Wednesday, August 30, 2017

Euthanasia Expertise Available To Local London Clergy



LONDON, ON – Local author and scholar, Lorna Gunning Fratschko, is delivering a series of workshops this fall to assist clergy in preparing for the euthanasia legislation as it impacts their parishioners and parishes. The first event, “Legal Implications for Clergy & Parishioners,” takes place September 12, 2017, at St. Stephen’s Memorial Anglican Church Campus, 727 Southdale Road East, London, Ontario.

During this workshop, the topic will be discussed in terms of the federal Euthanasia Bill C-14 and the provincial Euthanasia Bill 84. Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition, is the keynote speaker and will tie these pieces of legislation together, how they are applied, and the impact on clergy and their parishioners.

The Reverend Keith Nethery writes,
"It seems to me that Medically Assisted Death is poised to become a significant issue in a society that is consumed with living, but now having to come to terms with the fall out of that search. At the same time, with the increased acknowledgement of social justice issues, protecting the most vulnerable among us must remain key. It is time that the discussions on this subject in the faith community become much deeper and far ranging." 
Lorna Gunning Fratschko’s expertise is validated through the recent completion and publication of her dissertation, “The Euthanasia Debate: International Experience and Canadian Policy Proposals.” This paper has been read 879 times around the world. Now this expertise is being made available to clergy in the London area in order to assist clergy as they deal with this new reality.

These workshops offer a safe and open environment for discussion. Remaining seminar dates are October 17th and November 14, 2017.

Tickets are available at The cost is $25.00 + HST each or $60.00 + HST for the series of 3 fall seminars.


CONTACT: Lorna Gunning Fratschko, Living 360, 519-472-9060 or

Lorna Gunning Fratschko, HBSc, MTS, MA

Lead Facilitator, Living 360


Disability bias killed UK teen

By Taylor Hyatt

Policy Analyst & Outreach Coordinator, Toujours Vivant-Not Dead Yet.

Taylor Hyatt
Last week, the death of 19-year-old Tommy Swales made headlines in the UK. He had been diagnosed with Friedrich’s ataxia – a rare genetic disorder that causes heart disease and a gradual loss of mobility – four years ago. The teen fell easily and walked with a slouch, using a backpack to hide it. Those close to him were asked not to acknowledge his condition. The sudden change in his abilities caused him to become withdrawn, depressed, and isolated. He reportedly researched the assisted suicide organization Dignitas. While the family was out for the afternoon, he took his own life.

My first reaction to this story is grief. A young man who should be excited about everything life has to offer does not get to partake in it. His family and friends are left to mourn and wonder what could have been. Stronger than the sadness, though, is my frustration at the combination of factors that pushed him over the edge.

He told his mother, Michelle, about his greatest fear: having to use a wheelchair for the rest of his life. Before his death, he traveled to the United States, attended concerts, and cheered on his favourite soccer team – all activities he feared missing once he relied on a mobility device. After living without a disability for so long, learning to navigate the world all over again might seem overwhelming…but it is possible. Why didn’t anyone tell him that wheelchair users of all ages can still travel, work, and have active social lives? No mention was made of referrals to disability supports after his diagnosis. He also refused assistance from mental health professionals. Like many other youth with disabilities, he was isolated from a larger community that could have given him hope for the future.

The most concerning part of the story is his mother’s response. In statements given to media, Ms. Swales said, “Tommy tackled life with a quiet dignity and amazing strength and courage. We take comfort from all of this, alongside the knowledge that Tommy is where he wanted to be.” She noted that although people who have depression should reach out for support, her son was “different” and “didn’t want help” for his suffering.

I am floored that his death was accepted so casually. No one would express relief at a non-disabled person’s suicide. It seems everyone involved saw disability as a fate worse than death. Why did the family go along with this? If the average teen’s desire to die was treated the same way, outside authorities would intervene. As stories like Jerika Bolen’s demonstrate, disability is the only “acceptable” reason for a young person to end their life. Friedrich’s ataxia was the diagnosis he received. Ultimately, it was society’s bias against disability – and the fear of having to contend with this bias – that drove him to despair. He was not the first to respond this way; nor will he be the last. 

Life with a disability is nothing to fear or be ashamed of. How many more lives will be lost before this is understood?

Monday, August 28, 2017

Doctors pressured this woman to die by euthanasia. One year later she is much better.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Candice Lewis
Last month Candice Lewis's mother received a disappointing response from the local hospital after sending an official complaint about being pressured by doctors who wanted Candice to die by euthanasia.

Mother upset after doctor urged her to approve assisted suicide for her daughter with disabilities.

