach for Not Dead Yet, a national disability rights organization opposed to physician assisted suicide and euthanasia as deadly forms of discrimination against people with disabilities. I live in Rochester, New York, but work with people of color around the nation.

My primary reason for opposition to this bill and others like it is that disabled BIPOC (Black, Indigenous and People Of Color) are at particular risk of being harmed by it.

Our health care system is inherently racist. Studies show that Blacks and people of color receive inferior medical treatment compared to Whites. We are less likely to receive adequate treatment for heart conditions, diabetes, cancer and chronic pain.

The lives of people with disabilities are largely devalued by doctors and society, in general. The lives of BIPOC with disabilities are even more devalued due to racism and stereotypes about our communities.

As a Black Indigenous Latina, I could never wrap my head around the assisted suicide phenomenon. I thought that it was some odd thing that privileged White people were into. My thoughts were confirmed when I learned that the Pew Research Center recently found that while 54% of Whites supported assisted suicide, 65% of Blacks and Latinos opposed it.

Although assisted suicide requests in Oregon are lower among Blacks and people of color, that doesn’t mean that this won’t change in more diverse areas, especially as healthcare support lessens and assisted suicide becomes more acceptable due to the efforts of groups like Compassion and Choices.

Another reason for my opposition is that doctors would be the gatekeepers of people’s lives (anyone can ask for assisted suicide, but it is the doctor that decides who gets it), and can decide for you about your quality of life.

Further, doctors often make mistakes about whether a person is terminal or not. In June, 2009, while living in Washington state, my mother was determined to be in the final stages of Chronic Obstructive Pulmonary Disease and placed in hospice. Two months later, I was told that her body had begun the process of dying. My mother wanted to go home to Colorado to die, so the arrangements were made. A funny thing happened, though. Once she got there, her health began to improve! Almost eight years later, she is still alive, lives in her own home in the community and is reasonably active.

Because of the racist nature of our health care system and the tendency of doctors to devalue the lives of disabled and people of color, assisted suicide has no place as an option in Hawaii. Please vote NO on SB 1129!

Thank you for your attention.

Anita Cameron is the disability rights group - Not Dead Yet, director of minority outreach.

New Mexico assisted suicide bill moves toward Death on Demand.

This article was published by National Review on February 12, 2017

Wesley Smith

By Wesley Smith

Assisted suicide pushers are–to put it kindly–disingenuous.

For example, they often offer smooth assurances about “safeguards” to protect against abuse. Yet, new legalization schemes often dilute the traditional already-as-thick-as-water limitations in place where lethally prescribing is now legal.

For example, most laws require doctors to diagnose and prescribe lethally.

But a bill in New Mexico would open those who can help kill to nurse practitioners and physician’s assistants.

Generally a suicidal person needs to be terminally ill in US proposals (not so internationally), defined as 6 months left to live. (Some people so diagnosed never die of their condition, or live for years.)

But even that illusory protection is too strict for the New Mexico bill’s sponsors. Rather, it would institute far broader ”foreseeable” standard, first introduced by the Canadian government in its euthanasia law.

From House Bill 171:

F. “terminal illness” means a disease or condition that is incurable and irreversible and that, in accordance with reasonable medical judgment, will result in death within a reasonably foreseeable period of time.

“Reasonably foreseeable” could include illnesses like terminal breast cancer, in which longevity can be measured in years with aggressive treatment. Ditto, early Alzheimer’s and Parkinson’s.

Heck when you get down to it, being a frail 90 years old could be construed as a “condition” qualifying for a lethal prescription, since the death of someone that age experiencing morbidity is certainly foreseeable.

And, like Washington State, the bill would require prescribers to lie on death certificates:

SECTION 4. [NEW MATERIAL] DEATH CERTIFICATE–CAUSE OF DEATH 

The cause of death listed on an individual’s death certificate who is deceased pursuant to self-administration of medical-aid-in-dying medication pursuant to the End of Life Options Act shall be the individual’s underlying terminal illness.

The point of such legally mandated corruption is to destroy all transparency.

And look at this: Doctors must meet professional standards of care when treating patients. But in helping kill them? All they–and caregivers–need is the “good faith,” a completely subjective standard, which also applies to caregivers and family members.

A. A person that acts in good faith to comply with the provisions of Section 3 the End of Life Options Act shall not be subject to civil or criminal liability or professional disciplinary action for such action. 

This immunity extends to attending health care providers, a patient’s caregivers and another person that acts to assist the attending health care provider or patient.

And get this, there are no waiting periods required from request for a lethal prescription to its writing. That means a patient could be told she is foreseeably terminally ill, ask for the poison, and receive it, and kill herself on the same day. That’s almost akin to death on demand. Those pushing to permit medicalized killing pretend to want a very narrow license.

As I said above, and to put it as kindly as I can, that is… Aw to heck with tact: They are utterly mendacious. The Patients Rights Council (for which I am a paid consultant) offers a more detailed analysis of the New Mexico bill.