An article by Stephen Roberts that was published in the Northern Pen newspaper  on August 28 explained that Candice is doing much better after receiving excellent care from a hospital in St John's Newfoundland. The article reported:

According to her mom, Sheila Elson, Candice hasn’t been having any seizures, is now able to feed herself, walk with assistance, use her iPad, and is more alert, energetic and communicative since her stay in St. John’s. 
“She’s back to about where she was five or six years ago,” says Elson. 
After a two-week hospital stay, Candice, along with her mother, walked her sister Glennis down the aisle at her wedding in Dildo in August. 
She’s been able to do all this despite the fact that in 2016, doctors suggested that Candice might be dying. 
In September of that year, a doctor at Charles S. Curtis Memorial Hospital in St. Anthony had also suggested to Elson that physician-assisted death could be an option for Candice. 
What is satisfying her these days is her daughter’s health. Since returning to St. Anthony earlier this month, Candice hasn’t required a visit to the hospital. 
Elson believes Candice’s condition has improved because she is now on fewer medications.
Legalizing euthanasia (MAiD) gives physicians the right in law to lethally inject their patients. The doctors attitude toward Candice's "quality of life" were based on negative and discriminatory attitudes towards the lives of people with disabilities. The doctors thought that Candice was better off dead.

New Zealand assisted suicide bill would undermine suicide prevention

Press Release - Monday August 28, 2017

The number of suicide deaths in New Zealand have increased for the third year in a row. The provisional suicide statistics released today show:
  • 606 people died by suicide in the 12 months to June 2017 – almost twice the road toll (363 for the 12 months to 28 August).
  • Males are represented in about three-quarters of suicide deaths.
  • The highest number of suicide deaths are among 20 - 24 year-olds.
  • Maori continue to have the highest suicide rate of all ethnic groups.
“It is concerning that there is an assisted suicide bill before Parliament, despite our high suicide rate”, says Renee Joubert, executive officer of Euthanasia-Free NZ.

“Essentially the only difference between suicide and assisted suicide is the number of people involved in bringing about the death. In both cases the person likely desires death due to feeling that they’re suffering unbearably and/or have no hope for a better future.

“If suicide is to be prevented, assisted suicide should be prevented also.

“There is definitely a demand for ‘assisted dying’ as a means of suicide”, says Ms Joubert.

“We regularly receive phone calls and emails from suicidal people inquiring about ways to access euthanasia because they can’t bring themselves to executing other suicide methods. They usually start out talking only about their emotional reasons, and later mention physical medical conditions that would make them eligible for assisted suicide and euthanasia under David Seymour’s End of Life Choice Bill.

“Even if depression would be explicitly excluded from the eligibility criteria, suicidal people would still be at risk of accessing ‘assisted dying’. Depression and suicidal ideation can too easily be denied, hidden, dismissed or misdiagnosed. Even mild, subclinical depression could still affect a person’s will to live.

‘Assisted dying’ legislation would send the message that death is an appropriate response to suffering – a dangerous message to people who are emotionally vulnerable.

Such a law would change the role of doctors from only helping to prevent suicide, to also facilitating suicide.

Euthanasia-Free NZ call on politicians and the public to reject ACT MP David Seymour’s End of Life Choice Bill in principle.

If you or someone you know is in distress, please phone 0800 TAUTOKO (0800 828 865).


German nurse may have killed 84 people.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

If you think that safeguards can control euthanasia or that legalizing euthanasia will eliminate medical killings, think again.

First: Euthanasia laws lack effective third-party oversight. All of the laws require two doctors to approve euthanasia or assisted suicide (in Canada nurse practitioners can approve) and once death occurs all of the laws require the physician who carries out the act to self-report the act. No third-party oversight or witness at the time of the death is required. Physicians and nurse practitioners do not self-report abuse of the law.

Second: The abuse of the law that already occurs is usually not reported because the medical system lacks effective oversight and when abuse is uncovered, they rarely report the problem to the legal authorities, often based on fear of lawsuits. Just read about the Elizabeth Wettlauffer case in Ontario.

Now, a former German nurse who was convicted of killing 2 patients between 2000 - 2005 and later found responsible for 33 deaths is suspected of killing 84 people. Deutche Well news reported:
Niels Högel 
Following a three-year probe into all patients under Niels Högel's care, investigators revealed on Monday that the former nurse was responsible for 84 more deaths than initially thought.
Högel, who is already serving two separate prison sentences, was found to have injected patients with cardiovascular medication at hospitals in the northern towns of Oldenburg and Delmenhorst between 1999 and 2005. His aim was to induce heart failure or circulatory collapse before successfully resuscitating his patients to impress his colleagues. 
He was sentenced in 2008 to seven-and-a-half years for attempted murder after he was discovered trying to give an overdose to a patient. He was then jailed for life in 2015 after being found guilty on six counts of murder, two counts of attempted murder and one charge of battery after his "trick" failed to work. 
However, prosecutors alleged that he had likely killed many more people but kept the charges low to make their case easier to prove. 
During the 2015 trial, Högel also admitted to a psychologist to killing 30 people while working at the clinic in Delmenhorst, having injected the medication into at least 60 patients. Last year, prosecutors estimated the total number of deaths to be 43.

Over three years, investigators said they exhumed and probed 134 bodies for the traces of Högel's cardiovascular medication, raising the number of suspected killings to a further 84.

Oldenburg Police Chief Johann Kühme said the sheer scale of Högel's crimes "leaves us speechless," adding that some cases will never be proved as the bodies had since been cremated. "And as if all that were not enough, we must realize that the real dimension of the killings by Högel is likely many times worse."

The police chief also faulted local health authorities who failed to act as it allegedly came apparent that the death rate at Delmenhorst hospital's intensive care unit almost doubled while Högel worked there. "If the people responsible at the time, particularly at the Oldenburg clinic but also later in Delmenhorst, hadn't hesitated to alert authorities - for example police, prosecutors -" Högel could have been apprehended sooner, Kühme said.
In the Netherlands, where euthanasia has been legal since 2001, a study of deaths in the Netherlands found that 431 people died an assisted death without explicit request in 2015. 

A study examining deaths in the Flanders region of Belgium, where euthanasia has been legal since 2002, found that there were more than 1000 assisted deaths without explicit request in 2013

The only way to protect people is by prohibiting euthanasia and assisted suicide and closely monitoring the medical use of drugs and potential medical abuse.

Windsor man who was expected to die, is now home.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Don Brunelle

A Windsor Ontario man, who was expected to die, returned home last week, after living through three months of treatment including weeks in Coma. CBC news reported:
A 64-year-old Windsor man who fought for his life in hospital for three months following a harrowing car crash arrived home Friday to a hero's welcome, his body battered but his spirit unbroken. 
Don Brunelle was a passenger in a corvette that struck a cement hydro pole at close to 200 km/hr on May 26 in Wheatley. The driver was charged with drunk, stunt and reckless driving. Brunelle was in a medically induced coma for weeks. Doctors did not expect him to survive. 
His wife Brenda maintained a vigil at his bedside and remained unrelentingly positive. 
"I refused to believe what all the doctors — and I mean all of them — were telling me about how sick he was," Brenda said. "I asked all of that conversation about him not surviving this crash be taken outside of his room." 
"I'm just very grateful that I'm on the road to getting my life back with all my friends," he said.
This is a story of hope, but this story also causes us to question, what if Don had stated, in a legal document, that he would not want to live this way?

The Canadian government is researching the expansion of euthanasia to include incompetent people who had previously asked to be killed by euthanasia, when living with certain medical conditions.

The CBC article reports his wife, Brenda as saying.

"I think our battle now begins,"

"I think this is day one of his recovery. I think we're out of the hospital phase now."​
Thank you Brenda for showing us how to have hope.

Wednesday, August 23, 2017

Medical error is the third leading cause of death. Should legal euthanasia concern you?

Alex Schadenberg
Euthanasia Prevention Coalition

Recent studies indicate that, in the United States, medical errors have become the third leading cause of death.

A recent article by, lawyer Meghan Hull Jacquin points out that one out of every 18 patients in Canadian hospitals will experience a potentially avoidable harmful event.
Unfortunately, surgical and medical errors happen, and they can cause patients injury, disability, or even death. One recent study found that one in 18 people admitted to Canadian hospitals each year – 138,000 patients – experienced a harmful event that was potentially preventable. Of those patients, 30,000 faced more than one preventable harmful event. Some statistics suggest these hospital errors may be the third leading cause of avoidable death.
Now that euthanasia is legal in Canada and assisted suicide is legal in several US States the reality that medical errors will lead to death by euthanasia or assisted suicide.

For instance, the Canadian law permits euthanasia (lethal injection) if a person has a grievous and irremediable medical condition - meaning:
  • the person has a serious and incurable illness, disease, or disability;
  • the person is in an advanced state of irreversible decline in capability;
  • the illness disease or state of disability or the state of decline causes enduring physical or psychological suffering that is intolerable and cannot be relieved under conditions that the person considers acceptable; and
  • natural death has become reasonably forseeable taking into account all of the medical circumstances, although a prognosis as to the specific length of time remaining is not necessary.
Since a grievous and irremediable medical condition, or disability, can be caused by medical error, therefore medical errors will lead to deaths by euthanasia.

Further to that, medical misdiagnosis has led to death by euthanasia or assisted suicide. Laws permitting assisted death require the approval of two doctors (in Canada a nurse practitioner can approve euthanasia), but none of the laws require both doctors to examine the patient to ensure that a proper diagnosis has been made.

For instance, in April 2013, Pietro D'Amico died at a Swiss assisted suicide clinic, after receiving a wrong diagnosis. An article published in the Swiss news service, The Local, stated:
... lawyer Michele Roccisano told Italian newspaper Corriere della Sera. 
An autopsy carried out by the University of Basel’s Institute of Forensic Medicine found that D’Amico was not suffering from a life-threatening illness at the time of his death. 
Roccisano has called on the Italian and Swiss authorities to examine D’Amico’s medical records to determine what went wrong.
Death by euthanasia and assisted suicide will also enable unscrupulous doctors to cover-up their medical errors. It is too late to discover a medical misdiagnosis, after the death.

Legalizing assisted death is not safe.

Dying of Despair

This article was published by the National Review online on August 22, 2017

Wesley Smith
By Wesley Smith

I began my work against assisted suicide in 1993. 

In the intervening years, I have witnessed a very disturbing change. When I began, the emotional zeitgeist of society focused intensely on preventing suicide. Today, in many cases, the emotional oomph (if you will) supports suicide, not in all cases to be sure, but certainly in some. 

There has been a concomitant downgrading of suicide prevention intensity. As I wrote a few years ago, we now have what I call “invisible” suicide prevention campaigns. 

I write this because there is a very good article in First Things by UC Irvine psychiatrist Aaron Kheriaty that explores the general issue of suicide. He diagnoses the causes of our crisis as coming from a loss of hope, and to some degree, the decline of religious practice (as distinguished from affiliation). 

I intend to dig deeper into his article later. But for now, I want to focus on the assisted suicide aspect. 

I have long believed that promoting assisted suicide–even if you call it something else, like “death with dignity” or “aid in dying”–sends an enervating message to the suicidal that self-killing is an acceptable answer to suffering and life’s most difficult problems. 

Indeed I believe that the elevation of Brittany Maynard to movie star levels of adulation and celebrity–solely because she promoted and committed assisted suicide–was a tremendously destructive and subversive act that could help push people in dark directions. 

Dr Aaron Kheriaty
Kheriaty discusses that question too. From, “Dying of Despair
The law is a teacher, and American law ­increasingly teaches indifference to life when it runs up against respect for radical autonomy. 
California and Colorado recently joined four other states in permitting doctors to assist terminally ill patients to take their own lives. In the same week that Gov. Brown signed the California bill, two British scholars published a study showing that laws permitting assisted suicide in Oregon and Washington have led to a rise in overall suicide rates in those states. 
I wrote about that study here too. Back to Kheriaty: 
These findings should not surprise us. We know that publicized cases of suicide tend to produce copycat cases, often disproportionately among young people. Recall the recent spate of adolescent suicides in Silicon Valley. Social scientists call this “the Werther effect,” from Goethe’s eighteenth-century novel The Sorrows of Young Werther, in which the protagonist, thwarted in his romantic pursuits, takes his own life with a pistol. After the book’s publication, a rash of suicides among young men using the same means alarmed authorities in Germany…  
The case of fourteen-year-old Valentina Maureira, a Chilean girl who suffered from cystic fibrosis, illustrates both effects while highlighting the power of social influences.  
Maureira made a YouTube video begging her government to legalize assisted suicide. She admitted that the idea to end her life began after she heard about the case of Brittany Maynard, the twenty-nine-year-old woman who campaigned for the legalization of assisted suicide before ending her own life.  
Maureira, however, later changed her mind after meeting another young woman suffering from cystic fibrosis who encouraged her to persevere in the face of adversity. Her father complained that the media were only interested in her story when she wanted to die. 

If Maureira had killed herself, we never would have known she would, one day, change her mind. 

But that fact won’t resonate at all with those who increasingly believe that suicide, at least of the sick, is a right rather than a cultural crisis. They will simply shrug and sniff, “She didn’t do it so what’s the problem?” 

But there is a huge problem that could be taking the lives of some who would later want to live. Consider: We now see suicide parties extolled in the media–even joint suicides and euthanasia killings of elderly couples. Movies promote suicide of the sick and elderly. And one can’t discuss assisted suicide with out seeing the photo of a beautifully smiling Brittany Maynard holding a puppy. 

In all of this, I am reminded of a quote from Canadian journalist Andrew Coyne. Writing in the wake of widespread public support for a father who murdered his daughter because she had cerebral palsy, Coyne worried: 
A society that believes in nothing can offer no argument even against death. A culture that has lost its faith in life cannot comprehend why it should be endured. 
We aren’t there yet, but if we aren’t careful, we could become a pro-suicide culture, or at least a suicide-indifferent one. 

Indeed, when it comes to the ill, disabled, and elderly, many of us are already there. And the casualties are mounting.

Medical error or intentional death in Quebec?

This article was published by First Things on August 22, 2017.

George Weigel
By George Weigel

Those who persist in denying that the Church is engaged in a culture war, the combatants in which are aptly called the “culture of life” and the “culture of death,” might ponder this June blog post by my summer pastor in rural Québec, Father Tim Moyle:
Tonight I am preparing to celebrate a funeral for someone (let’s call him “H” to protect his privacy) who, while suffering from cancer, was admitted to hospital with an unrelated problem, a bladder infection. H’s family had him admitted to the hospital earlier in the week under the assumption that the doctors there would treat the infection and then he would be able to return home. To their shock and horror, they discovered that the attending physician had indeed made the decision NOT to treat the infection. When they demanded that he change his course of (in)action, he refused, stating that it would be better if H died of this infection now rather than let cancer take its course and kill him later. Despite their demands and pleadings, the doctor would not budge from his decision. In fact he deliberately hastened H’s end by ordering large amounts of morphine “to control pain” which resulted in his losing consciousness as his lungs filled up with fluid. In less than 24 hours, H was dead. 
Let me tell you a bit about H. He was 63 years old. He leaves behind a wife and two daughters who are both currently working in universities toward their undergraduate degrees. We are not talking here about someone who was advanced in years and rapidly failing due to the exigencies of old age. We are talking about a man who was undergoing chemotherapy and radiation treatments. We are talking about a man who still held onto hope that perhaps he might defy the odds long enough to see his daughters graduate. Evidently and tragically, in the eyes of the physician tasked with providing the care needed to beat back the infection, that hope was not worth pursuing. 
Again, let me make this point abundantly clear: It was the express desire of both the patient and his spouse that the doctor treat the infection. This wish was ignored.

Canada’s vulnerability to the culture of death is exacerbated by Canada’s single-payer, i.e. state-funded and state-run, health care system. And the brutal fact is that it's more “cost-effective” to euthanize patients than to treat secondary conditions that could turn lethal (like H’s infection) or to provide palliative end-of-life care. Last year, when I asked a leading Canadian Catholic opponent of euthanasia why a rich country like the “True North strong and free” couldn’t provide palliative end-of-life care for all those with terminal illnesses, relieving the fear of agonized and protracted dying that’s one incentive for euthanasia, he told me that only 30 percent of Canadians had access to such care. When I asked why the heck that was the case, he replied that, despite assurances from governments both conservative and liberal that they’d address this shameful situation, the financial calculus had always won out—from a utilitarian point of view, euthanizing H and others like him was the sounder public policy.

But in Canada, a mature democracy, that utilitarian calculus among government bean-counters wouldn’t survive for long if a similar, cold calculus were not at work in the souls of too many citizens. And that is one reason why the Church must engage the culture war, not only in Canada but in the United States and throughout the West: to warm chilled souls and rebuild a civil society committed to human dignity.

Then there is the civic reason. To reduce a human being to an object whose value is measured by “utility” is to destroy one of the building blocks of the democratic order—the moral truth that the American Declaration of Independence calls the “inalienable” right to “life.” That right is “inalienable”—which means built-in, which means not a gift of the state—because it reflects something even more fundamental: the dignity of the human person.

When we lose sight of that, we are lost as a human community, and democracy is lost. So the culture war must be fought. And a Church that takes social justice seriously must fight it.

Tuesday, August 22, 2017

Should we starve Alzheimer's patients to death?

This article was published by Wesley Smith on his website on August 20.

Wesley Smith
y Wesley Smith

The idea of starving a helpless elderly person to death used to be thought of as the most egregious crime. An abhorrence.

Now, for some, it is merely another form of “death with dignity.”

The assisted suicide advocacy organization Compassion and Choices–formerly the more honestly named Hemlock Society–teaches people (with a prime focus on the elderly) how to starve themselves to death, a form of suicide they call “voluntary stop eating and drinking” (VSED). 

But many in bioethics wish to take that avenue to dying further, requiring nursing homes to starve dementia patients to death if they so stated in an advance directive.
Now, as these things are wont to do, the idea has gone from the professional literature into the popular media. USA Today has a story about a man trying to force his wife to be starved because she has Alzheimer’s–this even though she willingly eats snacks and her meals. From the story
Across the U.S., the more than 5 million people living with dementia are typically encouraged to put their end-of-life wishes into writing early and to pick a trusted person to carry them out, said Beth Kallmyer, vice president of constituent services for the Alzheimer’s Association. 
That’s no guarantee, however, that those requests can — or will — be honored. In Nora Harris’ court case, her advance directive and testimony from her husband, her daughter and two close friends all indicated that she wouldn’t want anything to prolong her life. 
“That court decision basically condemned Nora to the full extent of the Alzheimer’s disease,” Bill Harris said. “They gave her no exit out of this situation.” 
The “exit” is to refuse medical treatment, such as antibiotics or a feeding tube when it becomes needed–which under the law, is deemed a medical treatment.

Feeding is care. not treatment.
But spoon feeding and handing out snacks, willingly eaten, is not medical treatment. It is humane care, the kind owed to every human being.

Advance directives govern medical treatments desired or to be refused when the signatory becomes unable to make her own decisions. It does not require caregivers to violate the fundamental rules of humanity.

Think of it this way: If a dementia patient had requested to be left in bed in front of an open window without a blanket on a winter’s night in order to die by hypothermia, should the nursing facility be forced to do that? Of course not! They owe the patient a duty to be kept warm. 

Ditto if a patient asked not to be turned to avoid bed sores. Or directed that their linens never be changed.

The same must go to spoon feeding and offering liquids, or we are no longer a moral country. That isn’t to say forced feeding, but if a patient willingly takes nourishment, that must control. 

The article goes on to describe VSED and says it can be a peaceful death without suffering. No–unless a doctor participates in the suicide with heavy palliative interventions. But even then, VSED committers can always change their minds.

That would not be true of a nursing home patient from whom food and water was withheld. 
Of course I understand that no one wants to go through Alzheimer’s. Of course I understand the grief families feel and the many sleepless nights caused by having a beloved stricken with this dread affliction.

But life is what it is. We should mitigate suffering as much as we can, but there are just certain lines that must not be crossed, both because others could be victimized–ever hear of elder abuse?–and because some acts and omissions are inherently wrong. 

On a more practical level: How many nursing homes would close their doors if the operators–many of which are religiously focused–knew they would be forced to starve some of their patients to death? 

How many loving and caring people would opt out of dedicating their lives to the people who live and are cared for in such facilities rather than risk killing their patients by a means that would now be branded criminal neglect, at best?

And no more of people saying that I don’t know what it is like to have people I love suffer. My mother died of Alzheimer’s in my home last year. My uncle died of it several years ago. Believe me, I know what Alzheimer’s is like, up close and personal!

Thursday, August 17, 2017

The New York Times and Assisted Suicide

This article was published by William Peace on his Bad Cripple blog on August 16.

Bill Peace pictured with some of his students.
About a week ago the New York Times published an opinion piece I can't get out of my mind. The title was provocative—“Should I help My Patients Die”. Written by Jessica Nutik Zitter, a physician, she discusses end of life issues and specifically the law in California that empowers physicians to end the life of their patients. So called death with dignity laws, have been passed in five states. The New York Times position on assisted suicide is very clear. For years the editorial board has been a staunch advocate of assisted suicide. (Link).

In terms of assisted suicide, there is no pretense of objective journalism at the Times. The New York Times is far from alone because when it comes to end of life issues a major cultural shift has taken place in the last two decades. In the post Jack Kevorkian era, most major newspapers in the United States are in favor of assisted suicide. If polls are any indication, the majority of Americans support assisted suicide legislation. The problem, as I perceive it, is that the discussion of assisted suicide is reliant upon a simplistic notion that one should not die in pain and person should be in control of how they die. This seems reasonable. Proponents of assisted suicide and legislatures rely upon the fact few people discuss end of life with their loved ones and physician in detail. Even fewer people read death with dignity legislation nor consider its larger implications. For well over twenty years those that advocate for assisted suicide or death with dignity as they phrase it are reliant on the implication of the phrase itself. Death with dignity implies that physician assisted suicide is the one and only way to insure a dignified death. This is patently false. The public has been sold a false bill of goods. There is the notion death with dignity legislation is all about pain—no person should die in agonizing pain. If one were faced with an agonizing death a person has the “right” or “control” of when to die. End of life is not this simple. People access assisted suicide because they fear a loss of autonomy and being a burden upon others.

The significant shift as I see it is cultural. There is a notion that people deserve a good death. What a good death is, I have no idea. But this phrase, a good death, is as misleading as death with dignity. A good death is now akin to a designer dress or enviable life style. Planned orchestrated deaths are the rage. What I find remarkable is even those that support assisted suicide legislation are concerned. For instance, Franklin G. Miller, a physician that supports assisted suicide legislation was disturbed by a long New York Times photo essay about a carefully scripted death. In “At His Own Wake, Celebrating Life and the Gift of Death Catherine Porter and photos by Lesley Davis lavish praise upon the end of John Shields life. There is no question the Canadian Shields led an interesting life. But that is not the point. The piece reads like a New York Times style section essay about a celebrity wedding. Like Miller, I found this essay deeply disturbing. In the Hastings Center Bioethics Forum he wrote:

Presented to the readers, in lavish detail, as the “Gift of Death,” with a very appealing protagonist, this article romanticizes the death of John Shields. More importantly, I see it as describing, and prescribing, a model for the good death in North America today. The article prominently features various quotes from Shields: “I think this is a mark of our humanity,” “What could be more meaningful than planning for the end of your life?” These are Shields’s own legitimate opinions, but I read them as being given a prescriptive force. 
Physician-assisted death remains ethically controversial. The end of life is an arena for diverging values. Commitment to pluralism means recognizing a variety of good or legitimate ways to face death and dying. Presenting the planned death of John Shields as a model for dying in our era uncritically places a premium on the choice and control of the sovereign individual. Letting death happen, with the aid of palliative care, is no less good than making it happen. We should beware of prescribing a particular form of “death with dignity” as a model for the end of life and not acknowledging other perspectives (Link). 
I understand talking about death is hard. Believe me I get it—in recent years I have had to deal with the death of a parent, siblings, and a beloved pet. I have also had to face my own mortality when I had a heart attack in June. We do not need assisted suicide legislation. What we need is a nuanced discussion of end of life issues and options. Here Miller and I are in agreement despite the fact we are on opposite sides of the debate about assisted suicide. Death with dignity need not involve assisted suicide yet that is exactly what one is led to believe if reliant on mainstream news outlets such as the New York Times.

Here I return to the New York Times opinion that I cannot get out of my mind. At first glance “Should I let My Patients Die” appears to be a nuanced view by a physician that has struggled with the new death with dignity law in California. Jessica Nutik Zitter, author of Extreme Measures: Finding a Better Path to End of Life is a critical care and palliative medicine doctor. In her opinion Americans die badly and many people needlessly suffer at the end of life in intensive care units. This is not new ground. What makes her opinion different is how she hooks the reader in the first paragraph of her essay: she tells a story about a colleague who tapped her on the shoulder and said, “I have a patient who is asking about the End of Life Option Act”…”Can we even do that here”. For half the essay Zitter plays the part of objective commentator and insider. It is not until she wrote about her own family, specifically her mother, that her real feelings become evident, as does her ableist bigotry. After discussing the first patient who asked her about assisted suicide she admitted she wanted this option for her family. She wrote:

I have seen much suffering around death. In my experience, most of the pain can be managed by expert care teams focusing on symptom management and family support. But not all. My mother is profoundly claustrophobic. I can imagine her terror if she were to develop Lou Gehrig’ disease, which progressively immobilizes patients while their cognitive faculties remain largely intact. For my mother, this would be a fate worse than death.

Replace the condition ALS with any other neurological calamity as a means of justifying death with dignity. This indicates just how deeply ableism is entrenched into the fabric of society. Alzheimer’s is a fate worse than death. Quadriplegia is a fate worse than death. Multiple Sclerosis is a fate worse than death. Muscular Dystrophy is a fate worse than death. Parkinson’s disease is a fate worse than death. Yes, the medical model of disability is quite clear—many conditions people live with for decades if not their entire life is a fate worse than death. I know this from personal experience; some think my existence is indeed a fate worse then death for strangers and more than one physician have expressed this to me directly.

Zitter goes on to state she does not feel comfortable shortening the life of any patient and wonders if this makes her a hypocrite. In search of an answer she turned to the “defacto specialist in our area on this issue for counsel. Dr. Lonny Shavelson, an emergency medicine and primary care physician in Northern California, who has been grappling with the subject for many years.” I find this is a remarkably unusual choice. Shavelson operates an unorthodox medical practice, Bay Area End of Life Options, that has gotten quite a bit of attention in the last year. Shavelson specializes in consulting with patients and physicians who are deemed terminally ill and are interested in or have requested assisted suicide in the state of California. This sort of practice is well out of the norm even in states where assisted suicide is legal. To be clear: in California it is legal to request assisted suicide if one is diagnosed as terminally ill, is able to self administer a lethal prescription, and retain the mental capacity to make such a decision. For more on the law here is a link:

Shavelson is not your average physician. He is coauthor of “Physician-Hastened Death” guidelines published in the Western Journal of Medicine and has written amicus briefs for the Supreme Court (1996 Quill vs. Vacco case). Shavelson, like many, believes in the idea of a “good death” and is a staunch advocate of assisted suicide legislation. In A Chosen Death: The Dying Confront Assisted Suicide Shavelson wrote about “death anarchy” and came to believe assisted suicide had to be legalized and regulated. In Forbes he stated: 
what I found during the 1990s was a horror show--people hoarding medicine, afraid of how they were going to die; doctors secretly assisting people in dying; family members tortured by the memory of helping someone in their family die. It was the equivalent of back alley abortions. I was calling it dark bedroom suicide. Link:
For Shavelson, assisted suicide “is not about being a death doctor. This is about being a good death doctor”. This sort of double speak reminds me of Jack Kevorkian. Dr. Death as he was called is largely forgotten (college students do not even know who Kevorkian was). In his place, physicians across the nation are calling for or establishing protocols, procedures and outcome measurements in states that have passed assisted suicide legislation. Thus Zitter argues that medical procedures all require training and thinks the process of dying is no different. Zitter wants physicians specifically trained to end the lives of patients. 

I shake my head in wonder. All week I have come back to the flip answer to the question “Should I Help My Patients Die”. The answer is an obvious no. Hastening the death of others is ethically objectionable. How we mange end of life, that is the process of death, speaks volumes about who we are as human beings. I am worried about the future of humanity for I believe life is precious.

Canadian euthanasia doctors want more money to kill.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Canadian euthanasia doctors are pressuring the provincial governments to pay them more money for euthanasia. Supposedly, some euthanasia doctors have stopped killing people based on money.

An article by Kelly Grant published in the Globe and Mail,
appears to pressure governments to pay more for euthanasia. The article insinuates that access to euthanasia has been impeded by the money doctors make to do lethal injections:
Dr. Pewarchuk, an internal medicine specialist in Victoria who has presided over 20 assisted deaths, took his name off the list of willing physicians last month after the body that sets doctors’ pay in British Columbia approved new fees that he and some of his fellow providers say are so low they could chase away even the most committed physician supporters of assisted dying.
Maclean's magazine published an article by Catherine McIntyre stating that physicians in the Netherlands are paid more money to kill:
In the Netherlands, for example, where physician-assisted dying has been legal since 2002, providers are paid a flat rate of about 1,500 euros. That’s $2,200 Canadian dollars and at least five times more than what MAID providers can earn in Canada. On top of that, Dutch physicians are given a paid day off after assisting a death to take care of themselves emotionally. 
In her article, Grant explains the BC government fee schedule for euthanasia:
Under the new fee schedule, B.C. physicians will now be paid $40 for every 15 minutes, up to a maximum of 90 minutes, to conduct the first of two eligibility assessments required by law. Each of the assessments has to be provided by a different clinician. That works out to $240, a significant increase from the $100.25 interim assessment fee that has been in place in B.C. since shortly after assisted death became legal. 
For second assessments, the time is capped at 75 minutes. 
In the case of providing an assisted death, the province has set a flat fee of $200, plus a home-visit fee of $113.15. 
Therefore, the price on a life in British Columbia is up to $553.15 ($240 + $313.15). 

In her article, Grant compared the fee for euthanasia in several Provinces:
By comparison, if a doctor spent three hours start to finish on an assisted death – excluding the formal eligibility assessment – he or she could bill $621.60 in Alberta, $600 in New Brunswick, $499.80 in Quebec, $480 in Manitoba and $465.60 in Saskatchewan. If doctors in those same five provinces billed for two hours, they could still earn more than B.C.’s $313.15 in every province but Saskatchewan, though not by much.
In January the Journal of the Canadian Medical Association published an article indicating that the Canadian healthcare system could save up to138 Million dollars now that euthanasia is legal.

Wednesday, August 16, 2017

I Oppose Assisted Suicide and Euthanasia Because It Is Ableist

This article was published by the disability rights group - Not Dead Yet on August 15, 2017

By Carol Cleigh Sutton

The very heart of the argument for assisted suicide/euthanasia (AS/E) is that an individual may be better off dead than disabled.

The fact that this argument can be made in respectable public forums demonstrates just how ableist this society is. How deeply the severely abled fear and loathe those of us who live with disability.

Ableism, like racism and sexism, is an ugly prejudice that society holds towards its minority members.

What does ableism look like? First you exclude us from nearly all public life and especially gainful employment and instead put us ‘on the dole.’ Then, periodically, you cut those supports from under us or make us try to prove that we’re ‘worthy’ of such supports. You openly stare at us and your comments and prurient questions make public spaces hostile. If we object, you accuse us of being maladjusted or just not being able to take a joke. A disabled man in the Netherlands is constantly told that it is ‘his fault’ that he lives with a disability; after all, he could kill himself. Where AS/E has become the norm, disabled people are even more outcast.

Our lives are seen as not worth living, but these are the lives we have.

This ideology, which we call BDTD (Better Dead Than Disabled), permeates ableist society, but even more deeply infects the medical system, and the more society in general accepts it, the more we encounter it every time we have to deal with medicine. My husband, who was nearly 80 and disabled, was brought to the hospital by ambulance after a heart attack. Until I arrived and started raising the roof, they put him in a dark room in the back. He should have been connected to an EKG and given aspirin, and IV lines should have been established. But because he was disabled, he received none of this. They assumed he’d want to die. Thankfully, we had years after that, but if I’d been held up in traffic? Would their killing him have been prosecuted? Investigated?

Are you really wanting to create this ‘special class’ of people who can be killed and no one prosecuted? A class whose deaths won’t even be investigated? Is your ableism so strong that you’d change the law to allow others to kill us without consequence? That is what happens in Oregon. Thomas Middleton’s death was not prosecuted. Did he ingest the poison willingly or was his death part of the real estate fraud for which his ‘caregiver’ was prosecuted? It’s already all too easy for those who would inherit, or steal, our property to arrange our deaths. Do you really want to make it easier? In US jurisdictions, assisted suicide laws give immunity to those who kill so long as they choose their victims from among the old, ill and disabled.

Before you say that this isn’t about disability, it’s only for those who are imminently dying, let me remind you of two things: First, physicians are notoriously bad at predicting when we’ll die. Oregon state data show that people outlive their 6 month prognosis every year; one lived for 1009 days. (2016 report, page 11) I’m 10 years past my last expiration date, and more than 60 years past the first, and still going strong. Secondly, and perhaps more importantly, there has never been an instance where this is legalized that it hasn’t expanded far beyond those at whom it was originally aimed, sometimes with breathtaking speed. Canada is already moving to use it on people who are not imminently dying and they legalized it just a year ago and, in the Netherlands, even those who advocated for it say that it is out of control.

Because the argument is based on BDTD, all who are considered disabled are at risk.